Knowledge, attitude, and practice of aesthetic medicine practitioners towards laser and/or light therapy for hypertrophic scars

Abstract

This study investigated the knowledge, attitude, and practice (KAP) of aesthetic medicine practitioners concerning laser and/or light therapy for hypertrophic scars. Conducted at Hebei Medical University Third Hospital from December 25, 2023, to January 7, 2024, the cross-sectional study utilized a self-administered questionnaire to gather socio-demographic data and KAP scores. A total of 424 valid questionnaires were collected, with 220 (52.26%) female participants. The mean scores were 27.24 ± 4.28 for knowledge (range 8–40), 34.14 ± 3.49 for attitude (range 9–45), and 26.22 ± 3.46 for practice (range 6–30). Significant positive correlations were observed between knowledge and attitude (r = 0.471, P < 0.001), knowledge and practice (r = 0.593, P < 0.001), and attitude and practice (r = 0.640, P < 0.001). Multivariate logistic regression revealed that both knowledge (OR = 1.260, P < 0.001) and attitude scores (OR = 1.547, P < 0.001), along with the intermediate professional title (OR = 0.233, P = 0.042), were significantly associated with proactive practice. The findings indicate a need for targeted educational initiatives to enhance practitioners’ knowledge in this area.

Supplementary Information

The online version contains supplementary material available at 10.1038/s41598-024-85037-0.

Introduction

Hypertrophic scars, characterized by their raised, red appearance, represent a complex medical issue and a significant global health burden, notably affecting patients’ quality of life through pain, itching (pruritus), and reduced overall well-being¹. Notably, hypertrophic scars occur in 40–90% of cases post-injury^2,3. Addressing this issue, a variety of treatments have been employed, including topical silicone application, compression or massage therapy, intralesional injections (utilizing triamcinolone, corticosteroids, or 5-Fluorouracil), laser and/or light therapy, and surgical interventions^4–6. Laser and/or light therapy presents promising potential for managing hypertrophic scars⁷. Laser therapy is effective in reducing dermis thickness and enhancing skin flexibility by targeting water molecules to induce selective thermal necrosis, which supports collagen remodeling over time^8–10. Photobiomodulation, utilizing low-level light therapy (LLLT), uses specific wavelengths of light to stimulate the body’s natural healing processes without thermal effects, reducing inflammation and fostering healing through nitric oxide and cytokines^11–14. Photodynamic therapy (PDT), which combines photosensitizers with light exposure, induces targeted tissue necrosis and apoptosis, showing potential in modulating immune responses, promoting neovascularization, and facilitating tissue regeneration^15–18.

Knowledge, Attitude, and Practice (KAP) survey explores a group’s understanding, beliefs, and behaviors on a specific topic^19–21. Aesthetic medicine practitioners play a pivotal role in the healthcare continuum, serving as crucial intermediaries between patients and the broader healthcare resources. They are often the first point of contact for patients, directly addressing their needs and queries. As laser and/or light therapy, continues to be a promising treatment modality for hypertrophic scars, understanding the KAP of aesthetic medicine practitioners toward this treatment is essential. Measuring KAP in this group can identify critical knowledge gaps, misconceptions, or variations in practice that may impact patient care. Insights gathered from such studies provide valuable information to guide future educational interventions and professional development, aiming to enhance the application and efficacy of laser and/or light therapy, in clinical practice. Despite its importance, there is a notable lack of KAP studies focused on this domain.

Therefore, this study aims to investigate the knowledge, attitude, and practice of aesthetic medicine practitioners regarding laser and/or light therapy for hypertrophic scars.

Methods

Study design and participants

This cross-sectional study was conducted on aesthetic medicine practitioners at the Hebei Medical University Third Hospital from December 25, 2023, to January 07, 2024. Ethical approval for the study was obtained from the Medical Ethics Committee of the Hebei Medical University Third Hospital (Approval No. 2023-111-1), and informed consent was obtained from all participants. The inclusion criteria were as follows: (1) healthcare professionals from plastic surgery, dermatology, or medical aesthetics; (2) those possessing a valid physician practicing certificate; and (3) individuals capable of cooperating and completing the survey. Interns, rotating doctors, and physicians in advanced training were excluded.

Questionnaire introduction

The questionnaire design was developed by the Chinese expert consensus on clinical scar prevention and treatment (2017)²². Following its development, a preliminary survey of 43 valid responses was conducted, yielding an overall Cronbach’s α coefficient of 0.938, indicating good internal consistency.

The final questionnaire, administered in Chinese, consisted of four main sections: demographic information (age, gender, education level, professional title, years of work experience, department, institution type), knowledge dimension, attitude dimension, and practice dimension (Additional file 1). The knowledge dimension comprised 8 questions, utilizing a five-point Likert scale ranging from “very familiar” to “very unfamiliar”, with corresponding scores from 5 to 1, resulting in a total score range of 8 to 40. The attitude dimension included 9 questions, also employing a five-point Likert scale with scores ranging from “strongly agree (5 points)” to “strongly disagree (1 point)”, yielding a score range of 9 to 45. The practice dimension consisted of 7 questions, rated from “never (1 point)” to “always (5 points)”, resulting in a score range of 7 to 35. Attaining scores above 70% of the maximum in each section indicated optimal knowledge, positive attitude, and proactive practice²³.

Questionnaire distribution and quality control

A dedicated data collection team was established to ensure systematic and high-quality data gathering. The distribution of questionnaires to participants was facilitated through an online platform. An online questionnaire was formulated using Questionnaire Star (https://www.wjx.cn/), with a QR code generated for easy access to the electronic form. Distribution of the questionnaire was carried out through various WeChat groups, including those associated with professional organizations such as the Chinese Medical Association Minimally Invasive Aesthetic Surgery Group, the Chinese Medical Association Laser Medicine Group, and the Chinese Scar Expert Learning and Exchange Group. The study objectives and content were introduced to participants through WeChat groups, where the QR code for the survey was shared, allowing them to access the questionnaire by scanning the code. The first page of the questionnaire provided detailed information about the study, including the research objectives, privacy and confidentiality measures, and the informed consent statement. Participants were required to review this information and provide their informed consent before proceeding with the survey. This approach ensured that participation was voluntary and based on informed consent, in line with ethical standards. To uphold the quality and reliability of the questionnaire responses, strict measures were implemented, including limiting each IP address to one submission and making all fields mandatory. Additionally, members of the research team meticulously reviewed each questionnaire for completeness, internal consistency, and logical coherence.

Sample size

The formula

can be utilized to determine the sample size for cross-sectional surveys²⁴. In this formula, α signifies the type I error (commonly set at 0.05), Z_1−α/2 equals 1.96, δ represents the permissible error (typically established at 0.05), and p is set at 0.5, as this value maximizes the result and ensures an adequately large sample size. Consequently, the computed sample size was 384. Taking into account an estimated questionnaire response rate of 80%, a minimum of 480 valid questionnaires was required.

Statistical analysis

SPSS 26.0 (IBM, Armonk, NY, USA) and AMOS 24.0 (IBM, Armonk, NY, USA) were used for the analysis. The normal distribution of continuous data was checked using the Kolmogorov–Smirnov test. The continuous variables conforming to the normal distribution were presented as means ± standard deviations (SD) and analyzed using Student’s t-test (two groups) or ANOVA (more than two groups). Those with a skewed distribution were presented as median (P25, P75) and analyzed using the Wilcoxon–Mann–Whitney U-test (two groups) or the Kruskal–Wallis analysis of variance (more than two groups). The categorical variables were described as n (%) and analyzed using the Chi-square test. Pearson correlation was used to determine the correlation among the KAP scores. Univariable and multivariable logistic regression analyses were used to perform the attitude and practice scores, using 70% of the possible maximum total score as the cutoff value. The variables with P < 0.05 in the univariable analyses were included in the multivariable analyses. Two-sided P-values < 0.05 were considered statistically significant.

Results

Characteristics of the participants

In this study, a total of 498 cases of questionnaires were collected, and the following cases were deleted: 3 cases of duplicated content; 41 cases of filling time < 60s; 25 cases of choosing other departments; and 27 cases of wrongly filling in the trap questions. After the exclusions, 424 valid questionnaires were included for analysis, with a validity rate of 85.14%. The mean age was 38.45 ± 9.40 years old. Of these, 220 (52.26%) were female, 246 (58.43%) had postgraduate or above education, 148 (35.15%) had been working for at least 16 years, 366 (86.94%) were working in public hospitals, 167 (39.67%) were from plastic surgery departments, 355 (84.32%) had operated scar-related laser and/or light therapy experience, and 396 (94.06%) working in institutions with laser and/or light therapy equipment (Table 1).

Table 1.

Baseline characteristics.

	N (%)	Knowledge		Attitude		Practice
		Score	P	Score	P	Score	P
Total score		27.24 ± 4.28		34.14 ± 3.49		26.22 ± 3.46
Gender			0.584		0.287		0.248
Male	201 (47.74)	27.31 ± 4.33		33.96 ± 3.71		25.95 ± 3.68
Female	220 (52.26)	27.17 ± 4.23		34.31 ± 3.29		26.47 ± 3.23
Age (years)	38.92 ± 9.61
Education			0.195		0.460		0.272
Below bachelor’s degree	175 (41.57)	26.91 ± 4.07		33.98 ± 3.56		25.99 ± 3.62
Postgraduate and above	246 (58.43)	27.47 ± 4.41		34.26 ± 3.45		26.38 ± 3.34
Professional title			< 0.001		< 0.001		< 0.001
None	35 (8.31)	24.6 ± 5.25		32.71 ± 3.62		25.6 ± 3.52
Junior	101 (23.99)	26.81 ± 3.67		33.15 ± 2.96		25.47 ± 2.82
Intermediate	145 (34.44)	26.82 ± 4.31		33.85 ± 3.46		25.7 ± 3.57
Associate senior and above	140 (33.25)	28.64 ± 3.94		35.53 ± 3.42		27.45 ± 3.45
Work experience			0.013		< 0.001		< 0.001
≤ 5 years	99 (23.52)	26.36 ± 4.59		33.48 ± 3.14		25.57 ± 3.03
5–10 years	99 (23.52)	27.17 ± 4.12		33.33 ± 3.51		25.85 ± 3.43
11–15 years	75 (17.81)	26.92 ± 4.05		34.08 ± 3.57		25.84 ± 3.3
≥ 16 years	148 (35.15)	28.03 ± 4.17		35.16 ± 3.45		27.09 ± 3.67
Institution type			< 0.001		0.168		0.120
Public	366 (86.94)	27.5 ± 4.36		34.22 ± 3.51		26.31 ± 3.46
Private	55 (13.06)	25.47 ± 3.18		33.62 ± 3.35		25.64 ± 3.41
Department			0.001		< 0.001		< 0.001
Plastic surgery	167 (39.67)	28.04 ± 4.48		35.18 ± 3.33		27.05 ± 3.4
Dermatology	120 (28.5)	26.12 ± 4.09		33.33 ± 3.64		25.13 ± 3.46
Medical aesthetics	134 (31.83)	27.25 ± 3.97		33.58 ± 3.25		26.16 ± 3.27
Previous scar-related laser and/or light therapy experience			< 0.001		< 0.001		< 0.001
No	66 (15.68)	23.95 ± 4.69		32.61 ± 3.43		24.21 ± 3.27
Yes	355 (84.32)	27.85 ± 3.91		34.43 ± 3.44		26.59 ± 3.37
Availability of laser and/or light therapy equipment in the institution			< 0.001		< 0.001		< 0.001
No	25 (5.94)	22.76 ± 4.35		31.6 ± 2.92		26.36 ± 3.47
Yes	396 (94.06)	27.52 ± 4.12		34.31 ± 3.47		26.22 ± 3.46

Knowledge, attitudes, and practices

The mean knowledge, attitude, and practice scores were 27.24 ± 4.28 (possible range 8–40), 34.14 ± 3.49 (possible range 9–45), and 26.22 ± 3.46 (possible range 6–30), respectively. Participants with different professional titles, work experience, departments, previous scar-related laser and/or light therapy experience, and availability of laser and/or light therapy equipment in the institution were more likely to have different knowledge, attitude, and practice scores (all P < 0.05). Additionally, whether or not it is a public institution may also affect the level of knowledge of the participants (P < 0.005) (Table 1).

Regarding knowledge of hypertrophic scars and laser and/or light therapy, 59.38% were familiar with the principles of the treatment (K4), 57.96% were familiar with the advantages of the treatment (K6), and 54.87% were familiar with the indications for this type of therapy (K5) (Table S1). The attitude dimension showed that 32.78% strongly agreed that laser and/or light therapy for hypertrophic scars is promising (A5), and 62.47% agreed that this treatment needs further introduction of new techniques and equipment (A9). When it comes to patient compliance (A8), 39.43% thought it was general. Also, 55.82% disagreed saying that they were skeptical about the treatment (A2) (Table S2). In the practice dimension, 33.97% always take the initiative to follow and learn the relevant knowledge and techniques (P2). For patients with hypertrophic scars, 48.93% often combine laser and/or light therapy with other treatments (P10), while another 40.86% sometimes prefer non-laser and/or light therapy (P4) (Table S3).

Correlation analyses

Correlation analyses indicated significant positive correlations between knowledge and attitude (r = 0.471, P < 0.001), as well as practice (r = 0.593, P < 0.001). There was also a positive correlation between attitude and practice (r = 0.640, P < 0.001) (Table 2).

Table 2.

Correlation analysis.

	Knowledge	Attitude	Practice
Attitude	0.471 (< 0.001)	–
Practice	0.593 (< 0.001)	0.640 (< 0.001)	–

Multivariate logistic regression

Multivariate logistic regression showed that working in private institution (OR = 0.252, 95% CI [0.128–0.496], P < 0.001), working in dermatology department (OR = 0.456, 95% CI [0.267–0.779], P = 0.004), had previous scar-related laser and/or light therapy experience (OR = 2.784, 95% CI [1.426–5.436], P = 0.003), and with the availability of laser and/or light therapy equipment in the institution (OR = 6.252, 95% CI [1.686–23.179], P = 0.006) were independently associated with optimal knowledge (Table 3). Concurrently, knowledge score (OR = 1.251, 95% CI [1.162–1.347], P < 0.001), working in dermatology department (OR = 0.427, 95% CI [0.216–0.846], P = 0.015), and working in medical aesthetics department (OR = 0.431, 95% CI [0.22–0.846], P = 0.014) were independently associated with positive attitude (Table 4). Furthermore, knowledge score (OR = 1.260, 95% CI [1.150–1.380], P < 0.001), attitude score (OR = 1.547, 95% CI [1.368–1.750], P < 0.001), and intermediate professional title (OR = 0.233, CI [0.057–0.952], P = 0.042) were independently associated with proactive practice (Table 5).

Table 3.

Univariate and multivariate analysis of optimal knowledge.

Knowledge dimension	Univariate		Multivariate
	OR (95%CI)	P	OR (95%CI)	P
Gender
Male	REF
Female	0.758 (0.516–1.115)	0.159
Age	1.033 (1.011–1.054)	0.002	0.997 (0.947–1.049)	0.897
Education
Below bachelor’s degree	REF
Graduate and above	1.108 (0.751–1.635)	0.605
Professional title
None	REF		REF
Junior	1.796 (0.816–3.953)	0.146	1.231 (0.493–3.072)	0.656
Intermediate	1.579 (0.739–3.374)	0.238	1.387 (0.488–3.936)	0.539
Associate senior and above	3.573 (1.651–7.731)	0.001	1.849 (0.593–5.768)	0.29
Work experience
≤ 5 years	REF		REF
5–10 years	0.851 (0.487–1.486)	0.57	0.602 (0.268–1.351)	0.219
11–15 years	0.905 (0.496–1.649)	0.743	0.643 (0.24–1.723)	0.38
≥ 16 years	1.921 (1.141–3.233)	0.014	1.353 (0.373–4.902)	0.645
Institution type
Public	REF		REF
Private	0.321 (0.175–0.591)	< 0.001	0.252 (0.128–0.496)	< 0.001
Department
Plastic surgery	REF		REF
Dermatology	0.425 (0.263–0.687)	< 0.001	0.456 (0.267–0.779)	0.004
Medical aesthetics	0.689 (0.433–1.095)	0.115	0.909 (0.531–1.558)	0.73
Previous scar-related laser and/or light therapy experience
No	REF		REF
Yes	3.625 (2.043–6.431)	< 0.001	2.784 (1.426–5.436)	0.003
Availability of laser and/or light therapy equipment in the institution
No	REF		REF
Yes	9.85 (2.9-33.451)	< 0.001	6.252 (1.686–23.179)	0.006

Table 4.

Univariate and multivariate analysis of positive attitude.

Attitude dimension	Univariate		Multivariate
	OR (95%CI)	P	OR (95%CI)	P
Knowledge dimension	1.255 (1.173–1.342)	< 0.001	1.251 (1.162–1.347)	< 0.001
Gender
Male	REF
Female	1.298 (0.806–2.091)	0.284
Age	1.03 (1.004–1.058)	0.025	1.008 (0.966–1.052)	0.713
Education
Below bachelor’s degree	REF
Graduate and above	1.323 (0.82–2.136)	0.251
Professional title
None	REF		REF
Junior	1.216 (0.514–2.878)	0.656	0.782 (0.289–2.114)	0.628
Intermediate	1.358 (0.592–3.113)	0.47	0.83 (0.293–2.354)	0.727
Associate senior and above	2.894 (1.187–7.059)	0.019	0.969 (0.26–3.619)	0.963
Work experience
≤ 5 years	REF
5–10 years	0.619 (0.325–1.18)	0.145
11–15 years	1.077 (0.512–2.264)	0.845
≥ 16 years	1.828 (0.925–3.613)	0.083
Institution type
Public	REF
Private	1.16 (0.559–2.408)	0.691
Department
Plastic surgery	REF		REF
Dermatology	0.325 (0.174–0.604)	< 0.001	0.427 (0.216–0.846)	0.015
Medical aesthetics	0.409 (0.22–0.762)	0.005	0.431 (0.22–0.846)	0.014
Previous scar-related laser and/or light therapy experience
No	REF
Yes	1.612 (0.882–2.947)	0.121
Availability of laser and/or light therapy equipment in the institution
No	REF		REF
Yes	2.368 (1.008–5.564)	0.048	0.933 (0.352–2.473)	0.889

Table 5.

Univariate and multivariate analysis of proactive practice.

Practice dimension	Univariate		Multivariate
	OR (95%CI)	P	OR (95%CI)	P
Knowledge dimension	1.372 (1.275–1.477)	< 0.001	1.260 (1.150–1.380)	< 0.001
Attitude dimension	1.622 (1.461–1.801)	< 0.001	1.547 (1.368–1.750)	< 0.001
Gender
Male	REF
Female	1.276 (0.832–1.956)	0.263
Age	1.027 (1.003–1.051)	0.026	0.987 (0.922–1.056)	0.706
Education
Below bachelor’s degree	REF
Graduate and above	1.235 (0.803-1.9)	0.336
Professional title
None	REF		REF
Junior	0.984 (0.438–2.21)	0.969	0.296 (0.086–1.013)	0.052
Intermediate	1.123 (0.514–2.451)	0.771	0.233 (0.057–0.952)	0.042
Associate senior and above	2.522 (1.105–5.753)	0.028	0.274 (0.056–1.341)	0.110
Work experience
≤ 5 years	REF		REF
5–10 years	1.263 (0.693-2.3)	0.446	2.741 (0.995–7.553)	0.051
11–15 years	1.112 (0.587–2.104)	0.745	1.731 (0.505–5.929)	0.383
≥ 16 years	2.057 (1.156–3.663)	0.014	2.354 (0.422–13.134)	0.329
Institution type
Public	REF
Private	0.576 (0.319–1.04)	0.067
Department
Plastic surgery	REF		REF
Dermatology	0.378 (0.22–0.65)	< 0.001	0.645 (0.312–1.336)	0.238
Medical aesthetics	0.463 (0.271–0.792)	0.005	0.647 (0.319–1.312)	0.227
Previous scar-related laser and/or light therapy experience
No	REF		REF
Yes	3.482 (2.026–5.985)	< 0.001	2.013 (0.918–4.413)	0.081
Availability of laser and/or light therapy equipment in the institution
No	REF		REF
Yes	3.62 (1.593–8.228)	0.002	0.611 (0.189–1.978)	0.411

Discussion

Aesthetic medicine practitioners exhibited suboptimal knowledge, but maintained a generally positive attitude, and proactive practice regarding laser and/or light therapy for hypertrophic scars. Given these findings, it is recommended that interventions be implemented to enhance the knowledge base of aesthetic medicine practitioners.

The overall findings of mean scores of the KAP dimension suggest that while aesthetic medicine practitioners demonstrate positive attitude and proactive practice in this domain, their knowledge remains suboptimal. Analyzing the relationships between various factors and KAP scores reveals several significant findings. Firstly, professional title and work experience exhibit positive associations with all three domains. Individuals with higher professional titles demonstrate enhanced KAP scores, indicating that career advancement correlates with improved competencies. This aligns with existing literature emphasizing the importance of continuous professional development in healthcare settings^25,26. Similarly, longer work experience correlates with higher scores, suggesting that practical exposure over time enhances proficiency. A study conducted in Saudi Arabia revealed that physicians with more experience had notably better knowledge of Vitamin B12 screening and supplementation in patients with T2DM²⁷.

Moreover, institutional factors significantly influence KAP scores. Professionals in public institutions outperform their counterparts in private settings, possibly due to differential access to resources or educational opportunities. Public hospitals in China typically benefit from larger budgets, government support, and access to advanced medical technologies, which can foster an environment conducive to continuous professional development and learning opportunities^28,29. Additionally, public institutions often attract experienced specialists and renowned experts, providing a conducive learning environment for healthcare professionals. As a result, aesthetic medicine practitioners working in public hospitals may have greater access to training programs, conferences, and research opportunities, all of which contribute to their higher KAP scores^30,31.

Additionally, the observed discrepancy in KAP scores among professionals from different departmental affiliations, with plastic surgery specialists demonstrating superior scores compared to dermatology and medical aesthetics counterparts, may be attributed to several factors. Plastic surgery professionals often undergo comprehensive training and specialization in scar management, including exposure to laser and/or light therapy techniques, which may contribute to their enhanced understanding and proficiency in this area^32,33. Additionally, the interdisciplinary nature of plastic surgery departments and their focus on research and innovation could provide plastic surgeons with unique opportunities for skill development and knowledge acquisition related to laser and/or light therapy^34,35. Diverse patient populations and case complexities in plastic surgery necessitate a nuanced approach to scar management, including laser and/or light therapy. This highlights the importance of specialized training, interdisciplinary collaboration, and clinical experience in enhancing professional competencies in scar management^32,36. Furthermore, hands-on experience significantly enhances KAP scores. This corroborates studies advocating for experiential learning to bridge theoretical knowledge gaps in clinical practice³⁷. Additionally, the availability of laser and/or light therapy equipment correlates positively with KAP scores, suggesting that access to specialized tools facilitates better understanding and implementation of laser and/or light therapy³⁸.

Multivariate logistic regression further elucidates factors independently associated with KAP scores. Working in private institutions and dermatology departments negatively impacts knowledge and attitude scores, underscoring potential disparities in resource allocation or educational emphasis. Conversely, previous scar-related laser and/or light therapy experience positively influences knowledge scores, emphasizing the value of practical exposure^39,40. Proactive practice is associated with higher knowledge and attitude scores, suggesting that a comprehensive understanding and positive attitude toward laser and/or light therapy drive implementation efforts^41,42. This finding is consistent with other KAP studies on healthcare professionals, where better knowledge and more proactive practices were also linked to improved clinical outcomes^43,44. Correlation analyses also revealed significant positive associations between KAP scores, reinforcing the interconnectedness of these domains in shaping professional competencies. This highlights the importance of addressing knowledge gaps and fostering a positive attitude to promote proactive practice in clinical settings. Strategies such as continuing education programs, hands-on training initiatives, and equitable resource allocation across institutions may help bridge these gaps and enhance professional competencies in this domain³⁶.

Aesthetic medicine practitioners showed varying levels of familiarity with laser and/or light therapy for hypertrophic scars, excelling in application but lacking knowledge of efficacy and adverse reactions. Positive attitudes were common, though some skepticism remained. They actively sought knowledge, but practice preferences varied. Targeted educational interventions, structured training, quality assurance, and standardized protocols are recommended to improve understanding, address skepticism, and promote consistent, evidence-based use of laser and/or light therapy in clinical practice. Interdisciplinary collaboration and mentorship can further enhance care delivery.

This study has several limitations that need to be addressed. One key limitation is the cross-sectional design, which restricts our ability to determine causal relationships between the variables. Secondly, the reliance on self-reported data via questionnaires may introduce response bias and potential inaccuracies in the assessment of knowledge, attitude, and practice. Thirdly, the online process of data collection may have limited the diversity of responses and introduced selection bias, as only participants with internet access and familiarity with online surveys could participate. Additionally, the relatively small sample size limits the generalizability of the findings, potentially reducing the external validity of the study. This paper’s strengths included a thorough exploration of aesthetic medicine practitioners’ KAP on laser and/or light therapy for hypertrophic scars, along with the application of multivariate logistic regression to uncover independent associations. It provided valuable insights for designing targeted interventions to enhance patient care and outcomes in medical aesthetics.

In conclusion, aesthetic medicine practitioners demonstrated suboptimal knowledge, but maintained a generally positive attitude, and proactive practice regarding laser and/or light therapy for hypertrophic scars. Based on these findings, targeted educational interventions be implemented to enhance the understanding and application of laser and/or light therapy among aesthetic medicine practitioners, with a particular focus on those in private institutions and dermatology departments. Additionally, it is advisable to develop standardized training programs and guidelines that address key areas of laser and/or light therapy knowledge and practice. Collaborative workshops, online courses, and certification programs may provide accessible learning opportunities, ensuring practitioners are equipped with up-to-date skills and knowledge. Further studies should also be conducted to evaluate the long-term impact of these educational interventions on clinical practice.

Electronic supplementary material

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Abbreviations

KAP

Knowledge, attitude, and practice

LLLT

Low-level light therapy

SD

Standard deviations

Author contributions

X.C. and L.Y. carried out the studies, participated in collecting data, and drafted the manuscript. W.Y. and H.L. performed the statistical analysis and participated in its design. X.C. participated in acquisition, analysis, or interpretation of data and draft the manuscript. All authors read and approved the final manuscript.

Funding

This study was funded by grants from the Hebei Traditional Chinese Medicine Scientific Research Project (2025319).

Data availability

All data produced or analyzed in this study are contained within this published article.

Declarations

Ethics approval and consent to participate

The study adhered to the ethical principles outlined in the 1964 Declaration of Helsinki and its subsequent amendments. Approval was obtained from the Ethics Committee of Hebei Medical University Third Hospital (2023-111-1), and informed consent was secured from all participants. All procedures complied with relevant guidelines and regulations.

Competing interests

The authors declare no competing interests.