Hypertrophic scars are common and cause functional and psychologic morbidity. Various treatment modalities have been advocated in the past, but the flashlamp-pumped pulsed-dye laser-585 nm (PDL) has been shown to be effective in the treatment of a variety of traumatic and surgical scars. This study was performed to determine the effectiveness of the PDL treatment of hypertrophic scars in Asians and to elucidate possible side effects and complications. Thirteen Asian patients with 19 hypertrophic scars that had no response to conservative therapies, such as pressure therapy, intralesional corticosteroid injection, or silastic gel sheeting for more than 6 months, were treated with the PDL. Three months after the last laser treatment, improvement in the appearance, reduction in scar height, and erythema as a result of the PDL treatment were evaluated and compared with baseline values. Compared with the baseline appearance, hypertrophic scars treated with the PDL showed a satisfactory clinical improvement of 84% (16 of 19), a significant percentage of scar flattening of 58.9 +/- 22.1%, and of erythema elimination of 75.7 +/- 19.9% at month 3 after the last laser treatment. The PDL treatment of hypertrophic scars can effectively improve scar pliability and texture and decrease erythema and associated symptoms. In addition, multiple treatment sessions are suggested for achieving greater response, but lower fluences are recommended for prevention of side effects in Asians with a higher melanin content of the skin.