A new era of outcomes for pediatric burn patients has begun as burn care continues to improve. Unfortunately, complete restoration of burn-injured skin may be limited by the development of hypertrophic scarring. Treatment with ablative fractional carbon dioxide laser therapy is one of the newest forms of scar therapy available. Although laser therapy has only been adopted by burn clinicians within the last several years, early evidence suggests that it may offer significant benefits. At present, a well-designed randomized controlled trial that evaluates the effectiveness of laser therapy for improving hypertrophic burn scars in children has not yet been conducted. Thus, the proposed study will answer the following research question: In children aged 1 to 18 years with a hypertrophic burn scar, is the addition of ablative fractional carbon dioxide laser therapy to standard scar management more effective at improving the appearance and texture of the scar compared to standard scar management alone, as measured by the Vancouver Scar Scale from baseline to month 12? Ultimately, the completion of this study may lead to a fundamental change in the standard treatment of pediatric hypertrophic burn scars. In addition, the study findings will also be applicable to children and adults with scars resulting from other etiologies.