A wide variety of things can cause scars including sports injuries, surgery, chickenpox and acne but most will fade substantially over time. Some scars may disappear completely but large scars that are indented or raised may persist and cause disfigurement. A variety of therapies are available for the treatment of these types of scars including dermabrasion and chemical peels but for many scars the best option is laser scar removal. Laser treatment for scars is around 80% effective in reducing the scars appearance. This type of treatment however is not usually recommended for sufferers of some skin diseases such as psoriasis, dermatitis or cystic acne. In addition if you are thinking of laser scar removal you should not take isotretinoin for the six months before any treatment.

What are the different types of scars?

Scars vary in their appearance and have been classified accordingly. Hypertrophic scars are firm, raised and often pink and usually disappear over time. Keloid scars develop gradually and often cover more than the original area that was damaged. They are usually firm and raised and may be red or purple. Atrophic scars are the small pits that are caused by a skin disease such as acne or chickenpox.

 What type of lasers are used for laser scar removal?

There are different lasers used for scar removal and the most appropriate one for your skin and scar type will be used by your practitioner. For the removal of acne scars YAG (neodymium-doped yttrium aluminium garnet) and CO2 lasers are usually used. They work by removing the top layer of the skin, known as ablation. Both will need some healing time after treatment although CO2 lasers recovery is usually shorter than for the YAG lasers. A modification of this technique is to use a fractionated YAG or CO2 laser which works in  a slightly different way by causing damage in small areas underneath the scar and is a controlled method of wound healing. With this type of laser the recovery time is minimal.

For keloid scars a pulsed dye laser may be used. The treatment is also often used with other treatments such as injections of five percent fluorouracil or steroid injections which can help to make the scars flatter. Pulsed dye laser treatment does not require any recovery time.

Who can benefit from laser scar removal?

In general laser scar treatment is best for those with fair skin although recent improvements in fractionated IR (infra red) lasers have allowed their use on acne for those with dark skin. However, at the present time, hypertrophic and keloid scars can still only be treated on fair skin. If you suffer from any form of dermatitis, cystic acne or psoriasis a dermatologist will be able to tell you if there is a laser treatment that is suitable for you.

How does laser treatment work on scars?

There are two types of techniques used for laser scar treatment, ablative or non-ablative. Ablative laser treatment literally peels of the top skin layer and new skin then grows over the scarred area. For non-ablative laser treatment the cells in a deeper layer of the skin are damaged which causes new growth of collagen, the structural component of the skin. Pits and indents are then filled in as the collagen grows.

What happens during laser scar treatment?

Laser treatment can be undertaken as an out-patient and requires a local anesthetic. It Will take between ten minutes and an hour. The area will be washed with a gentle soap solution and antibiotic cream applied. There are also medications that can help to fade the scar which may also be prescribed. For ablative laser treatment a pain medication may be prescribed.

How does the skin heal after treatment?

A few days after treatment the skin will start to regenerate. Healing times will vary depending on a number of factors including the type of laser used and the condition of your skin prior to treatment. Side effects can include a change in pigmentation which can be increased if you expose your skin to the sun.

Conclusion

Laser scar treatment is very successful in minimising the look of a variety of scar types including those caused by acne. It is expensive however, the costs varying depending on the the size of the scarred area and how severe the scarring is. Newer lasers, that do less damage to the skin and involve much less healing afterwards have been introduced recently. Your dermatologist will be able to tell you if your scars are suitable for this type of treatment and which type of laser treatment is most suitable.