Laser Scar Removal

The wound-healing process begins with inflammation, progresses to tissue formation and ends with modifying specific factors in the anatomy – such as collagen, the main protein found in connective tissue that supports the skin, bone, cartilage and blood vessels. Scarring occurs when the wound-healing process is disrupted by certain factors such as too much or too little collagen. For example, a keloid scar is a mass of collagen.

Today's laser scar removal techniques can reduce the appearance of several types of scars, including Keloid Scarring, Hypertrophic Scarring and Atrophic Scarring. like pockets in the skin that can result from skin conditions or diseases such as acne. Not everyone is a candidate for laser scar removal. People with skin disorders such as psoriasis, cystic acne and dermatitis may not be ideal candidates. Those using certain medications such as isotretinoin for acne must stop using the medication for six months prior to the procedure.

During laser scar removal, the laser is moved along the scar. This can vaporize or remove a layer of skin and expose a more natural-looking skin layer, which heals over time to minimize scar appearance. Other lasers may target lower layers of the skin, stimulating new collagen growth and correcting scars from the inside out. The laser scar removal procedure is often performed under local anesthesia in an outpatient surgery center, surgeon's office or hospital. Sometimes, general anesthesia is used. The surgery takes anywhere from a few minutes to an hour and a half.

Many types of lasers are available, each of which has unique benefits for scar removal. The CO2 and Er:YAG lasers are best suited for acne scarring. The CO2 is an ablative laser that basically sandblasts the skin away; resulting in some substantial downtime. The Er:Yag is also ablative, but less so than the CO2; meaning that it is less damaging. Many different companies manufacture CO2 and Er:YAG lasers.

Fractionated CO2 and Er:YAG lasers including the Fraxel and fractionated radiofrequency treatments also are very helpful for acne scarring, but they require multiple treatments. Fractionated lasers work by treating a fraction of the skin's surface. These lasers create tiny wounds in the deeper layer of the skin. Each wound is surrounded by untreated skin, helping to repair the treated area via a controlled wound-healing process. Both CO2 and Erbium YAG lasers as well as radiofrequency treatments can be fractionated.

Until recently, African-Americans were not considered ideal candidates for laser scar removal, but times are changing. Certain lasers (such as fractionated infrared lasers) and radiofrequency devices such as Thermage may be helpful in treating acne scars among African-Americans. There is still little that lasers can do to treat keloid scars affecting this population.