Greetings from sunny California! I had the pleasure of recently attending and delivering some lectures at the Controversies and Conversations in Laser and Cosmetic Surgery Symposium in Dana Point, California. A gathering of the some of the preeminent dermatologists, plastic surgeons and cosmetic surgeons around the country, this symposium is our annual meeting to discuss and debate new technology, treatments and issues in the cosmetic field.
Hot topics this year included non-surgical fat reduction and body contouring, non-invasive skin tightening and the treatment of excessive sweating. Although all these topics were fascinating, what I am most excited about is the continued advancement in our ability to treat scarred skin.
Lasers have been used to treat scars since the 1980s. The pulsed dye laser (PDL) was the first shown to reduce scar redness, thickening and itchiness while increasing the pliability (softness) of the affected skin. The PDL is very safe when used properly and has helped thousands of patients over the years improve the look and feel of their scars after a series of treatments.
More recently, fractional lasers have been introduced. Although these lasers were first used on old acne scars, their positive effects can be seen on surgical or traumatic scars too. By breaking down some of the abnormal, scarred collagen in a scar and replacing it with collagen fibers like ones seen in normal, non-scarred skin, fractional lasers can help blend the scar in to the surrounding skin. In addition to enhancing the look of the scar, the fractional lasers have also been used to effectively soften thick scars to allow better movement of the skin.
Some advanced protocols in the treatment of scars use a combination of the PDL and fractional lasers with the application of a topical solution immediately after treatment to enhance the effects of the lasers. A few cutting-edge protocols are using topical steroids or other types of solutions to try to penetrate to the bottom of thick scars.
When it comes to getting the best results with lasers for scars, it’s important for the surgeon to examine the skin closely to identify the type of scar that’s present and then use the laser (or combination of lasers) that is appropriate. The overall number of treatments needed and the expected result of laser therapy will depend on the type of scar.
There are several good resources to help identity laser surgeons with a particular interest in treating scars. One is the American Society for Laser Medicine and Surgery and another is the American Society for Dermatologic Surgery. The laser treatment of scars is often one of the most rewarding treatments a laser surgeon can offer as it has the ability to safely and effectively improve scars and thus the quality of life for so many of our patients.