Laser scar removal is possible for all skin and scar types. Scars result from trauma to the skin. In darker skin types, the dermal injury causes an initial darkening call PIH – post inflammatory hyperpigmentation. Generally, all scars improve with time. The addition of silicon gels and creams improves the healing process and leads to a better scar outcome. However, more extensive operations, trauma or infection can result in more severe scar outcomes and sometimes require scar revision treatments. Most often, this can be performed non-surgically with laser scar treatment. However, sometimes, scar revision surgery is needed. Laser scar removal is a common request for people with self-harm, as it is a reminder of a past traumatic period in their lives, as well as facial scar removal.
The Types of Scars that Respond to Laser Scar Treatment include:
Surgical scars, burns, acne scars, stretch marks, self-harm scarring and facial scars & PIH.
Laser Scar Removal
Laser scar removal is performed with different lasers, and the choice depends primarily on your skin type. Previously challenging to treat ethnic, indigenous and Asian skin types can now be treated with the Picosure Laser. The picosure was the first picosecond laser which started a new breed of lasers revolutionising scar treatment in darker skin types. Radiofrequency skin needling such as Infini and Secret Rf can be used for all skin types and especially useful for stretch marks and acne scars. The gold standard fractionated CO2 laser can be used only in skin types 1 -3, but not Asian skin. It is often combined with radiofrequency skin needling.
Other modalities used for scar removal include dermapen skin needling, prp injections, steroid injections, prescription creams and over the counter silicon gels.
Acne Scar Removal
Laser acne scar treatment is only one piece of the treatment planning puzzle. Acne scar treatment often involves combinations of several modalities including TCA cross, subcision, dermal fillers as well as lasers. Lasers useful for acne scars include picosecond lasers for darker skin types, fractionated CO2 lasers and radiofrequency skin needling such as Infini. It is essential to diagnose the nature of acne scarring and build a plan. It is never possible to achieve 100% removal. However, considerable cosmetic gains can be achieved with combination treatments.
Stretch Mark Removal
Stretch marks are considered scars, though there is no break to the skin they result from tearing of collagen and elastin in the dermal layer of skin. Laser stretch mark removal improves the appearance of stretch marks up to 80%. The best treatment approach depends on the age of the stretch marks. New stretch marks respond to silicone gels, radiofrequency skin needling and vascular lasers. Whereas older scars respond to radiofrequency skin needling and CO2 lasers.
Self Harm Scar Reduction
This type of scarring can be difficult to treat and combinations of lasers, including fractionated CO2 laser and radiofrequency skin needling.
PIH or post inflammatory hyperpigmentation is not scarring but is often consider with this. It is generally a transient darkening of the skin and occurs in skin types high 3 and above. Asian and ethnic skin types are more prone to this. It occurs after any trauma to the surface, although acne is the most common cause. Sometimes injury results in a permanent PIH. PIH can be treated with the new picosecond lasers.
Hypertrophic Scar Treatment
Hypertrophic scars result from abnormal healing. Their occurrence is determined by genetics, part of the body affected by injury and the degree of trauma or infection that occurs. These scars can be treated with silicone gel and injection of corticosteroids.
Facial Scar Removal
Facial scar removal is one of the common requests because facial scars alter the visible appearance and hence esteem significantly. The laser treatment once again depends on the skin type. Fractionated CO2 laser, radiofrequency skin needling and picosure for scar remodelling in darker skin types.
Scar Revision Surgery
Sometimes non-surgical approach will not work, and satisfactory cosmetic outcome requires scar revision surgery. In the case of traumatic scars or surgical scars impacted by infection, a second attempt with controlled healing under optimal conditions is required. Scar revision surgery is performed with back up of silicone gels to optimise healing outcome.
Chicken Pox Scar Treatment
TCA cross is useful for these as well as enlarged pores. 2-3 treatments are required spaced 6-8 weeks apart.