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Laser Scar Removal / Resurfacing

Overview
Laser skin resurfacing is a popular cosmetic procedure to rejuvenate the skin and reduce the effects of the sun, aging, and scars. It can be used to treat a variety of skin conditions including scars, wrinkles, spider veins, sun damage, and many others. Laser light heats the dermis, stimulating the formation of new collagen and elastin fibers. With new advances in laser technology, skin resurfacing can be done on many parts of the body including the face, chest, arms, and hands.

Detailed Description
Types of Lasers

The most commonly-used lasers for treatment of skin conditions are carbon dioxide (CO2), erbium, and the pulsed dye laser:

CO2 Laser

The CO2 laser is the highest intensity laser treatment currently available and is used mainly for acne scars. After being treated with the CO2 laser, the surface of the skin appears tighter and smoother, since the laser uses heat to restrict collagen bands beneath the skin. This laser can eliminate the appearance of most wrinkles, scars, and birthmarks. The CO2 laser has even been used to treat skin cancer in its earliest stages.

Erbium (Er:YAG) Laser

The erbium laser has a very precise wavelength that leaves normal skin unaffected. The erbium laser removes thinner layers of skin than the CO2 laser. This laser is often a better choice for patients with dark skin, as there is less of a risk of permanent changes to skin pigmentation. With a shorter healing time, erbium lasers are also better for patients who only need to treat minimal fine lines and scars.

The Pulsed Dye Laser

Pulsed dye lasers emit high-energy light in rapid pulse durations with intermingling periods of time between each pulse. The pulsed dye laser has been used in the treatment of warts, port-wine stains, hemangiomas, hypertrophic scars, and telangiectasias. The pulsed dye laser can be used as an alternative to surgical excision for treating conditions related to blood vessels.

What is the difference between ablative and non-ablative treatment?

Ablative treatment involves removal of the epidermis and some of the dermal tissue. Although this method is effective in achieving healthy looking skin, immediate results may include red, raw skin, a risk of infection after treatment, and an extended recovery period.

Non-ablative treatment sends light pulses into the dermis, without damaging the epidermis. This allows for quick recovery without the severe side effects of ablative treatment. Traditional non-ablative lasers have shown limited results in treating severe skin conditions.

What is fractional laser resurfacing?

Fractional photothermolysis is a new treatment available to patients that avoids damage to the epidermis as in non-ablative treatment, while achieving long-term results comparable to ablative treatment. Fractional lasers, which may be either erbium or CO2 based, are different in the way in which they transfer the laser light to the skin. These lasers deliver hundreds or thousands of microscopic beams of light to a fraction of the skin. Whereas ablative lasers create a continuous lesion that spans over the entire area of treatment, fractional lasers result in intermittent micro-columns of coagulated tissue amidst undamaged tissue. The healthy tissue, which surrounds the treated micro-columns, is able to accelerate the recovery of damaged tissue and restore pigment levels to normal by providing melanocytes to the treated areas.


The Procedure

Treatment typically involves two or more sessions between 10 minutes and 2 hours in length although it is heavily dependent upon the size of the area to be treated and the severity of the skin condition. Laser resurfacing is an outpatient procedure, typically requiring local anesthesia in combination with an oral or IV sedative.

Each person reacts differently to the procedure, although most report only minimal pain during the resurfacing. Fractional lasers and non-ablative treatment can dramatically reduce discomfort during the procedure and in the recovery period afterwards. Immediately following the laser resurfacing, you may feel like you have sunburn. Additionally, you may experience swelling, itching, and redness for a few days after the procedure. Applying a high SPF sunscreen throughout the day can help reduce this discomfort. Smoking or prolonged exposure to the sun may complicate the healing process.


Frequently Asked Questions

Q: How soon after surgery can surgical scars be treated?

A: This answer varies depending on the surgery and the surgeon. Different surgeons recommend anything from one month to six months. We recommend asking your own doctor.

Q: Can areas of thin skin, such as on the back of your hands and neck, be treated with fractional laser treatment?

A: Yes, thinner skin areas such as on the hands, neck and chest can be treated with fractionated lasers. Usually they are treated with a decreased number of passes and diminished energy use. As always, we recommend starting with test spots.

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Last updated: 17-Nov-08


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