Can a Laser Reduce My Scar?
The short answer is “Yes!” Now for a longer answer. As you may have guessed, it depends largely on what sort of scar it is.
What is a scar?
A scar is the body’s attempt to heal an injury. Cells called fibroblasts create filaments, strands of collagen, which stick together to protect the area, to fill the cut tissue, replace the burned tissue, or whatever the injury was. The fibroblasts continue making these fibers, dissolving old ones and substituting new ones, until the body thinks the wound is well enough healed.
Ideally, the injured area is gradually rebuilt until it matches the surrounding areas. This rebuilding, or remodeling, progresses quickly when we’re young but slows down as we age, so that scars can remain for many years and perhaps never disappear.
So we may be left with a scar we consider ugly: it’s the wrong color, it’s prominent, doesn’t blend well with the surrounding skin, it feels hard, it should be fixed.
Types of Scar
Keloid scars are very thick and raised and often grow larger than the original injury area. They can be red or purple and some people have a genetic tendency to develop this type of scar. They’re hard to treat because they tend to grow back after treatment.
Hypertrophic scars are also thick and prominent but at least they don’t grow outside the wound area and they’re easier to treat.
Burn scars can be very large, depending on the area of skin lost in the burn injury. This type of scar often contracts, pulling on the surrounding skin, and even pulling on muscles and tendons. They must usually be treated with surgery.
Acne scars are usually soft and shallow and thus easier to treat than other scar types.
Some scars are indented, i.e., they’re lower than the surrounding skin surface. Some are connected to underlying tissue such as muscle or tendon, which makes them difficult to treat.
What is a laser?
“LASER” is an acronym standing for Light Amplification by the Stimulated Emission of Radiation.
It was invented in 1958 by two brothers-in-law working on it in their spare time, who at first came up with the Maser (Microwave Amplification by the Stimulated Emission of Radiation) and after switching to work with shorter wavelengths, arrived at the laser. The first working laser was built in 1960. Lasers are now used for many things besides surgery; for instance, we see them every day at the supermarket checkout, and we use them in printers and scanners. A laser can be as tiny as a grain of sand or as large as a building. Lasers used in medicine are the size of a pencil.
Laser Skin Treatments
Laser beams can heal softer scars and unlike microdermabrasion and chemical peels, can penetrate the skin deeply enough to work on deep scars. The shining of a laser light through the skin stimulates those fibroblasts and makes them start creating new cells again. Light is a type of energy, and when the cells feel that impact, they become more active in response, and do their job of creating collagen.
After several laser treatments over a period of months, the scar slowly fades away. Some scars are more resistant, as described above.
Two types of laser beams
Ablative lasers treat the skin from above. They vaporize the top layer of skin so that new skin can replace it in just a few days. They wake up the fibroblasts, which start making new strands of collagen, which gradually merge with the surrounding skin for a smooth finish. Just one or two such treatments are all that’s needed. They also make the skin surface red (for a month or 2) and a bit swollen (for just a week or so). And only softer scars will be successfully removed.
Non-ablative lasers do a better job on indented or hard, raised scars, and the ones bound to underlying tissue. They’re also preferred by people who’d rather not have their skin red for a couple of months. With this type of laser, the skin is treated from below the surface, so that there’s no redness and little swelling. The scars that are bound to tissue below them release and dissolve. Indented ones rise and become smoothed out. Raised scars soften and flatten out, and the coloring of scars fades to the person’s natural skin color.
Between 3 and 6 treatments are usually required, over a period of 3 to 6 months. The surgeon will numb the face before beginning, and will give either a mild sedative, or sometimes a general anesthesia, depending on the patient’s needs.
In summary, laser treatments create smoother, more youthful-looking skin, with renewed elasticity, and they can remove even deep scars entirely. They don’t help with sagging or other effects of aging, but they can be done in conjunction with facelifts or other facial cosmetic surgery, for a dramatic outcome.