Scar Removal: Are Lasers the total Answer?

A scar is an unpleasant reminder of a healthy body process, created when your skin repairs a wound caused by an accident, infection, inflammation, or surgery. Scars vary in shape and size. They may start out red and thick and fade over time, or turn flat, sunken, or lumpy — leading you to wonder about cosmetic procedures to eliminate them.

These days, skin laser technology has advanced to the point where much can be done to treat scars. Laser scar removal or reduction is a common procedure performed in a dermatologist’s office or at a skin laser clinic. With a laser, scars can be lessened significantly and possibly erased, depending on their severity. There are three main types of skin laser treatments available:

• Laser resurfacing, sometimes referred to as “ablative” laser resurfacing
• Fractionated laser resurfacing
• Non-ablative laser resurfacing

Laser Resurfacing

In this treatment, dermatologists use a high-powered laser to remove the top layer of skin that has been scarred. The laser also penetrates to the skin's middle layers, tightening and smoothing the skin.

Laser resurfacing is performed on an outpatient basis in a doctor's office or skin laser clinic, and usually takes one to two hours. Goggles protect your eyes from the laser's bright light during the procedure, and you’ll be given a local anesthetic for the pain and twilight sedation — you’re not “out,” but you are sedated. The dermatologist will run the laser, which resembles a handheld wand, over the scar to remove the damaged skin cells. Each pass of the wand will remove more cells.

There are two types of lasers used for skin resurfacing, each with their own pros and cons:

• CO2 laser is a powerful laser that penetrates deeply into the skin and is better at removing thicker and deeper scars. As a consequence, recovery time is long, usually about two weeks. The procedure also can be painful.
• Erbium: YAG laser is less powerful than the CO2 laser and is most often used to treat shallow scars. You’ll need less anesthetic and sedation when you undergo laser scar removal with this laser, and your recovery time is faster, about a week.

Skin laser resurfacing can be expensive, starting at around $2,700 to treat just one portion of the face.

Fractionated Laser Resurfacing

This precise laser therapy uses tiny beams of light that penetrate deeply into the skin. The result is dozens or even hundreds of microscopic holes where skin cells have been removed, surrounded by healthy skin. The holes help break down old skin cells while stimulating collagen production within the deeper skin layers. The surrounding healthy skin helps to quickly heal the damage done by the laser therapy, resulting in fresh, new skin cells.

Topical anesthetic will prevent pain. This therapy is much less invasive and requires little to no recovery time — it also doesn't produce the same amount of skin improvement as full-fledged laser resurfacing. Patients usually experience redness or minor swelling that fades within a few days. You’re likely to need three to five treatments, spaced out at least a week apart. While some improvement will be seen immediately, you will have to wait a few months to get the real results of the treatment. A full-face treatment runs about $1,500, so if you are having a specific area of skin treated you can expect to pay less than that.

Non-Ablative Laser Resurfacing

Dermatologists use infrared skin lasers to heat the inner layers of the skin while leaving the surface untouched. This promotes collagen production and creation of fresh new skin cells that will replace the scars’ damaged cells. The pro for this procedure is the time involved. It does not require the recovery time needed following laser skin resurfacing and also takes less time in the doctor's office, 15 to 30 minutes for each treatment.

As for the cons, the procedure can be somewhat painful, but while the laser is operating, it releases a cooling spray to prevent damage to your surface skin. Also, because the healing is taking place deep inside your skin, it can be months before you see results. Four to six treatments may be required to receive the full benefit of the therapy, with each one costing $400 to $600.

The type of skin laser treatment that will be most effective for you depends on the type of scar you have. A consultation with a doctor experienced in laser scar removal will determine the best strategy

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