Scarring is a natural part of the healing process and occurs when this process is disrupted by certain factors such as an excess of protein. Whether they are permanent or not, the scars that are left as a result can be painful, inconvenient, or cause self consciousness and embarrassment. Fortunately, laser technology now offers the option of permanent scar removal.
There are different types of scars, and the three that are able to be removed by laser are Keloid, Hypertrophic, and Atrophic scars. They differ in appearance, texture, and composition as they can be created by a tear in the fibrous tissue, an excess of collagen or protein, or an interrupted healing process. The type of laser used will depend on the type of scarring on the skin's surface.
- Keloid Scars - raised, reddish-purple scars that extend beyond the initial wound and continue to grow over time.
- Hypertrophic Scars - raised, pink marks that may fade over time.
- Atrophic Scars - made up of depressed pin pockets, formed from skin conditions or acne.
In the 1980s it was discovered that lasers could be used to improve the appearance of scars. Initially, CO2 lasers were used as an ablative tool to remove the top layers of the epidermis to smooth the appearance of scars. These were very aggressive and required a long period of recovery following treatment. Eribium lasers quickly followed on the market, removing thinner layers of skin and offering a better option for those with minimal fine lines or even wrinkles. The Erbium laser also offered these options to people with darker skin as there was less chance of skin discoloration with this method. The pulsed-dye laser that was originally designed for vascular surgery has since been converted for use in scar removal. It is able to improve both colour and texture of scars and only requires topical anaesthesia as in is not painful. More recently a fractionated laser has been used successfully on acne scars. It creates microscopic holes in the dermis, causing the surrounding healthy cells to heal the scar wound. This type of laser is also found in beauty salons but the cost is comparable as this method does require repeat visits.
- CO2 Lasers - the oldest and original form of laser used for scar removal "blasts" away the surface layers to reveal smooth skin underneath.
- Erbium Lasers - similar to CO2 lasers, these are more precise and able to remove thinner layers of skin.
- Pulsed-dye Lasers - improve both colour and texture and are used to treat Keloid and Hypertrophic scars.
- Fractionated Lasers - pierce the dermis with holes to encourage re-growth of healthy skin. They are most often used to treat Atrophic scars.
The procedure involves going for an initial consultation to see if you are a suitable candidate for laser scar removal. They will take into consideration the type and size of scar, as well as your skin colour. From this they will be able to recommend the best course of treatment. Most laser scar removal procedures are successful after the first session, but if you wish to treat Atrophic scars caused by acne you will need numerous sessions over a period of weeks or months. Deep scars from a trauma that have damaged skin on all three layers may also require multiple treatments to remove them.
The speed of recovery depends on the type of laser used, individual skin characteristics, and how well the patient follows the after care instructions. Although most people can return to school or work the following day, skin regeneration will usually take a minimum of four days to start. The side effects of laser scar removal can be limited by carefully following any after care instructions given by the clinic. The area should be washed gently with a mild soap then covered in antibiotic ointment and a non-stick bandage. A cold mask could be used for pain relief. If these instructions are not followed, the wound could become infected. Other risks include hyperpigmentation (dark spots) or hypopigmentation (white spots) appearing on the surface of the skin. While these are usually temporary conditions that gradually fade over the next few months, they could be permanent.
Generally speaking, people with fair skin are better candidates for all types of laser scar removal; however dark skinned people are now able to have laser treatment for atrophic scars resulting from acne. As current technology stands, people with darker skin are unfortunately still unsuitable candidates for removal of Keltoid scarring. A consultation with a reputable clinic will inform you as to whether of not your individual condition would benefit from laser scar removal.
For those who are unable to have laser treatment, there are other options for scar removal. Many beauty salons and clinics offer such treatments as microdermabrasion, chemical peels, and collagen injections. Even pharmacies and chemists sell over-the-counter creams and gels that claim to fade scars. That being said, dermatologists recommend laser treatment as the only option for severe scars that are long, wide, or in prominent areas.
- Microdermabrasion - the removal of the top layer of skin to reduce the appearance of fine lines or wrinkles. This is often done in beauty salons and requires multiple visits.
- Chemical Peels - similar to the concept of microdermabrasion, chemical mixtures are applied to the surface of the skin to remove the top layer.
- Collagen Injections - this method repairs the skin from the inside out, not by encouraging the production of collagen but by replacing the damaged or non existent collagen.
There is no way to estimate the fees before a consultation as the health care practitioner must first perform an examination to determine the specific type of scar tissue that is the issue. Cost also factors in the anaesthesia, facility and physician fees which can range depending on the experience and reputation of the clinic. Although laser scar removal is not normally covered under insurance, many clinics do offer financial payment plans.
The removal of unwanted scars can be a life-altering change but depending on the procedure, it can be costly and painful with serious side effects. It should also be noted that major scarring will probably not be erased entirely but made to appear less visible. A consultation with a reputable clinic is the first step to determining if you are a suitable candidate for laser scar removal.