Scars and Lasers

Scars and Lasers
May 5, 2020 Dr. Tali Arviv, MD

Scars and Lasers

By: Tali Arviv, MD

One of the most difficult conditions to treat yet the most rewarding is scars. Scars come in all shapes, sizes, and forms. Patients often come to improve scars from acne, chickenpox, accidents, bites, on the face, and on the body. It is extremely important for patients to improve the appearance of scars because it affects their self-esteem, especially if they are on the face. When I have the opportunity to treat patients with scars, it is a very rewarding experience. Fractional CO2 is the best treatment for scars in patients who are Fitzpatrick skin type I-IV. In most cases, it requires multiple treatments but up to 30% improvement with each treatment can be seen. 

Prior to 2004, CO2 lasers were resurfacing 100% of the skin, this was a high-risk procedure with many potential side effects including infections, hypo and hyper-pigmentation, and prolonged healing process lasting weeks. However, after 2004 when fractional lasers were introduced the treatment of skin resurfacing became safer with less side effects and it even cut healing time to less than 1 week. Fractional means we are only resurfacing a fraction, a percentage of the skin, usually 20-50% of the skin is ablated using multiple small laser points that penetrate each square inch leaving healthy skin in between. The healthy skin left behind allows it to heal faster and protects it from infections. The laser breaks down the scar tissue and stimulates collagen-producing improving the texture of the skin. 

The controlled thermal destruction of this laser allows us to treat different types of scars. For example, with acne scars, we are contracting the skin, which shrinks the scar, but also building collagen which builds more volume at the base of the scar so it is not as deep. At the same time, we have surgical scars that are too contracted resulting in restriction of movement or even pain. We had a patient who underwent surgery for skin reduction of her upper arms. The scar left behind restricted her from lifting her arm all the way up. We did a CO2 treatment for her scar. The destruction of the scar tissue and reorganization of the collagen resulted in increased mobility for the patient. This prevented her from having to go back for a revision. Seeing the progress patients make with CO2 and their skin is extremely rewarding for both the patient and the provider. 
If you have a scar or scars that you have been wanting to treat, contact a provider with experience and a Fractional CO2 laser. 

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