Scars come in all shapes and sizes. Lasers are particularly good at improving red scars, in which they will remove the red color as well as helping to improve the texture of the scar significantly. Keloids, are large thick scars that extend beyond the boundaries of the original wound, and hypertrophic scars are their somewhat smaller cousins. Keloids and hypertrophic scars are often best treated by injecting steroid medicines into them at monthly intervals. This will shrink them considerably, although the first few injections may not make much of a difference, sticking with the monthly injections can lead to dramatic flattening of raised scars.
Once a keloid or hypertrophic scar has been injected enough times to cause it to flatten out, there may often be more redness than was present originally, but not to worry, lasers are extremely effective at removing the unwanted redness and will also improve the texture of the scar. One should be very cautious in proceeding with surgical removal or revision of a keloid, since very large keloids often result from removing smaller ones surgically. I prefer steroid injections followed by laser treatments in the majority of cases.
Scars, often in addition to being red, will have increased brown pigmentation (hyperpigmentation) along the line of the scar. The reason this happens is unclear, but in some way the inflammation that causes a wound to heal will also cause increased pigmentation or brown discoloration of the surface of the skin. To treat brown-colored scars I often prescribe topical creams to lighten this discoloration prior to, or during, a series of laser treatments. Red scars respond extremely well to the vascular lasers, which remove redness and improve texture remarkably well. If further textural improvement is desired after removing all or most of the redness in a scar, I will switch to a different type of laser, the fractionated lasers (the Fraxel Dual is the best known) to further improve the texture of a scar. Acne scarring on the face and elsewhere responds very well to laser treatments, and often a combination of lasers are used to treat acne scarring. The Fraxel Dual is a mainstay of treatment for improving acne scars.
To answer your specific questions or schedule a consultation, call Dr. Bernstein today at 610-645-5551.
Dr. Bernstein was the FIRST physician in the WORLD to get the Candela V-Beam/Perfecta laser and has published extensively on its use for the treatment of rosacea, spider veins, port-wine stains, scars, and facial rejuvenation.
Dr. Bernstein performed a research study for Solta, makers of the Fraxel Dual, to further knowledge of this innovative treatment. The Fraxel Dual is one of Dr. Bernstein’s leading treatments for photodamage and acne scarring, and is the market leader in fractionated or pixelated lasers.
Dr. Bernstein was the first physician in the United States to get the Fraxel Permea Clear and Brilliant to treat patients with wrinkles.