There are many types of scarring and different severities of scars. It is an advanced aesthetic treatment to remove scars and is becoming increasing popular as a procedure to avoid surgery.
A scar is a mark or channel on the skin that is the result of a wound or an injury that has healed. The scar that is left after the injury or wound is part of the natural healing process of the body and will generally fade, become less visible or can completely heal over time depending on the severity.
A scar can be caused from a number of different reasons and conditions such as:
A scar can form on any part of the body and will vary dramatically in shape, size and appearance. The type of scar and the cause will often determine how the scar heals and the time it takes.
Scars range in appearance from barely noticeable to raised, red and discoloured. Scars can also leave pitting in the skin as well.
All scars, no matter what the cause, need to be kept clean and highly moisturised to aid the healing process.
Scars can either heal due to the natural healing process of the body or can be treated. There are a number of different treatment options that could be advised for scars such as:
Laser therapy can improve the appearance of scars by removing the surface of skin. It can also be used to stimulate collagen regrowth and help with pigmentation issues.
IPL Can be used to stimulate collagen regrowth and help with pigmentation. It should not be considered a stand-alone solution. IPL targets blood vessels which can help reduce redness associated with scars.
LED therapy is showing promising results as it is non-invasive and works by using light to stimulate skin repair and regeneration. LED light in the red spectrum promotes the production of collagen which is key for skin elasticity and repair. It can also reduce inflammation and accelerated healing.
Surgical scar revision is used to improve the appearance of the scar but is invasive and requires recovery time.
Other treatments for scarring include:
It is also very important when dealing with scars no matter what the treatment you chose to maintain good skin health to promote scar healing, this includes things such as:
A combination of treatments can also generally be the best option for scar revision.
Laser is popular for the treatment of scars and works by either stimulating collagen production or by resurfacing the skin. Lasers stimulate collagen by creating a controlled injury to skin to trigger the body’s natural healing response.
Laser energy is fired at the skin where it is absorbed by the water within the skin, this absorption creates heat which in turn causes microscopic damage to the skin. The body’s response to this is it perceives an injury and initiates healing. As part of the healing the body produces new collagen to repair the damaged tissue.
Laser scar removal pain is dependent on the type of laser used, the sensitivity of skin and the individual. Ablative lasers are more painful than other types of lasers as they removed the top layer of skin.
Ultimately, the benefits of laser scar removal often outweigh any temporary discomfort experienced during the procedure.
The type of laser used determines the depth of penetration and the level of heat generated.
Types of lasers used for scar revision include:
Can improve the appearance of scars including acne scars, surgical scars and burns scars
Can reduce:
The treatments are also very quick and can improve skin texture by stimulating collagen production to help smooth the skins surface
Laser can also
Laser scar revision is dependent upon the types of laser used and the depth of treatment needed.
Less aggressive lasers such as fraction lasers involve less downtime with redness and swelling subsiding within a few days.
More aggressive Co2 lasers require more healing time and can be often several days of redness, peeling and crusting.
Middle of road laser would be such as erbium yag laser.
The recovery period is affected by:
The length of treatment for scar is affected by:
Individually you will generally see improvements after one treatment but significant results can take multiple sessions.
The cost of laser treatment will vary dependent on:
Facial scars generally cheaper to treat due to less sessions and severity
Body scars often take longer to treat and can be larger
Cost of treatments can vary from a few hundred to a few thousand pounds
Laser scar revision is considered a safe treatment when performed by a qualified practitioner with experience. There are small risks associated with laser scar revision such as:
Correct recovery is essential to optimise results and minimise complications.
Immediate after treatment- Mild, fragrance-free cleanser to clean the area followed by a fragrance free moisturiser. Then applying sun protection.
During healing – use specific medications, dressing and skin care as advised and avoid irritants to skin. Remember to drink plenty and protect from the sun.
Long term – Sun protection is key to avoid further scarring and pigmentation issues. Keep hydrated and use gentle skincare avoiding irritants and harsh products.
Laser treatment is sometimes different for different scar types so we will look at specific laser treatments for specific scar types
Keloid scars - Often lasers are used in conjunction with other treatments for optimal results. Lasers reduce blood supply to the vessel that feeds the keloid helping to reduce size and growth. Lasers also break down excess scar tissue to flatten the keloid scar and finally reduce redness and pigmentation associated with a keloid scar.
Laser types used are often pulsed dye and fractional laser and is used in conjunction with corticosteroid injections, pressure therapy, silicone gel sheeting and possible surgical removal.
Keloid scars are very difficult to treat and often cannot be completely removed.
C-section scars – Laser is an effective way to improve the appearance of C-section scars. The laser will stimulate collagen production which helps to rebuild the skin. This leads to improvements with respect to:
As with other scars different types of lasers can be used including fractional, co2 and erbium lasers.
Remember to consider as with most scars results will vary depending on the age of the scar, skin type and scar severity. Multiple sessions will generally be needed.
Stretch marks – These are also a type of scar and occur when the skin stretchers. This causes underlying collagen and elastic fibres to tear. When the skin heals the results are indented lines which we call stretch marks and like other types of scars can fade over time but are unlikely to disappear on their own.
Stretch marks are very similar to keloid scars with laser treatments can lead to improvements with:
These are best treated with fractional lasers and pulsed dye lasers.
Atrophic scars – These are scars formed when the skin does not produce enough collagen during the healing process and the appearance is sunken and pitted.
Atrophic scars are caused from conditions like:
The different types of atrophic scars are
Ice pick- small, narrow and deep
Boxcar- Round or oval with sharp edges
Rolling scars – wavy and uneven
Again laser treatment is possible and very effective at treating atrophic scars and works by stimulating collagen and resurfacing the skin.
Most popular lasers used are:
Fractional Co2 – Considered the gold standard. It creates microscopic holes in the skin, triggering collagen production and skin renewal.
Fractional erbium:YAG – less aggressive but still effective for milder scars
Pulsed Dye lasers- used to treat the redness associated with the atrophic scars
Acne scars as mentioned are a type of atrophic scar and these can still be treated on dark skin but the best laser treatment requires careful consideration and a skilled laser technician.
Laser treatment can be effective for scar reduction in individuals with dark skin, but it requires careful consideration and a skilled practitioner. There is a high risk of hyperpigmentation on dark skin which are dark spots and certain types of lasers are better and the settings are very important and need to be kept as low as possible.
Fractional non-ablative lasers – Penetrate the skin without removing the outer layer so reducing the risk of hyperpigmentation. They stimulate collagen to improve the appearance of scars in dark skin.
Picosecond laser – These breakdown the pigment of the scar and can also help with the skin tone and texture
