Thursday, October 21, 2021

Efficacy, Before & Afters, Cost

  • Laser skin resurfacing uses pulses of laser light to reduce the appearance of acne scars either by removing damaged tissue or encouraging collagen growth
  • Depending on the type of laser used, it can effectively treat either atrophic or hypertrophic acne scars
  • The cost of a procedure ranges from $200–$3,000 depending on the type of scarring and the size of the treatment area.

Laser skin resurfacing is a cosmetic procedure that uses high-frequency pulses of laser light to smooth the appearance of facial skin. Laser skin resurfacing for acne scars targets and destroys scar tissue and stimulates collagen production, resulting in regenerated skin that is smoother and more even in texture.

Can Laser Skin Resurfacing Treat Acne Scars?

Acne scars form as the result of tissue loss (atrophic scars) or excess collagen production (hypertrophic scars) following a breakout. Laser skin resurfacing treatments are effective in reducing the appearance of both types of scars, however some types of laser treatments are better suited to treating specific scars.

The two primary types of laser treatments are ablative and nonablative. Ablative lasers function by removing the surface skin, while the latter penetrate directly to deeper tissues, leaving the surface skin unharmed.

There are four main types of acne scarring:

  • Boxcar scars are shallow atrophic (or depressed) scars with sharp, defined edges that commonly form on the cheeks and jaw
  • Rolling scars are wide atrophic scars characterized by sloped edges that give the skin a bumpy, uneven appearance
  • Ice pick scars are small, narrow atrophic scars that run deep below the surface skin, and are some of the most difficult to treat
  • Hypertrophic or keloid scars appear raised and red in color; they often develop on the body rather than the face, and are common among those with darker skin.

Ablative treatments

Ablative lasers such as CO2 or erbium lasers function by burning away the surface skin. This smooths the uneven surface of scarred areas and stimulates collagen production, which fills out depressions and leaves the skin appearing more even-textured.

These laser procedures are particularly effective in treating shallow atrophic scars such as boxcar scars. However, they are not an appropriate treatment for hypertrophic rolling and ice pick scars as the collagen production they stimulate can worsen the appearance of these scars.

Since ablative lasers function by removing surface skin, they are more invasive than other forms of treatment and require longer recovery periods.

Nonablative treatments

Nonablative lasers such as pulsed dye lasers do not remove the outer layers of skin. Instead, they directly stimulate the production of collagen within deeper tissues, which accelerates the rate at which scar tissue is re-formed.

Pulsed dye lasers are an effective treatment for hypertrophic scars as they can smooth their appearance, reduce redness and increase the pliability of scar tissue.

Candidates

Laser resurfacing is an appropriate acne scar treatment for most individuals, however gentler treatments are usually advised for those who are prone to scarring. Their skin may be unable to recover from temporary damage caused by the laser, leading to further scarring.

Anyone with active breakouts should avoid these treatments, as inflammation could worsen. Those with dark skin should also avoid laser treatments, as they are at a high risk of developing hyperpigmentation as a side effect.

What to Expect During Treatment

It is important to choose an experienced professional to perform this procedure; laser light can burn the skin and cause permanent scarring if used incorrectly.

Before beginning this procedure, the provider will place a protective covering over your eyes. They will then administer local anaesthetic to the treatment area to numb the skin.

During the procedure, you will be in a supine position. The provider will use a small handheld device to administer the laser pulses to the treatment area. They will gradually move this device over your skin, targeting a small area for a few seconds at a time before moving on. A full treatment can take up to two hours.

It is normal to feel a warm tingling sensation in the skin during the procedure. If an ablative laser is used, you may also feel stinging or discomfort.

Recovery time

Depending on the type of laser used, it can take up to 2 weeks for the skin to fully recover following treatment; for smaller, less invasive procedures, recovery can be as brief as 3 days. However, downtime is typically not needed, and most patients are usually fit to resume their usual activities the next day or just a few days after treatment.

After a procedure, the treated area will have some redness, much like a sunburn. You may also notice some skin peeling or bruising. You’ll need to limit your sun exposure for 6–8 weeks following treatment to allow time for your skin to fully heal. Be certain to apply a high SPF sunscreen when spending time outdoors during this time.

Residual redness may take 1–2 weeks to fade completely. Once this clears, the results of a treatment will become fully visible. If you notice persistent swelling or the formation of pus these are signs of infections, and you should see a doctor.

Results and Reviews

Most patients are satisfied with their results following laser skin resurfacing treatments. Almost all report feeling some discomfort during and following the procedure, but see a noticeable improvement in their skin’s appearance and texture.

Only one treatment is typically needed for noticeable and permanent improvements to appear. Multiple sessions, however, are usually required for more dramatic results, to treat large areas or to clear deeper types of acne scarring such as rolling and ice pick scars.

Before and Afters

Cost

The cost of laser skin resurfacing procedures varies greatly depending on a number of factors: The type of laser used, the size of the treatment area and the experience level of the provider. These all play a role in determining the price of a session.

Removing a single scar can cost as little as $200, while more elaborate treatments may cost as much as $3,000.

At-Home Laser Skin Resurfacing Treatments

Portable treatment kits designed to mimic professional laser resurfacing procedures are commercially available, and can be used at home. However, these devices are significantly less powerful than their in-office counterparts. As such, they are unlikely to effectively treat acne scars.

Takeaway

Laser skin resurfacing procedures are a common and effective treatment method for acne scars of all kinds. Their efficacy will depend on a number of factors including the type of laser used, and the type of scar being treated.

The types of lasers used in resurfacing treatments are ablative or nonablative; ablative lasers work by removing the surface skin, while nonablative lasers penetrate directly to deeper tissues. 

Boxcar scars can be effectively addressed with ablative laser treatments, while nonablative laser procedures can treat hypertrophic scarring. Rolling and ice pick scars are more resistant to treatment, but will gradually improve with multiple sessions.

Most people can safely undergo laser acne scar removal procedures. Side effects are common but generally mild, and include redness, dryness, peeling, irritation and sometimes bruising. Those who have darker skin, are prone to scarring or are experiencing active breakouts should avoid laser resurfacing treatments, as they face a higher risk of side effects.

Sources

  • Khatri KA, Mahoney DL, McCartney MJ. Laser scar revision: A review. J Cosmet Laser Ther. 2011 Apr;13(2):54-62. doi:10.3109/14764172.2011.564625
  • Al Harithy, R. & Pon, K. Scar Treatment with Lasers: A Review and Update. Curr Derm Rep (2012) 1: 69. https://doi.org/10.1007/s13671-012-0009-7
  • Xiao A, Ettefagh L. Laser Revision Of Scars. [Updated 2020 Sep 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539686/
  • Kono T, Erçöçen AR, Nakazawa H, Nozaki M. Treatment of hypertrophic scars using a long-pulsed dye laser with cryogen-spray cooling. Ann Plast Surg. 2005 May;54(5):487-93. doi:10.1097/01.sap.0000155276.93061.93
  • Batra RS, Jacob CI, Hobbs L, Arndt KA, Dover JS. A Prospective Survey of Patient Experiences After Laser Skin Resurfacing: Results From 2½ Years of Follow-up. Arch Dermatol. 2003;139(10):1295–1299. doi:10.1001/archderm.139.10.1295
  • Hession MT, Markova A, Graber EM. A review of hand-held, home-use cosmetic laser and light devices. Dermatol Surg. 2015 Mar;41(3):307-20. doi:10.1097/DSS.0000000000000283

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