Scars are a common result of skin injury. While many fade, some become raised and discolored, impacting appearance and comfort. Laser treatment offers a sophisticated method to improve these prominent scars. This article focuses on hypertrophic scars and the science behind their laser-based improvement.
What Are Hypertrophic Scars?
Hypertrophic scars are raised scars confined to the original wound area. They appear red or pink, can be firm, and may cause itching or pain. These scars commonly form following burns, surgical incisions, or other skin trauma.
Their formation involves an imbalance in the natural wound healing process, with excessive collagen production within the wound boundary. Collagen, a protein that forms new skin, is laid down in a disorganized manner, leading to their raised and stiff appearance. Hypertrophic scars are distinct from keloid scars, which extend beyond the original injury site and rarely regress. Unlike keloids, hypertrophic scars stay within the original injury’s boundaries and may flatten over time, though often not completely without intervention.
The Science Behind Laser Treatment
Laser treatment for hypertrophic scars uses specific wavelengths of light to remodel scar tissue and reduce its visibility. Two primary types of lasers are employed, each with a distinct mechanism of action.
Vascular lasers, such as Pulsed Dye Lasers (PDL), target blood vessels within the scar. These lasers emit light absorbed by hemoglobin in red blood cells. This absorption causes selective heating and coagulation of microvessels, reducing blood flow and inflammation. By decreasing vascularity, PDL helps reduce scar redness and contributes to flattening.
Fractional lasers, including fractional CO2 and Erbium lasers, create microscopic columns of thermal injury in scar tissue while leaving surrounding areas untouched. This fractional approach stimulates the body’s natural healing response, promoting collagen remodeling and breaking down excess collagen. The controlled micro-injuries encourage new, healthier collagen production, improving the scar’s texture, flexibility, and overall appearance. Laser types are selected based on scar characteristics and desired outcome.
What to Expect During Treatment
Laser treatment for hypertrophic scars begins with an initial consultation to assess the scar and develop a personalized treatment plan. Before a session, patients are advised to avoid extensive sun exposure or tanning on the treatment area for several weeks, as tanned skin cannot be treated. It is also common to stop using skincare products containing retinol or glycolic acid, and certain medications or supplements that can slow healing, for 2 to 4 weeks prior to the procedure.
During a laser session, the skin is cleansed, and a topical anesthetic cream is applied to minimize discomfort. Patients may experience a sensation similar to a rubber band snapping against the skin during laser application. The duration of each session varies, usually 30 to 90 minutes, depending on the scar size. Most patients require multiple sessions, often two to five treatments, spaced several weeks apart to allow the skin to recover and for gradual improvement to occur.
Results and Recovery
Following laser treatment, immediate post-treatment effects can include mild redness and swelling in the treated area. Some individuals may also experience light bleeding, skin crusting, or temporary discoloration. These effects generally subside within a few days to a week.
Recovery typically ranges from 3 to 10 days for the skin to heal. Patients are advised to apply a cold pack to the treated area to reduce swelling, and to wash and moisturize the area daily. Sun protection is recommended for at least 4 to 6 weeks after treatment, using sunscreen with SPF 30+ and avoiding direct sun exposure. Over time, patients can expect to see a reduction in scar redness and itching, along with flattening and softening of the scar tissue. Overall scar texture and flexibility often improve, but results are gradual and can vary among individuals.