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Thoughts on Scar by Dr. Ashish Bhatia, MD, FAAD
December 2019

Tremendous progress has been made in the use of lasers for the treatment of traumatic scars and contractures. My partner Dr. Jeffrey Hsu and I presented some of our early work on improving the appearance, texture, and pliability of scars with fractional CO2 laser in early 2012.

Other groups have further demonstrated the ability of lasers to restore structure, cosmetic appearance, and function after traumatic scarring. Some findings include the following:

  • Wounded soldiers in our armed forces with scars that resulted from devastating injuries regained significant range of motion and function with laser treatment.
  • A series of five treatments spaced 4 weeks apart using the 1550 nm Fraxel Restore laser in patients with third- and fourth- degree burns demonstrated improvement in skin texture (90% of patients), in discoloration (80% of patients), and in hypertrophy/atrophy (80% of patients) at 3 months after the final treatment. Patients reported moderate to excellent improvement in burn scar areas and significant improvements in self-esteem.

The take-home message from this body of work is that scars, whether traumatic scars, burn scars, or scars from other causes, can be significantly improved in both cosmetic appearance and function by repeated treatments with fractional CO2 lasers.

Furthermore, specific cosmetic issues, such as erythema and the appearance of small blood vessles (telangiectasias), can be targeted using lasers of appropriate wavelengths, such as the pulsed dye laser or intense pulsed-light devices. Repeated treatments are necessary to achieve significant outcomes.

It is wonderful to have the opportunity to change people’s lives by improving their health and function with innovative use of current tools and with discovery of new tools.