Lasers deemed highly effective treatment for excessive scars

November 27, 2013

Current laser therapy approaches are effective for treating excessive scars resulting from abnormal wound healing, concludes a special topic paper in the December issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

The review by Dr. Qingfeng Li and colleagues of Shanghai Ninth People's Hospital in Shanghai, China, provides strong support for laser treatment of hypertrophic scars—but less so for another type of abnormal scars called keloids. The authors highlight the need for further research in this and other key areas, including the benefits of different types of lasers and the results of laser treatment for scarring in patients with darker skin.

Seventy Percent Success Rates with Laser Treatment for Excessive Scars…

Dr. Li and coauthors identified and analyzed previous studies of laser treatment for abnormal scarring. They found 28 well-designed clinical trials using various medical lasers for two types of excessive scarring: hypertrophic scarring and keloids. Both are abnormal tissue responses that lead to raised and thickened areas of scarring, resulting in cosmetic and sometimes functional problems.

Hypertrophic scars are limited to the initially injured area. Keloids—which are more common in dark-skinned individuals—can spread beyond the area of the initial wound. Most of the studies evaluated the effects of for hypertrophic scarring; just three reports focused exclusively on keloids.

Data from more than 900 patients showed high success rates with laser treatment: about 70 percent for both hypertrophic scarring and keloids. Based on studies targeting scars that were less than one month old, laser therapy had a similar success rate in prevention of excessive scarring.

The responses appeared best with two specific lasers: the 585/595 nm pulsed-dye laser (PDL) and the 532 nm laser. (The figures in nanometers [nm] indicate the wavelength of the laser light used.) About two-thirds of the studies reviewed examined the 585/595 nm PDL; just three studies evaluated the 532 nm laser.

Some studies provided data on objective responses to laser treatment, reporting improvements on standard rating scales and measures of scar height and redness. Data from the PDL studies suggested that the best interval for repeated laser treatments was five to six weeks; PDL treatment appeared most effective in patients with fairer skin types.

More Research Needed on Darker Skin, different Laser Types

Plastic surgeons are the main surgical specialists involved in the treatment of excessive scarring. Several different treatment approaches are used, but there is little guidance from evidence-based research. Modern lasers used for treatment of excessive scarring are "nonablative": they work by coagulating deep tissues. Compared to older lasers, which worked by destroying abnormal scar tissue at the skin surface, modern nonablative lasers provide more consistent results with a lower risk that excessive scarring will return.

Dr. Li and colleagues hope their review will provide with a useful update on the evidence for laser therapy for excessive scarring. The results strongly support the effectiveness of the 585/595 nm PDL in patients with lighter skin types. The researchers emphasize the need for further studies of in dark-skinned patients, who are more prone to complications of therapy. They also highlight the need for better evidence on the effectiveness of lasers for treating keloids.

Explore further: Novel approach found for treating hypertrophic scars

Related Stories

Novel approach found for treating hypertrophic scars

March 27, 2013
(HealthDay)—Same-session therapy with fractional ablative laser treatment followed immediately with topical application of triamcinolone acetonide suspension is effective in treating patients with hypertrophic and restrictive ...

Treatment interval doesn't affect benefit of acne laser Tx

October 19, 2013
(HealthDay)—Fractional CO2 laser treatment is safe and seems effective for atrophic acne scars, with no difference observed for treatment with a one- or three-month interval, according to a study published online Sept. ...

Ablative carbon dioxide laser effective for rhinophyma

October 17, 2013
(HealthDay)—Good cosmetic outcomes are possible using fractionated ablative carbon dioxide laser therapy for mild-to-moderate cases of rhinophyma, according to research published online Oct. 5 in Lasers in Surgery and Medicine.

African-Americans 7 times more likely to have keloid scarring of the head, neck

March 6, 2012
African Americans are seven times more likely than Caucasians to develop an excessive growth of thick, irregularly shaped and raised scarring on their skin – known as a keloid – following head and neck surgery, ...

Fat grafting helps patients with scarring problems, reports

September 25, 2013
Millions of people with scars suffer from pain, discomfort, and inability to perform regular activities. Some may have to revert to addicting pain medicine to get rid of their ailments. Now, and with a new methodology, such ...

New targeted therapy to treat facial lesions

November 8, 2013
Research conducted by Roy G. Geronemus, M.D. and Yoon-Soo Cindy Bae-Harboe, M.D., was selected as Editor's Choice for the November 2013 issue of Lasers in Surgery and Medicine (LSM).

Recommended for you

Is a common shoulder surgery useless?

November 21, 2017
(HealthDay)—New research casts doubt on the true effectiveness of a common type of surgery used to ease shoulder pain.

Study shows electric bandages can fight biofilm infection, antimicrobial resistance

November 6, 2017
Researchers at The Ohio State University Wexner Medical Center have shown - for the first time - that special bandages using weak electric fields to disrupt bacterial biofilm infection can prevent infections, combat antibiotic ...

Obesity increases incidence, severity, costs of knee dislocations

November 3, 2017
A new study of more than 19,000 knee dislocation cases in the U.S. between 2000 and 2012 provides a painful indication of how the nation's obesity epidemic is changing the risk, severity and cost of a traumatic injury.

Defining optimal opioid pain medication prescription length following surgery

September 27, 2017
A new study led by researchers at the Center for Surgery and Public Health at Brigham and Women's Hospital analyzed opioid prescription data from the Department of Defense Military Health System Data Repository, identifying ...

Is older blood OK to use in a transfusion?

September 27, 2017
(HealthDay)—Using older red blood cells to give transfusions to critically ill patients doesn't appear to affect their risk of dying, Australian researchers report.

One weight-loss surgery shows lasting results

September 21, 2017
(HealthDay)—Obesity surgery can have long-lasting effects on weight and the risk of developing type 2 diabetes and high blood pressure, a new study finds.

2 comments

Adjust slider to filter visible comments by rank

Display comments: newest first

dana_s_goldberg_9
not rated yet Dec 03, 2013
I am a plastic surgeon myself http://www.drdanamd.com , and there is actually much more people can do to improve Hypertrophic scars than they might think. I highly recommend silicone based scar creams to my patients all the time, and the results are fairly dramatic with the scar cream alone if used at the right time.
denniejones
not rated yet Dec 09, 2013
Laser treatments are one of the best ways to remove scars. Its advantage is that except for a very small percentage of people it does not cause any side effects. I work at Cosmedical Rejuvenation Clinic, Toronto and there we use laser treatments for hair removal, skin tightening and many more. There is still a long way to go for laser technology.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.