Laser Acne Scar Treatment Options
Article by Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
Many different lasers can be used for the treatment of acne scars. In part this is because there are many different types of acne scars. It's also because there are many different laser manufacturers and types of lasers.
Generally speaking acne scars fall into two basic categories - textured (bumpy, icepick or indented) acne scars and pigmented (brown or red) acne scars. The type of lasers we use to improve textured acne scars include the Erbium Yag, Erbium Glass and Q-switched lasers. While the manufacturer name is important, the wavelength of light is more important and this is determined by the type of laser used (ie Erbium Yag), not the manufacturer name.
Erbium laser resurfacing is a commonly used treatment for textured acne scar treatments because it has the ability to remove (resurface) the outermost layers of the skin. The key concept behind Erbium laser resurfacing is to remove enough of the surface layer so as to get down near the base of the scars. When the skin tissue regenerates (after several days of redness and peeling), it comes back smoother and more pliable without the memory of the acne scars we are treating. It is difficult to get rid of textured acne scars completely, but with Erbium resurfacing we generally see improvement between 25% and 75%. The improvement in the acne scars depends on depth of scars, age of scars, and the number of laser acne scar treatments and the expectations would be set once we see the scars and evaluate the patient.
The type of lasers used for the treatment of pigmented acne scars depends on the type of pigmentation (red or brown). Pulsed dye lasers are typically used for lighter skinned individuals where the colored acne scars appear red in nature. For darker skin types and darker acne scars, we typically use q-switched lasers, the same type of lasers that are used to remove other pigment in the skin such as tattoos, freckles, age spots, etc. The Pulsed dye laser for red acne scars works by closing the small blood vessels (capillaries) that cause the redness and the q-switched lasers for dark acne scars work by heating up and breaking down the melanin (skin coloring) developed by the trauma of acne.