I have several flat straight-line white scars on my thighs from glass shattering in an accident 10 years ago & have olive skin tone. Will laser help? I have been told an ablative or CO2 laser may cause hyperpig w/ my skin tone. I have also been told nonablative & fractionated won't help. Should I do fractionated or non? Ablative or non? Erbium or CO2? Sciton, Fraxel, Palomar, Mixto or which other laser will work best? Can the scar shrink in width or ever get pigment? What are the dangers?
Best Laser for Flat, White Hypopigmented Scars from Glass Shattering on Lower & Upper Thigh on Olive Skin?
Doctor Answers 5
Laser to improve hypopigmented scars
There have been reports that fractional non-ablative laser, such as Fraxel Restore, can induce repigmentation in some scars. I have not been able to produce good results though, in some of my patients in whom we've attempted this. I avoid ablative lasers, fractional or non-fractional on the body as there is a higher risk of scarring. There is an excimer laser but i am concerned of risk of skin cancer developing years later from this device.
Fractionated lasers can help hypopigmented scars
Hypopigmented scars are felt by some to be caused by a thin sheet of scar tissue that sits like a plate in the upper levels of the skin. As a result the cells that make color (melanocytes) have a hard time getting back to the area to color the skin like before the trauma. By poking microscopic holes in it with a fractionated laser, some also feel that the cells can migrate back in and being to repopulate the area. Recently, at one of the scientific meetings, someone demonstrated the use of fractionated lasers with the eyelash growing medication Latisse. One of the side effects of Latisse is that it can color the skin. This is not a big deal on the eyelid margin because most women use mascara so the effect is welcome. The physician who presented the study demonstrated the improvement of hypopigmented scars with this combination. You may want to talk to a local laser expert about this approach.
Lasers for flat, hypopigmented scars
It is very difficult to help the skin repigment in a shallow (or deep) white scar.
In my experience, a fractionated CO2 Laser (3-4repeat treatments) may help, at least partially by allowing some migration of pigment producing cells and of pigment from the underlying hair follicles.
Make sure that you are being treated by a Board Certified Dermatologist or Plastic Surgeon with experience in this area.
P.S. Regarding Latisse: I was not at the meeting where the effect of Latisse was presented, but I heard about it. I would be affraid of using it anywhere for this purpopse except on a man's face, for fear that it may also stimulate hair growth.
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Hypopigmented scars are difficult
Hypopigmented scars are difficult to restore pigment in. We occasionally do see some improvement in pigmentation with the use of fractionated lasers. These might include Active FX CO2 or a fractionated Erbium laser. These lasers should be focused directly onto the scar and used at the proper settings to avoid any unwanted pigment change to the surrounding skin. It is also important to consider that it would likely take several treatments to achieve any significant changes.
Laser for small scars
Most scars respond to repeated gentle erbium-yag fractional resurfacing with a laser such as the Pixel.
It is important to design a treatment that is unlikely to hurt your existing pigment.
It is also important to discuss realistically what your expectations are from the procedure.
Fully ablative CO2 laser would likely be a mistake.