Best Laser Treatment for Hyperpigmented Scars?

Question

I have tan-colored hyperpigmented scars from a surgery done many years ago. What would be the best scar laser treatment to fade them?

Raffy Karamanoukian, MD, FACS · Answer

Hyperpigmented scars can be improved by combining laser and cream modalities, including Melarase AM and Melarase PM first, then performing laser treatment.

Harold J. Kaplan, MD · Answer

Hi Fairlady,
Below are a few options in order of complexity and cost.

Hydroquinone Bleacing agents.
Q-switched Nd:Yg lasers. These are the same ones used for tattoos, sun spots, birthmarks, etc and are a much better option than the fractionated and pulsed dye suggestions. Fractionated Erbium and CO2 are designed for textural issues, wrinkles, acne scars, etc. not pigment.
Surgical Revision.

Go to a few consultations as you will have differing opinions regarding which treatment will work best for you based on your condition.

Hratch Karamanoukian, MD, FACS · Answer

Melarase AM and Melarase PM are excellent topical creams to reduce hyperpigmentation. I also recommend a broad spectrum high SPF (50+) sunblock to prevent ongoing damage. Spectrase is available from VenaSmart.H Karamanoukian MD FACS

Carlos Cordoba, MD · Answer

A simple surgical solution is scar revision for this mature hyperpigmented scar.

	Follow the post operative recommendations very closely.

	 

	Dr. Carlos Cordoba
	MDCM, CSPQ, FRCS, FACS
	Plastic & Esthetic Surgeon
	4055 Ste-Catherine O. Suite 100
	Montreal, QC. Canada H3Z 3J8
	514-932-7667

Peter A. Aldea, MD · Answer

I totally agree with Dr. Di Saia. Before embarking on expensive treatments which may not work, it is always best to try the simple options first and proceed with more complicated and expensive ones later.
No reason why you could not try Pro-fractionated resurfacing (see Sciton Joule, for example) AFTER an attempt at scar revision.
Dr. P. Aldea

John P. Di Saia, MD · Answer

Hello,
I have seen people who came after having spent thousands on laser treatments who are improved by relatively simple scar revision surgery. Be careful you look into all options and get good advice before you choose a treatment path.

W. Tracy Hankins, MD · Answer

Either a nd-Yag pulsed dye laser or a fractional laser (erbium or Co2) should help hyper-pigmented scars. We have been obtaining excellent results by combining the Echo 2 co2 laser and the Spectra laser form Lutronic.

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