1540 Fractional Laser when predisposed to hypertrophic scarring?

Question

I am thinking of having 1540 Fractional Laser for treatment of sun spots and hormonal brown pigmentation on my face. I have had a lesion removed on my back which resulted in a hypertrophic scar and was wondering if this would be a risk factor in having laser treatment . I know there is risk if predisposed to keloid scarring but not sure if the same for hypertrophic. Thank you in advance. Kellie

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for acne scars depending on the depth of atrophy or hypertrophy. Acne scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of acne scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic acne scars and indented acne scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your acne scarring.
 
Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Jason Emer, MD · Answer

Fractional lasers work great for treating hypertrophic scarring, although any lasers can cause scars. I find that 1540 nm isnt nearly as good as the 1550 Fraxel Dual, Venus Viva or Skinfinity devices. I suggest you see an expert.  Best, Dr. Emer.

Jed H. Horowitz, MD, FACS · Answer

I think your skin tone and texture would improve with this treatment, although it is hard to determine without seeing you in person.  I would recommend you try the Clear and Brilliant by Solta. Little to no downtime afterwards, and the results are great! You will need a series of at least 3 treatments, spaced 2-4 weeks apart. Be well!#keloids  #fraxel  #fractionaldiolite

Larry S. Nichter, MD, MS, FACS · Answer

There is little to no risk, since you are not breaking the skin with this type of laser treatment. I would recommend you try the Clear and Brilliant by Solta. Little to no downtime afterwards, and the results are great! You will need a series of at least 3 treatments, spaced 4 weeks apart. Good luck to you#keloids   #fraxel   #fractionaldiolite

Ramon Peleaux, DDS, MD · Answer

You are correct in that if you have a tendency for keloid formation, you cannot have treatment with the 1540 Fractional Laser, however, there is no contraindication for it's use if you have hypertrophic scarring.  Please advise your practitioner of this tendency, however, as he/she will want to do a test spot to judge your skin's reaction and help determine the proper settings to use for you.

Hratch Karamanoukian, MD, FACS · Answer

Hypertrophic scars are on a spectrum of scarring with keloid formation being the most scarring where the scar goes over and beyond the area of injury. Seek treatment by someone who can reduce this effect. Dr Karamanoukian

1540 Fractional Laser when predisposed to hypertrophic scarring?

Answers (6)

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