Erbium Laser for White Scarring Caused by Co2 Laser Resurfacing?

Question

Can Erbium Laser Be Used for White Scarring Caused by Co2 Laser Resurfacing

Brent Moelleken, MD · Answer

No laser restores pigment cells into an area depigmented by aggressive laser resurfacing.

	However, erbium fractional resurfacing can blunt the transition from the face to the neck, or if the laser was done patchwork (usually mouth and eyes), fractional laser resurfacing around this area tends to blend things in better.

	It is unwise, for many reasons, to perform aggressive CO2 laser resurfacing ablatively in the face:  whiteness, waxiness, atrophic skin, etc. etc.

William Ting, MD · Answer

There is a reason why traditional CO2 laser resurfacing is no longer popular due to extended downtime and the risk of hypopigmentation (which is a semi-permanent loss of pigment) in certain treated area. Fractional CO2 laser resurfacing is now the new standard of care for acne scarring, reversal of sun damage and rejuvenation for fair skin individuals. Further ablative laser treatment such as Erbium laser may not be helpful for treatment-induced hypopigmentation.

Ron Shelton, MD · Answer

Whether there was a fully ablative or fractional (Fraxel Repair) ablative treatment, some cases of hypopigmentation have been caused by these lasers, delayed as much as one year in onset with the Fraxel Repair. There have been a few reports of laser improvement with repigmentation of the hypopigmentation in surgical scars with the use of Fraxel but more investigation needs to be done. If the hypopigmentation is very bothersome to you, it might be worth a test spot (in the most remote area) with the Fraxel Restore to see if it helps.

	There are ultraviolet lasers for psoriasis and vitiligo but I am concerned about the long term effects of this laser, especially for an aesthetic condition, in case, along with your own sun exposure history, there may be a contributory effect to developing skin cancer later in life.

Darryl J. Blinski, MD · Answer

No in fact I feel it os contra indicated in this issue of hypopigmentation. From MIAMI Dr. Darryl J. Blinski

Steven Wallach, MD · Answer

If you have hypopigmentation from laser resurfacing using a CO2 laser, an Erbium laser which also performs ablative resurfacing wil not improve the color.

Paul Carniol, MD · Answer

This question cannot be answered generically.

It would require a full history of how and when these scars developed.  How you have been treating them etc.

The brief answer, in general which may or may not apply to your problem is for a hypopigmented scar is that before considering other treatments which may be effective you should give this scar adequate time to mature.

Depending on multiple details treatment could vary between none to vascular, nonablative or fractionated lasertechnologies.  Furthermore some scars may repsond to other local therapy

Erbium Laser for White Scarring Caused by Co2 Laser Resurfacing?

Answers (6)

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