Can I Use Fraxel for New Scars?

Fraxel lasers promote the synthesis of new collagen fibers that are present throughout your skin. The difference between these fibers and the scar tissue is simply how they are arranged. These lasers work by allowing your skin to produce the normal collagen fibers that help to "fade out" the scars. There are different Fraxel systems (e.g. Repair, Restore, Dual and Refine). The choice to go with one or another has to do with the issue, and the individual characteristics of your skin (like skin tone etc.) But of course, it is important to discuss this with your doctor. 

The variety of Fraxel lasers (such as the Re:Store, Dual, and Re:Pair) along with the other fractional resurfacing lasers (such as the Palomar Artisan, ActiveFX and others) are wonderful tools in the strategy to minimize scarring, whether these scars are old or new.

Although there are treatments for scars of all ages, I believe getting to scars earlier than later can be of benefit in many cases, as I feel we can affect the way new collagen and scars form in a positive way.  In fact, when I perform Mohs micrographic surgery for the treatment of skin cancer, I will often employ a variety of lasers to reduce any scar appearance during the initial routine follow-up visits.  Of course, each situation is different and must be individually evaluated.  However, if scars begin to show evidence of uneven textures (either thickening or thinning), the use of ablative (i.e. superficially wounding) fractional lasers (such as the Fraxel Re:Pair) in the near term (i.e. first 1-2 months) can be very valuable.  When the developing scars show evidence of just slight uneven texture, the non-ablative (non-wounding) fractional resurfacing lasers are often valuable.  If scar redness is prominent, the pulsed dye laser (such as the Candela VBeam laser) can also be integrated at the same time.  When broken blood vessels become evident, other vascular lasers can be employed to augment the pulsed dye laser therapy, such as the Gemini laser.  These lasers, in combination with injecting a variety of medications can also help minimize the appearance of scars.  I will often consider injecting steroids (such as Kenalog) and 5 fluorouracil depending on the situation.

I realize there is a lot of information out there, but the good news is that scars can be markedly improved and its valuable to consider the entire arsenal of tools out there and even a combination approach.  To summarize the question that prompted this discussion: yes, Fraxel lasers are a very valuable component in the treatment of new scars, but consider all the options and combination therapies that are available.

Sincerely,

Robert Anolik, MD

I use two laser systems to optimize the appearance of newly healing scars.  For scars that are thick and red, I prefer using the pulsed dye laser possibly in combination with injection of steroids into the scar.  This combination reduces the redness and thickness components of the scar.  If the scar is relatively flat, I can use the Fraxel laser system to improve the texture and overall appearance of the scar.  In some instances, I may ultimately use both systems.