the one fear I have about laser treatment like Fraxel is the danger/risk/side effect of scarring. are laser scars avoidable?
How to Prevent Scars or Scarring from a Laser Treatment?
Doctor Answers 17
Scar Prevention - Choose the Right Physician
Lasers treatments are the most unregulated medical...
Lasers treatments are the most unregulated medical procedure performed today. Many medi-spas and skin clinics that offer laser treatments do not have an experienced medical doctor on site to evaluate the patient before the procedure and to be present to deal with any potential complications.
Ideally, laser treatments should be performed in a medical setting (not in the so-called medi-spas or skin clinics), such as the offices of a dermatologist or a plastic surgeon.
The nurses and aestheticians who actually perform the laser procedures should be under the supervision of a plastic surgeon or dermatologist who is physically present on site. Presently, less than 20% of laser treatments are performed in such a manner.
How to Prevent Scars from Laser Treatments-Choose a Competent Doctor
Complications or Laser Resurfacing such as scars are caused by:
- Too deep treatment
- Poor post resurfacing wound care
- Improper patient selection
- Poor patient compliance with post op wound care instructions
It is not the Laser that causes scars but how the laser is used and how well the patient follows post operative wound care instructions.
The best way to avoid scars after Laser Resurfacing is to:
- Find a very experienced doctor who has used laser resurfacing for many years with good results
- Fastidiously follow post operative instructions
- Find someone who uses Fractional Erbium Laser Resurfacing-CO2 lasers are more likely to cause scarring in my opinion
If proper depth of treatment is used the most common cause of scars is failure to cleanse and moisturize the skin after treatment.
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There are two simple rules to follow. Be treated with...
There are two simple rules to follow.
- Be treated with one of the newer fractional lasers.
- Remember that all lasers are high powered machines. Scars can and do occur when these technologies are used by inexperienced doctors - it is not the fault of the machine! Always make sure your doctor is board-certified and qualified to use the technologies in their offices.
Avoid scars from Laser Resurfacing
The risk for scarring from laser resurfacing treatments can be minimized by focusing on a few issues:
1. Make sure that you independently verify that the laser being suggested for your treatment is appropriate for your skin type. For example if you are African American and your physician suggest CO2 resurfacing, I would be worried. There are lots of lasers available but many should be limited to certain skin types.
2. Choose a physician that has done hundreds if not thousands of the procedures being proposed. Preferably one that has a specialty in lasers.
3. Ask lots of questions. Has the laser been used with your skin type commonly? What is the incidence of side effects? What are the most serious side effects that have been encountered? What is being done to minimize unintended side effects in the treatment?
Scarring from lasers
I have been asked to be an expert witness in multiple cases where a laser technician has burned and scarred a patient of theirs . The answer to your question is that every laser can scar a patient when used at settings that don't fit or in patients with certain circumstances that predispose to scarring. The key to avoiding this complication is to seek an experienced dermatologists office with years of experience with lasers including knowledge of the science behind the laser , safe protocols , good aftercare and the ability to adjust laser settings appropriately to get the optimal results while minimizing the risks.
Preventing scars fron Laser treatments
The most important factor in preventing scars from laser treatments is checking out the qualifaications of your Physician. Board Certification in Cosmetic procedures is essentinal. Both Dermatology and Plastic surgery meet this reqirement. Next, How many procedures have they done? a minimun of 500 is a good place to start. Prophylactic treatment with an an Anti Herpes medication and an antibiotic are essential. Patients with dark eyes and/or easy tanning should be placed on skin exfoliaters, 6% Hydroquinone and Sunscreen SPF 60 or higher for at least 3 weeks prior to the procedure to prevent long term increases in pigment. I give my patients a multi page document of possible problems and my home and cell phone numbers so that they can reach me if they have any concerns. Scars can be prevented if infections do occur by prompt, (less than 12 hours) intervention
Have Laser Treatments with experienced credentialled practitioners
Laser is simply a monophasic beam of light. The theory is that each laser wavelength targets a specific part of the tissue. In hair removal, the wavelength chosen is absorbed greatest by black color in the follicles, whereas wrinkle reducing lasers target the water chromophore and cause energy absorption and tightening.
Experience with your skin complexion is most important in seeking a physician to perform laser treatments. I see patients regularly with laser complications. When you delve into their history, time and time again, the patients report going to an inexperienced or non-credentialled practitioner.
Erbium over CO2 laser
The best prevention of scarring as a result of laser resurfacing is to choose erbium over CO2. CO2 coagulates tissue, creating char and heat sink effect, which can cause deep second or third degree burns. Permanent hypertrophic scarring can result. Erbium laser, on the other hand, does not coagulate bleeding therefore the operating surgeon is forced to stay in the superficial capillary dermis.
Clinical effect achieved with erbium laser is equal or greater, in my experience, to that of CO2 laser. Patients don't have lifestyle changes or the waxy pigmentation that is often seen with CO2.
Prevent Scars or Scarring from a Laser Treatment
In the hands of an expert and experienced treating physician, scars from laser are avoidable with proper planning, the correct choice of laser, and proper patient selection.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.