Keloid Scarring: Will Laser Therapy Help?

I have adult acne which has scarred my chin. Would laser therapy help remove the scars and also reduce the amount of eruptions?

Doctor Answers 4

Acne scarring on chin

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There are various options for acne scarring, but a proper assessment by your dermatologist is the critical first step. If you are still breaking out with new acne, this needs to be stopped with proper topical or oral medications. Once the acne is cleared up, various treatments can fade the leftover marks and scars, from chemical peels and microdermabrasion, to deeper procedures like subcision or laser resurfacing.

Toronto Dermatologic Surgeon

Acne scarring on the chin

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Keloids are possible but uncommon on the chin.  If you truly have raised firm scars that stick out above your skin, a true keloid, then aggressive laser treatment can worsen that by creating more keloids.  If your scarring is not truly a keloid, then a laser such as the Smoothbeam from Candela, can both help the scarring and shrink the sebaceous glands and decrease breakouts in the future.  In our office we do not perform this procedure in patients who truly are keloid formers as the risk to the patient outweighs the benefit.

Madeline Krauss, MD
Boston Dermatologic Surgeon

Acne Scarring Comes in Various Forms

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Unfortunately, your question does not specify the nature of your acne scars.  Acne scars come in a variety of types, each of which carries a particular treatment.  Scars can be raised, depressed, distensible or non-distensible.  A distensible scar is a depressed scar that improves when you pinch it. Raised scars can usually be improved with monthly injections of cortisone, which soften and shrink the scar tissue. Occasionally lasers can be of benefit for these, but results are not generally better than those achieved with cortisone injections.  

Depressed scars that are distensible (improve  when you pinch them) are easily treated with injections of fillers, my favorite for acne scars being Artesense (Artefill).  Depressed scars that are not distensible are the most difficult to treat and a variety of treatments, including laser, chemical peeling, and subcision are common treatments for these.  I personally find that, in many cases, the role of lasers is limited for such scarring.  However, in some cases, the results can be dramatic.  To achieve the best outcome, you should consult a Dermatologist with extensive experience in treating acne scars, before deciding on a treatment that you might have read about.

Sheldon V. Pollack, M.D.

Toronto Cosmetic Skin Surgery Centre, Inc

Sheldon Pollack, MD
Toronto Dermatologic Surgeon

Keloid scarring

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Lasers do not tend to do well with hypertrophic/keloid type scarring.  Cortisone injections should be considered for this kind of thickened scarring.  Certain lasers can be used to improve the discoloration of a thickened scar or help to even out skin textural changes and depressed acne scars.  My opinion at this time is that prescription treatment of acne is generally more effective than laser treatment for acne.

Bryan K. Chen, MD
San Diego Dermatologist

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.