Best Laser for Flat, White Hypopigmented Scars from Glass Shattering on Lower & Upper Thigh on Olive Skin?

There have been reports that fractional non-ablative laser, such as Fraxel Restore, can induce repigmentation in some scars. I have not been able to produce good results though, in some of my patients in whom we've attempted this. I avoid ablative lasers, fractional or non-fractional on the body as there is a higher risk of scarring.  There is an excimer laser but i am concerned of risk of skin cancer developing years later from this device.

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Most scars respond to repeated gentle erbium-yag fractional resurfacing with a laser such as the Pixel.

It is important to design a treatment that is unlikely to hurt your existing pigment.

It is also important to discuss realistically what your expectations are from the procedure.

Fully ablative CO2 laser would likely be a mistake.

Hypopigmented scars are felt by some to be caused by a thin sheet of scar tissue that sits like a plate in the upper levels of the skin.  As a result the cells that make color (melanocytes) have a hard time getting back to the area to color the skin like before the trauma.  By poking microscopic holes in it with a fractionated laser, some also feel that the cells can migrate back in and being to repopulate the area.  Recently, at one of the scientific meetings, someone demonstrated the use of fractionated lasers with the eyelash growing medication Latisse.  One of the side effects of Latisse is that it can color the skin.  This is not a big deal on the eyelid margin because most women use mascara so the effect is welcome.  The physician who presented the study demonstrated the improvement of hypopigmented scars with this combination.  You may want to talk to a local laser expert about this approach.

Good luck.

Hypopigmented scars are difficult to restore pigment in.  We occasionally do see some improvement in pigmentation with the use of fractionated lasers.  These might include Active FX CO2 or a fractionated Erbium laser. These lasers should be focused directly onto the scar and used at the proper settings to avoid any unwanted pigment change to the surrounding skin.  It is also important to consider that it would likely take several treatments to achieve any significant changes.