Laser Treatment for Post-Acne Scar
Acne is a common condition which affects about 80% of the young population.1 Scarring is an unfortunate sequelae of acne.2 Post acne scars occur due to compromised collagen production during the natural wound healing process, which results in depressions.3 Acne and acne scarring can affect the quality of life, feeling of embarrassment and low self-esteem.2 Acne scar can be distinguished from other types as it occurs in the spot where a pimple was.4
Treatment Options: ̶
Acne scarring is permanent, but it can be treated. There are different kinds of treatments available depending on the kind of scarring present such as:
- Laser/light therapy
- Chemical peel2,5
- Surgical Excision and punch replacement graft
- Soft-tissue fillers
Laser therapy can improve the appearance of the scar.3 It reduces scar appearance and minimizes pain and itching from the old acne outbreaks by stimulating new, healthy skin growth.6 Although it cannot completely remove scars, it can make them less noticeable and cosmetically better in appearance. However, laser treatment is contraindicated if there is ̶
- Light sensitivity
- Active acne
- Skin sores/ Herpes
- Keloid or keloidal tendency
Different types of laser therapy
There are different types of lasers used for acne scarring. Each of these devices works in a specific way to target the scars.
- Ablative laser resurfacing: Uses an erbium YAG or carbon dioxide CO2 laser. Ablative facial resurfacing involves wounding the skin to the dermal level, thereby removing photodamaged areas of the epidermis. Dermal wound healing stimulates collagen production. Ultimately, ultrastructural remodeling results in rejuvenated skin. It can take 2-3days before the redness from ablative lasers begins to subside.
- Carbon Dioxide (C02) Fractional Laser Resurfacing removes layers of skin tissue in a fractionated method (columns of skin are removed, leaving the skin surrounding each column intact to aid in healing)
- Non-ablative laser resurfacing: Uses infrared lasers, it retains the skin's surface while affecting the layers underneath. The heat from these lasers stimulate collagen production and encourage new cell growth to replace damaged, scarred tissue.
How can laser treatment help with scars?
Laser therapy for acne scarring works in two ways.
- First, heat from the laser removes the top layer of skin where a scar has formed. Because when the top layer of scar peels off, the skin appears smoother, and the scar appearance becomes less noticeable.
- Second, when the scar tissue breaks apart, heat and light from the laser also encourage new, healthy skin cells to grow. Blood flow is drained to the area by the laser heat, and inflammation is reduced when blood vessels in the scar are targeted.
- Both works to decrease scar appearance by making them less raised and red. It also promotes skin healing.6
A dermatologist will review the patient's medical history and conduct a physical exam before the procedure. Here, one can discuss expectations, potential risks and outcomes of the procedure.
Patient's should also note:
- Since the procedure can trigger breakouts in at-risk individuals, any susceptibility to cold sores or fever blisters around the mouth should be discussed.
- Avoid medications or supplements that can affect the outcome of the procedure.
- Avoid smoking for two weeks before and after the procedure for better results.5
- Avoid products that contain glycolic acid or a retinoid for 2–4 weeks.
- Stay out of the sun and not expose the skin to ultraviolet (UV) light for extended periods as doctors may not be able to use laser therapy if a person has a tan or sunburn.
- Avoid using lotions, deodorants, perfumes, or any other products that could potentially interact with the laser treatment as skin should also be clean on the day of the procedure.
Before a person undergoes laser treatment, a doctor will examine the scar and mark the skin with a pen to identify the area for treatment. The treatment process may work:
- A thorough history and consent are taken.
- A technician or assistant will clean the area to be treated with antiseptic and topical anesthetic, which will help to numb the treatment area.
- If the scar is on the face, they may ask the person to wear protective goggles.
- The laser is passed over the scar tissue.
- After the treatment, the doctor will apply an antibiotic ointment or soothing lotion to cover the area.
- The treated area may remain red for several hours after the procedure.
- Applying moisturizing lotion and sunscreen is often recommended at least twice daily, and makeup should not be applied until the redness is there.
- After laser treatment post-treatment care is of utmost importance, follow your dermatologist's instructions for at-home care after laser treatment will help you see the best results and prevent possible side effects.
- Satisfactory results may take months to be noticed. A little improvement is seen at first.
There is some downtime of laser therapy to treat acne scars. The effects will vary according to the kind of laser, skin type, and the number of treatments needed.6 A doctor will discuss potential side effects and risks before performing the laser procedures.7 These include:
Since laser treatments for scars are cosmetic and elective procedures, they are not typically covered by insurance.8 Some doctors will also charge a consultation fee to take a look at the skin and recommend a treatment plan. 6
Also, one might need more than one laser treatment to get the desired results.8 The suggested number of overall treatments will affect the cost as well.7
A laser can seem like a magic wand that can make any scar disappear. Medical lasers, however, are no child's toy to play with. To get impressive results and avoid serious side effects, it is essential to know these basic facts before you have laser treatment for a scar.
1. Laser treatment cannot get rid of a scar. It makes a scar less noticeable.
2. Your results depend primarily on the skills of the person performing the laser treatment. A board-certified dermatologist can safely treat many types of scars with different lasers.
3. A medical consultation is crucial before any laser treatment. Hence, if someone promises to treat your scar before providing medical consultation, walk away.
Some acne scars fade over time but, for those who don't specific procedures might help. If a person is concerned about a scar's appearance, they can talk to their doctor about treatment options. The laser ideally allows new, healthier-looking skin to grow in place of scarred skin. Scar treatments can improve patients' quality of life.
- Gozali MV, Zhou B, Luo D, Effective Treatments of Atrophic Acne Scars, J Clin Aesthet Dermatol. 2015;8(5):33–40.
- Boen M, Jacob C, A Review and Update of Treatment Options Using the Acne Scar Classification System, Dermatol Surg. 2019;45:411–422.
- Keyal U, Huang X, Bhatta AK, Laser treatment for post-acne scars– A review, Nepal Journal of Medical Sciences. 2013;2(2):165-70.
- Acne Scars 101: A Complete Guide to Getting Smooth Skin Again, https://www.everydayhealth.com/acne/remove-acne-scars.aspx, last accessed on 12th October 2020.
- Laser Resurfacing for Acne Scars, https://www.asds.net/skin-experts/skin-treatments/laser-resurfacing/laser-resurfacing-for-acne-scars#:~:text=Ablative%20laser%20resurfacing%20is%20a,reveal%20newer%2C%20more%20youthful%20cells, last accessed on 12th October 2020.
- Everything You Want to Know about Laser Treatment for Acne Scars, https://www.healthline.com/health/beauty-skin-care/laser-treatment-for-acne-scars, last accessed on 12th October 2020.
- What to know about laser treatment for scars, https://www.medicalnewstoday.com/articles/325762, last accessed on 12th October 2020.
- Laser Treatment for Scars: What You Should Know, https://www.healthline.com/health/laser-treatment-for-scars, last accessed on 12th October 2020.