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Laser Treatments for Acne Scars

July 12, 2008



Laser treatments for acne scars of various wavelength and intensity may be used to re-contour scar tissue and reduce the redness of skin around healed acne lesions. The type of laser used is determined by the results that the Laser treatments for acne scar aims to accomplish.

Tissue may actually be removed with more powerful instruments such as the carbon dioxide laser. In some cases, a single treatment is all that will be necessary to achieve permanent results. Because the skin absorbs powerful bursts of energy from the laser, there may be post-treatment redness for several months.

Laser treatments for acne scars consist of 3 -6 sessions done at 3 – 4 week intervals. Consultation is free and treatment can be done on the same day, if desired. There is some discomfort associated, however, and a topical anesthetic is highly recommended. This can be bought over the counter and applied at home ½ to 1 hour prior to treatment or done in the office. After Laser treatments for acne scars the skin is red but, typically, returns to normal within 2 to 4 hours. Some minimal and transient side effects have occurred in a few cases. These include red raised areas, blisters and hyper pigmentation. A test area can be done at the time of consultation, if desired.

Laser treatments for acne scars, There are 2 major categories of laser used in acne scar therapy. They are the resurfacing (aka ablative) lasers and the non-ablative lasers.

Ablative lasers literally remove the outer layers of the skin, burning away scar tissue and stimulating the dermal collagen to tighten, reducing the amount of scar visibility. The ultra pulsed carbon dioxide laser and erbium YAG laser are most frequently used in laser resurfacing.

Because the skin is injured and unprotected tissue exposed, great effort must be put into wound care and infection prevention. The skin may remain reddened for several months or a year afterwards.

Non-ablative lasers trigger changes within the dermis without injuring the epidermis. They are the “lunchtime” form of laser therapy. This targets and heats the sebaceous gland, helping reduce sebum and acne formation. Heating the collagen helps tighten the dermis, resulting in less visible scarring.

Another option is the yellow pulse dye laser. The yellow light laser also helps treat keloidal scars, flattening and reducing redness as well as helping control itching of the raised scar.

A topical anesthetic like LMX 4% Topical Anesthetic Cream – 30gm is applied about an hour before the procedure. The surface of the skin is cooled to prevent the laser from damaging the epidermis. A patient will feel both the cold spray as well as some amount of stinging and heat during the session. The application of a topical anesthetic an hour before the procedure makes this tolerable. The procedure takes about an hour. Typically 3 sessions a month apart are performed.

The pulsed dye laser procedure is typically performed on an outpatient basis without general anesthesia. Local anesthesia is usually administered with a topical anesthetic cream, intralesional injections or nerve blocks. Adjacent, non overlapping laser pulses are delivered over the scars. The immediate result may produce a purplish coloring. The treated scars are then evaluated 6-8 weeks later, where another treatment, at the same or slightly higher strength may be necessary.

Local, regional nerve block or intravenous sedation may be required for CO2 laser resurfacing of atrophic acne scars depending on the extent of damage. Follow-up examinations and skin cleanings are scheduled often during the first postoperative week and patients are encouraged to keep the area moistened with healing ointments and/or cooled compresses. Early evaluation and intervention are important in order to prevent long-term scarring.

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