Laser scar removal has become more topical recently as Laser machines are being sold as a cure for all skin problems. It is therefore important to understand what Laser does to skin.
Basically, Laser is a narrow beam of high intensity light which converts to heat as it is absorbed into skin.
The basic principle is that the scar tissue is heated up with laser light rapidly, inducing a controlled injury in the hope that the new healed tissue will look more like normal skin.
There are some basic problems with this theory.
- Thermal injury:
Laser induces a heat injury to skin.
It is well known that heat is a major cause of scarring, (as witnessed by burn, hypertrophic scarring.)
The reason for this is that, blood vessels present in the skin are badly damaged by heat injury leading to poor healing, as the body cannot mount a normal healthy healing response.
The skin therefore heals with scarring.
Exactly the same thing happens when Lasers are used for repairing scars.
At best, with laser scar removal, a better-looking scar will replace the original scar.
The aim of any invasive and very expensive laser treatment should not be to cook the skin in the hope that the new scar, which eventually contracts, will be not as disfiguring as the original one.
- Subcision: Most mature scars are unfortunately disfigured i.e. contracted, shrunk or sunken.
This happens because early fibroblasts change to myofibroblasts, which lay down contracting collagen.
This collagen is thick, dense bands of abnormal collagen fibres, that attach the skin to deep skin or even fascial layers.
For new skin to be laid down, these bands of skin adhesions must be removed.
This is the reason why plastic surgeons carry out horizontal mechanical subcision using instruments like scissors to cut & release skin which is stuck down.
Therefore, Atrophic acne scarring, where the skin is sunken & contracted cannot be released without this subcision. Laser can heat up an area but is unsuitable to cut fibrosis.
It becomes clear from the above discussion that there is no known healing mechanism for a burns injury i.e. laser scar removal other than scarring.
To suggest using laser scar treatment is not only irrational, but totally illogical.
Post-laser treated skin shows that the dermis is much thinner,with abnormal collagen because it is abnormal scar tissue.
Any one choosing to undergo laser scar removal should ask the therapist to explain how a heat injury will remove their scar? You may be surprised by the baffled look on their face!
There are much more rational & effective treatments available that make sense.
Micro-needling is such a treatment where multiple needles mounted on a cylinder roll over the scar tissue to induce new collagen formation with bleeding, as well as carrying out vertical subcision, that helps release the fibrous bands, causing the disfigured scars seen in acne or old surgery.
Another method is to superficially peel the skin using compound peels containing a fruit acid like Glycolic acid, Azelaic acid (anti-acne skin lightener) as well as Phytic acid (antioxidant skin lightener) & Salicylic acid.
This method of resurfacing using Acnex peeling mask is highly successful for mild scarring with minimal atrophy. However, if the skin is contracted with multiple depressions commonly seen in acne, then subcision is necessary & micro-needling with a Dermarollex is necessary.
Any procedure requires a post procedure maintenance cream with the following ingredients:
- Silicone(Mandatory) :Dimethicone & Cyclopentasiloxane. Occludes,seals & hydrates.
- Healing promoters: Vitamin C 10 %, Hyaluronic acid, Vitamins A&E.
- Anti-inflammatories: Salicylic acid 2%,Rutin anti-histamine(histamine induces scar itching).
Therefore, checking ingredients is important, as all above are evidence-based, with considerable clinical backing from peer reviewed trials.
Scar Repairex® Ultra is the only preparation containing all the above ingredients.