Scar Prevention & Treatment
What causes scars?
Scarring can occur as a result of injury, surgery, or skin conditions such as acne, and it can significantly impact self-esteem and quality of life. Common symptoms include raised or depressed skin areas, skin discolouration (ranging from red, brown to white), thickened or irregular texture, and tenderness or discomfort.
Scars form when the skin's surface is damaged and the body produces collagen to repair it. The resulting scar tissue can be raised, discolored, or indented. Scars are often disfiguring and are sometimes painful and embarrassing.
Some factors that can affect scar formation include:
The location and depth of the wound
The person's age, skin type, and genetics
Whether the wound was clean or infected
Whether the wound was sutured or left to heal naturally.
Types of scars
Hypertrophic scars: These scars are raised and often appear reddish in color. They develop when the body produces too much collagen during the healing process. A combination of red lasers, fractionated lasers and medication is used to manage these. Usually, 3-4 sessions separated by 4-6 wks are required to manage this
Keloid scars: These scars are similar to hypertrophic scars but can grow beyond the boundaries of the original wound. They are more common in people with darker skin. People with a history of previous hypertrophic or keloid scarring are at a greater risk of developing keloid scars.
Atrophic scars: These scars are typically flat and depressed, and can occur as a result of acne, chickenpox, or injury.
Contracture scars: These scars can occur after a burn or other injury that causes the skin to tighten and restrict movement.
Stretch marks: These are a type of scar that forms when the skin is stretched rapidly, such as during pregnancy or weight gain.
Surgical scars: These are scars that result from surgical incisions.
Traumatic scars: These scars are caused by injuries such as cuts, burns, or abrasions.
Acne Scars: these are unique and require their own approach to treatment.
Scar Prevention & Optimisation post surgery & injury: Latest understandings
Preventing scars
Prevention is often easier than treating a thick scar once formed. While it's not always possible to prevent scars from forming, there are steps you can take to minimize their appearance. Here are some tips for scar prevention:
Keep the wound clean and covered with a sterile dressing until it has healed.
Avoid picking at scabs or scratching the area, as this can slow down healing and increase the risk of infection.
Use sunscreen to protect the area from UV radiation, which can darken scars.
Scar Reduction: techniques for treating scars
There are many treatments that are available for the reduction of scars. Dermatologists are skilled and trained in scar management. The size, shape, thickness and location of the scars determines how they are managed and each scar needs to be assessed on an individual basis. Rarely is a single treatment alone effective. Multiple modalities and techniques combing laser and medical therapy are required for effective results.
Timing is key. Latest research shows that the sooner treatment occurs following surgery, the better. Treatment as soon as the sutures are removed or even at the time of surgery has been shown to be advantageous. Early fractionated laser can assist in scar remodelling, even if performed immediately just after suture removal. Laser energy is directed at the scar tissue, which breaks down the collagen fibres and stimulates the production of new well formed collagen.
Corticosteroids
Pressure garments
Medicated creams such as imiquimod
Silicon creams and gels
Laser resurfacing
Radio frequency
Vascular laser
Skin needling/Dermaroller
Laser treatment for scars
Lasers are now considered first-line therapy for the management of traumatic, post-surgical, and contracture scars. Common laser platforms include vascular lasers, ablative, and non-ablative fractional lasers. A combination of multiple laser types (e.g., vascular lasers and ablative fractional lasers) is often employed for optimal results. Early intervention is also recommended to help prevent scars from worsening.
At Northern Sydney Dermatology & Laser (NSDL), we have a range of laser wavelengths available to ensure optimal outcomes using advanced laser technologies. Lasers offer several benefits over traditional treatments, including precision, safety, and effectiveness. Combining ablative lasers with topical drug delivery (laser-assisted drug delivery), particularly corticosteroids like triamcinolone acetonide and 5-fluorouracil (5-FU), can further improve outcomes.
The treatment process is guided by a clinical assessment of scar characteristics such as pliability, thickness, colour, and subjective symptoms (pain and itching).
How Lasers Work for Scar Treatment
Laser scar treatments work by using focused light energy to either vaporise scar tissue (Ablative Lasers) or heat deeper skin layers (Non-Ablative Lasers), stimulating collagen production and improving skin texture and pigmentation. Vascular lasers reduce redness and inflammation, and a combination of lasers can target multiple aspects of a scar. Laser-Assisted Drug Delivery enhances treatment for thick or resistant scars.
Number of Treatments
The number of treatments depends on your scar features and severity. This can vary from 3 to 10 treatments spaced 8-10 weeks apart.
Side effects, recovery time, and safety
Laser treatment is generally safe, and side effects are uncommon but may include skin atrophy (dimpling), poor response to treatment, recurrence of scars, and rare occurrences of hypo- or hyperpigmentation. Recovery is typically fast. Some patients may experience purple bruising that lasts 7-10 days, and skin may become dry and scaly for 7-10 days if ablative laser treatments are used.
When to expect results
Initial improvements may be seen after a few weeks, but full effects usually take several months to appear. As the skin rebuilds, scars progressively fade and smoothen over a 6-12 month period.
Aftercare and Follow-Up
Keep the treated area moisturised and protected from the sun. Avoid picking or scrubbing the area to prevent irritation or infection. Apply silicone tape daily (available from Amazon) and use pressure garments as needed. Massaging thick scars for 20 minutes daily can also be beneficial.
If you experience prolonged redness, swelling, or signs of infection, contact the clinic immediately. While complications are rare, they should be addressed promptly. Follow-up visits are generally recommended every 8 weeks until the scar reaches a satisfactory point.
Bibliography:
Seago, M., Shumaker, P. R., Spring, L. K., et al. (2020). Laser treatment of traumatic scars and contractures: 2020 international consensus recommendations. Lasers in Surgery and Medicine, 52(2), 96–116. https://doi.org/10.1002/lsm.23201
Before & After
Book in for a Scar Consultation with one of our Dermatologists below.
If you have already had a consultation with one of our Dermatologists, and are ready to book in your Laser Treatments, please phone: (02) 9958 1555.
FAQs
How does laser treatment for scars work?
Laser treatment targets scar tissue with focused light energy, stimulating the body’s healing process and encouraging collagen production to smooth the skin and blend the scar with surrounding skin.
What types of scars can be treated with lasers?
Lasers effectively treat acne scars, surgical scars, traumatic scars, hypertrophic and keloid scars, and pigmented scars.
How many laser treatments will I need?
Most patients need 3-6 sessions spaced several weeks apart, depending on the size, type, and severity of the scar.
Is laser scar treatment safe for all skin types?
Yes, but darker skin types may require special precautions to minimise the risk of pigmentation changes.
Does laser scar treatment hurt?
Most patients experience mild discomfort, similar to a snapping sensation on the skin. Numbing creams or cooling devices are often used to minimise discomfort.
What are the side effects of laser scar treatment?
Common side effects include temporary redness, swelling, and mild discomfort. Deeper treatments, like CO2 lasers, may have a longer recovery period.
How soon will I see results from laser scar treatment?
Initial improvements can often be seen in a few weeks, with full results developing over several months as collagen rebuilds.
Can laser treatment remove scars completely?
While laser treatment can significantly reduce the appearance of scars, it cannot remove them completely. The goal is to make scars less visible and blend them better with the surrounding skin.
Are there any risks or complications?
Laser treatments are generally safe when performed by experienced dermatologists, but there is a small risk of infection, pigmentation changes, or scarring.
What should I do after the treatment to care for my skin?
Keep the treated area clean, moisturised, and protected from the sun. Apply sunscreen regularly to prevent pigmentation issues.
Can I combine laser treatment with other scar therapies?
Yes, laser treatments can be combined with therapies like laser-assisted drug delivery, corticosteroid injections, or fillers for enhanced results.
Is there any downtime after laser scar treatment?
Mild treatments have little to no downtime, while more intensive treatments like CO2 lasers may require up to a week of recovery.
All medical and cosmetic procedures involve some risks. The information provided here is for general educational purposes only. The results achieved for patients in before and after pictures are individual and may not be achievable for you specifically. For specific advice regarding your situation, please book an appointment at NSDL.