The Role of Laser Therapy in Scar Management

Laser therapy has increasingly played a role in the treatment of scars, making the need for surgery practically obsolete. In a review published in the Journal of Cosmetic Dermatology, researchers provide an update on the most recent literature describing the current role of lasers in surgical scar clearance.

Scar remodeling interventions using pulsed dye laser (PDL) rely on 585 nm and 595 nm wavelengths, the most commonly used PDL types in this context. Research has shown that PDL can reduce scar volume and height as well as improve pliability and texture.

Several randomized and nonrandomized trials suggest the 595 nm wavelength with PDL features a moderate efficacy in the treatment of hypertrophic scars. In contrast, a randomized study from Egypt found no statistically significant difference between PDL 595 nm and ND:YAG laser for improving hypertrophic scars.

The variable pulsed Er:YAG laser may be useful and safe for the treatment of atrophic and hypertrophic scars; this laser uses shorter and longer pulse durations between 500 microseconds to 10 milliseconds. A higher absorption coefficient coupled with shorter pulse duration may lead to better absorption by water-containing tissue and reduced thermal diffusion. Research indicates the Er:YAG laser may produce a 50% improvement in scars after 3 months of treatment.

Intense pulsed light (IPL) is characterized by the delivery of non-coherent light energy across a 515 nm to 1200 nm spectrum at a fluency up to 40 J/cm². Although IPL was initially used for cosmetic purposes, such as for hair removal and hyperpigmentation, different wavelengths can be used for collagen stimulation and management of hypertrophic scars.

According to the researchers, many studies on the use of laser therapy for scar clearance have primarily focused on the short-term outcomes and improvements in scar appearance. In contrast, many of these studies have lacked a longitudinal assessment of scar appearance and outcomes over time following laser therapy.

“Therefore, further studies like randomized controlled studies are needed to confirm their efficacy in the long term and optimal treatment protocol specifically when used in combination,” the researchers wrote. As such, this additional study may promote better understanding to support “the optimal implementation of these therapies in clinical practice for the treatment of hypertrophic scars.”

Reference

Chowdhury B, Kassir M, Salas-Alanis J, et al. Laser in surgical scar clearance: An update review. J Cosmet Dermatol. Published online July 2, 2021. doi:10.1111/jocd.14325