Laser Treatment Improves Color and Texture of Acne Scars

Acne scars may vary in terms of color. Red-colored acne scars appear due to dilated small blood vessels just below the skin. Brown scars are due to excessive pigmentation whereas white scars are due to lack of pigmentation. Treatment with laser therapy varies according to the color of the scar.

Red-colored acne scars are dealt with laser therapies like pulsed dye laser (PDL), potassium-titanyl-phosphate (KTP) laser, intense pulsed light (IPL), and neodymium:yttrium-aluminumgarnet (Nd:YAG) laser. Among these, treatment with PDL is particularly useful in treating red acne scars. It can be performed on all skin types including hair-bearing areas. The KTP laser is only effective in superficial layers of the skin. IPL devices allow treatment at greater skin depth and at a faster speed. They cover large areas of the skin and can treat multiple conditions at the same time. Nd:YAG lasers treat dilated blood vessels in the deeper layers of the skin. The new microsecond-pulsed Nd:YAG lasers are used for more superficial blood vessels.

Brown or dark acne scars are treated with IPL, quality-switched (Q-switched), microsecond-pulsed Nd:YAG, both confluent and fractionated ablative erbium:YAG (Er:YAG), and yttrium-scandium-gallium-garnet (YSGG). Following laser treatment, the person is advised to avoid the sun wherever possible and to use sunscreens and skin lightening creams. Q-switched lasers can target very small cells like melanocytes. Microsecond-pulsed Nd:YAG lasers in addition to treating red scars, also target melanin pigment and can treat brown scars. Confluent ablative Er:YAG and YSGG lasers are used over large skin areas whereas fractionated therapy is used for the treatment of localized lesion alone.

White acne scars are also treated with laser therapy; stimulation of melanin production is brought about by using ultraviolet light from Excimer lasers. Fractionated ablative lasers (Er:YAG, YSGG, and carbon dioxide) also reduce the size of the white scars.

The skin texture is often altered over an acne scar. Skin texture defects should preferably be treated before treatment of color defects. Steroids, when used over or injected into the scars along with laser therapy, help to flatten and soften the scars to allow better penetration of laser. Fractionated ablative lasers (Er:YAG, YSGG, and carbon dioxide) soften acne scars. Confluent ablative laser treatment (Er:YAG, YSGG, and carbon dioxide) may be employed soon after surgery to the base of the lesion so that it does not recur.

Depressed scars are treated by softening the edges between the scar and the normal surrounding skin. The scars are treated with confluent ablative Er:YAG, YSGG, and carbon dioxide lasers. Fractionated ablative laser treatment may also be used for this purpose. Depressed rolled scars may be treated with confluent and fractionated nonablative laser treatments and fractionated ablative laser therapy.

A good understanding of the different types of lasers available helps in choosing the correct treatment according to the type of lesion.

Reference:

1. Laser Management of Acne Scarring; Tiffany Kwok et al; Skin Therapy Letter.com 2012

Source-Medindia