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