Scar revision using laser – review of the literature and an appraisal

Abstract

A variety of scars – erythematous, pigmented, atrophic, and hypertrophic – may occur as a result of trauma, surgery, burns, and skin disease such as acne. Surgery with other adjunctive methods including radiotherapy, intralesional steroid, and pressure therapy have shown variable results. Laser scar revision has been used since the early 1980s. The continuous wave lasers including continuous wave carbon dioxide, argon and the Nd: YAG laser achieve some improvement, but their use is limited by inherent problems of continuous mode lasers. Pulsed lasers have been effective for scar revision probably due to their selective photothermolysis. The pulsed dye laser has been successfully used in erythematous and hypertrophic scars. The pigment-specific lasers have shown a good improvement for pigmented scars. The high-energy pulsed carbon dioxide laser has been used for distensible facial scarring. The erbium: YAG laser may have advantages because of reduced thermal damage to surrounding tissue and low risk of pigmentary change. The selection of appropriate lasers alone or in combination may be of value for scar revision.