Scarring is one of the most dreadful complications of acne. Long after the actual acne is gone, the scars that it leaves can continue to lower the patient’s self-esteem. A number of treatment options are available to combat this problem but their effectiveness varies depending on the type of scar and the definition of “acceptable” results for the patient. According to experts, laser technology is by far the most useful treatment as it is indicated for more severe cases of scarring. Today, dermatologists use a variety of lasers to treat severe cases of acne.
The term “ablative” means removal of some body tissue. Thus, the use of an ablative laser involves the removal of the outer surface of the skin. This type of laser is best used on pitted scars. There are two types of ablative laser for acne scars and they are CO2 and Erbium lasers. CO2 lasers produce a 50-80% improvement in skin texture and were initially thought to be better than Erbium lasers. However, CO2 lasers have much more side effects compared to Erbium so the latter is preferred by dermatologists despite being the less effective of the two.
According to studies, the side effects of CO2 lasers are often seen in patients with dark skin with skin discoloration being the most commonly reported. Other side effects include redness, itching, milia (small bumps of dead skin), infection, bleeding and formation of acne-like bumps. Erbium lasers produce the same side effects but they are milder in nature. Ablative lasers tend to produce excellent results if performed properly by a board-certified specialist.
Although ablative laser is considered one of the best treatments for acne scars, it is limited by its side effects. These limitations led to the development of non-ablative lasers which produce fewer side effects but less effective results. The idea behind using this type of laser is to induce collagen formation in the deeper layers of the skin without damaging the outer layers.
Non-ablative lasers can be further classified as infrared lasers and visible light lasers. Infrared laser is the kind of laser used in leg veins and hair removal. Their role in the treatment of acne scars is based on findings that show they can also promote the formation of collagen and cause destruction of fibrotic collagen in scars. These mechanisms, when combined together, cause significant improvement of both raised and pitted scars.
The concept of fractional lasers was introduced in the early 2000s to address both the limited effectiveness of non-ablative lasers and the undesirable side effects of ablative lasers. Fractional lasers work by creating zones of thermal damage on smaller fractions of the skin.
The damaged part of the skin is healed and repaired by the surrounding uninjured skin. Healing occurs in a much shorter period of time so the risk of infection and other side effects are significantly reduced. Any side effects should resolve in one month or less.
This type of laser is newer than the others and has proven to be an effective way of getting rid of pitted acne scars. This laser is the picosecond laser which was originally used for removing tattoos. More details about this interesting new laser treatment are available here.
Laser treatment continues to be an effective way to stop the misery of acne scars. With the numerous types of lasers available today, it can be quite challenging to tell which laser is the best choice for a patient. Knowing which one to use is extremely important as using the wrong type can do more harm than good. As always, patients should consult with a board-certified dermatologist for proper evaluation and treatment of their acne scars. A dermatologist is the right person to determine which type of laser is suitable to use on patients.