Lasers and ancillary treatments for scar management Part 2: Keloid, hypertrophic, pigmented and acne scars

Abstract

The formation of a wide range of excessive scars following various skin injuries is a natural consequence of healing. Scars resulting from surgery or trauma affect approximately 100 million people per annum in the developed world and can have profound physical, aesthetic, psychological and social consequences. Thus, scar treatment is a priority for patient and physician alike. Laser treatment plays an important role in scar management with additional support from ancillary modalities. Subsequent to part 1: Burns scars, part 2 focuses on our strategies and literature review of treatment of keloid, hypertrophic, pigmented and acne scars where lasers are used in conjunction with other measures, and illustrated with case studies.Lay SummaryScars can result as part of the normal healing process after a burn or other trauma such as surgery or injury. However, there is a range of scarring from ‘good’ to ‘bad’ depending on various features of the scars. Some can be can be lumpy and raised (hypertrophic and keloid scars), have changes in pigmentation (increased or decreased colouration) or have specific features related to the cause (for instance acne scars, burns scars). We review the senior author’s experience over twenty years in treating scars with a range of treatments in conjunction with lasers. This is the second and final article in the series looking at 4 main aspects of scarring. In part 1, the focus was burns scars.In Part 2, we now focus on hypertrophic and keloid scars (thickened raised scars); pigmented scars and acne scars. Lasers play an important role in managing a variety of scars in our practice, which work best in combination with other treatments as described.