Lasers becoming standard of care for scar treatment

Laser treatments are rapidly becoming the standard of care for a wide variety of scars, according to an expert who spoke Thursday at the 2014 Annual Meeting of the American Society for Dermatologic Surgery.

“This is really laser organ repair,” says Jill S. Waibel, M.D., a board-certified dermatologist specializing in cutaneous laser surgery and dermatologic care at Miami Dermatology and Laser Institute in Miami, Fla. “I tell patients that the laser is like a mechanic. We’re not going to give you a new car, but there’s nothing like the original equipment we got.”

READ: More coverage of the ASDS 2014 Annual Meeting

The first step is to use basic dermatology skills to diagnose the scar, Dr. Waibel says. “You really want to stare at that scar and figure out what the issues are.”

According to Dr. Waibel, small scars may be treated by injected antimetabolites in some cases, and surgery may be appropriate for scars under tension, such as those on the chest and shoulder, she says.

But lasers are appropriate for a wide variety of scars, including acne scars, keloids (“earlobe ones are your best bet”), surgical scars and deep atrophic scars, which are dermal depressions due to collagen destruction following injury, she says. Burn and trauma scars - including skin grafts, mesh grafts and donor sites - can be treated too, and there’s a growing need because “we now have a 95 percent survival for burned civilian and wounded warrior patients,” she told attendees.

“We can treat any scar, any age,” Dr. Waibel says, often by using several laser technologies in combination. It’s important to act quickly to treat new scars like those from surgery and burns, she says. “The sooner you get your laser on, the better.”

She also suggests that dermatologic surgeons perform multiple treatments on scars if necessary. “The more the better,” she says. “Sometimes you have to go to seven or eight treatments, but I rarely go through that many.”