Laser Therapy: Acne Laser Treatment Proves Successful

Despite their prevalence, acne scars have always been a condition notoriously difficult to treat.
In the past, Dermatologists have used all kinds of treatments, such as excision, punch grafts, dermabrasion and chemical peels, with a low degree of success.
It wasn't until the late 1980's that experiments using pulsed dye lasers were initiated on thickened, overgrown scars.

Dr. Alster, MD, Washington Institute of Dermatologic Laser Surgery and Georgetown University and her colleagues have since then reported prolonged improvement in the appearance of most scars after pulsed dye laser treatment. "Clinical assessments and skin surface texture analyzes using a computer image analyzer showed that the laser-irradiated scars approximated normal skin characteristics."

Clinical research over the years has led to textural improvements of both thickened and deeply colored red scars. "After one or two pulsed dye laser treatments, a 57% to 83% improvement was observed. Facial acne scars have been very responsive to this treatment."

Research has shown that combining the use of the pulsed dye technology with carbon dioxide laser vaporization was found to provide improvement in non-reddened, minimally thickened scars. Atrophic acne scars where there is a breakdown of the skin, have been found to respond most favorably to carbon dioxide laser resurfacing. The number of treatments necessary depends on the type of lesion and each individual's collagen and wound healing response. Usually two or more treatments are needed for hypertrophic (thick) acne scars.

Advances in laser technology have progressed so rapidly during the past decade that successful treatment of many cutaneous concerns and congenital defects, including vascular and pigmented lesions, tattoos, scars, and unwanted hair-can be achieved.
The demand for laser surgery has increased substantially by patients and dermatologists alike as a result of the relative ease with which many of these lesions can be removed, combined with a low incidence of adverse postoperative sequels.
Refinements in laser technology and technique have provided patients and practitioners with more therapeutic choices and improved clinical results. In this review, the currently available laser systems with cutaneous applications are outlined, with primary focus placed on recent advancements and modifications in laser technology that have greatly expanded the cutaneous laser surgeon's armamentarium and improved overall treatment efficacy and safety.

The pulsed dye laser procedure is typically performed on an outpatient basis without general anesthesia. Local anesthesia is usually administered with a topical anesthetic cream, intralesional injections or nerve blocks. Adjacent, non-overlapping laser pulses are delivered over the scars. The immediate result may produce a purplish coloring. The treated scars are then evaluated 6-8 weeks later, where another treatment, at the same or slightly higher strength may be necessary.

Local, regional nerve block, or intravenous sedation may be required for CO2 laser resurfacing of atrophic acne scars depending on the extent of damage. Follow-up examinations and skin cleanings are scheduled often during the first postoperative week and patients are encouraged to keep the area moistened with healing ointments and/or cooled compresses. Early evaluation and intervention are important in order to prevent long-term scarring.

The American Academy of Dermatology is the largest medical society representing physicians who specialize in treating skin, hair and nail conditions.

Dr. Tina Alster is widely recognized as one of the world's leading authorities on dermasurgery.