Lasers Treatment are now very popular treatment of different skin conditions including acne. They use different wavelength and intensity and remove the scar tissue and reduce the inflammation and redness of skin around healed acne lesions. Various Laser treatments are available and the choice of laser treatment depends on type of Acne scar.
There are 2 main categories of laser treatment used in acne scar therapy which are Ablative lasers and Nonablative lasers. However, these laser treatment may only treat the superficial skin layers and is not much effective for deeper scars like ice pick scars.
Ablative laser are mainly used to treat on the surface skin cells( Epidermis). These Lasers emit high energy densities at extremely short pulses to heat and vaporize target tissue with limited damage to surrounding tissue or skin. They offer better control of resurfacing compared with dermabrasion. Ablative Lasers use either carbon dioxide or Er:YAG. The Er:YAG laser is a more gentle ablative therapy than the carbon-dioxide laser. This may be of benefit for hypertrophic scars, rarely keloids, and shallower boxcar scars. For other icepick scars, Rolling scars and sallow boxcar scar dual-pulsed modes or dual-mode Er:YAG may be beneficial. The healing process may take upto 6-8 weeks and if needed scar is treated with additional laser sessions.
Although these lasers have been considered as “gold” standards for skin resurfacing there are more potential side effects, which may include delayed healing, erythema, milia, acne, edema, hyperpigmentation or hypopigmentation, infection, or even scarring . The risk of post laser scarring is even higher with CO2 laser resurfacing compared with Er:YAG resurfacing because the thermal tissue damage is more with CO2 lasers then Er:YAG lasers.
Non-ablative lasers are solely used to treat below the skin usually on mid layer of skin ( Dermal Collagen) . These lasers may include 1320-nm or 1064-nm neodymium:yttrium-aluminum-garnet lasers (Nd:YAG) and diode (1450 nm) lasers, and the 585-nm pulsed dye laser (PDL). Side effects are generally mild and the effectiveness of reducing acne scarring may also be lower then ablative lasers. It has been suggested that best results may be achieved when these lasers are combined with another modality such as surgery or chemical peels. Because these modalities are less aggressive as a whole, they are more useful for atrophic, rolling, or possibly hypertrophic scars rather than icepick, boxcar, or keloid scars.
Although the recently developed technique of fractional laser skin resurfacing has been reported to be effective in acne scarring, the risk of hyperpigmentation/hypopigmentation, scabbing, milia etc.. may be the factors nonablative scar resurfacing are still popular for acne scar reduction.
Fractional laser treatment:
Fractional laser treatment for acne scars are now being widely popular as these type of lasers treat both outer and inner layer of the skin. But, the procedure may be painful, so topical anesthetics are used along with forced air cooling to increase patient comfort. A variety of ablative fractional resurfacing lasers are now available and the initial impression is that these lasers may be more effective than nonablative fractional lasers for acne scars. However, side effects may also be more of a concern with the ablative fractional lasers treatment. There are similar side-effect concerns as other ablatives but there tend to be less problems overall because of the selective sparing of skin rather than total ablation, there is still the possibility for transient erythema or edema, dryness, scabbing, milia or acne, hyperpigmentation or hypopigmentation, prolonged healing, or infection.
Unlike other, you can apply makeups or sunscreen immediately after a treatment session. As postoperative edema and erythema may be common, so to avoid it application of ice during the first 24 hours may be beneficial, erythema will resolves in 5-6 days.