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Laser scar removal composite - red beam on shoulder

Am I a good candidate for laser scar removal? Here is what a doctor will look for

Editorial note: this article was updated on June 26, 2020.

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If you have leftover scar tissue from surgery or trauma to the skin, you may be eligible for scar revision, using several methods. This also goes for indented acne scars that have created rough patches of skin on the face. Aesthetic lasers are among the latest of technologies for getting rid of scars. However, not all patients make good candidates for laser scar removal.

Below, we explain what doctors look for to determine your eligibility for this type of procedure.

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You are not tanned and generally have lighter skin

Laser light beams are attracted to pigments in your skin. Even if you are not fully tanned, as long as melanocytes are active in your skin layers, you could be at risk for side effects from laser treatments.

Melanocytes are the little ‘factories’ that create melanin in your skin. Melanin is what makes your skin’s colour, basically. Melanin levels are what make some people naturally light-skinned, or dark-skinned.

The best candidates for laser scar removal will be light skinned, and will not have been recently exposed to UV light from any source – be it from the sun, tanning beds, or anything else.

If you try to skirt this issue with your doctor, and attempt to get laser treatments anyway, you could put yourself at risk for more scarring, or pigmentation. Remember, you don’t need to have a visible tan for this to be a possibility. You just need to have been exposed to UV light.

If you have naturally dark skin, a doctor may be able to work on your scar revision with lasers. However, the laser’s ‘dose’ (so to speak) will need to be lowered. Because of this, it can take longer to see results on your skin type. If you fall into this category, a doctor who is experienced at treating dark skin should be your top choice for laser scar removal. It is a very sensitive procedure to have done in these cases.

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You have time to heal from skin resurfacing effects

When using skin resurfacing lasers, such as a CO2 laser, a fractional laser or even an ablative laser, you will need time to heal after treatment sessions. These types of lasers attempt to remove ‘old’ skin (i.e. scar tissue) so that your body will replace the area with new, fresh skin. They are collagen-builders in that way.

In order to get your skin looking healthy and smooth again, the scarred layers will need to be ‘peeled’ off. This can be painful (but not totally intolerable). You will be red and swollen for a few weeks. Extreme cases can cause redness for much longer. You can also expect skin to shed more than it usually does.

Some people don’t like going out in public with a red, flaky face. Not to mention, avoiding sun exposure is a MUST after these treatments. So, if you don’t have the time to stay home for a while afterwards, they may not be for you.

If laser resurfacing is done on other parts of your body (i.e. not the face), you may get away with covering up your treatment area, to get out of the house while your skin heals.

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You are patient, persistent and reasonable about expectations with laser scar removal treatments

Laser scar removal can require multiple sessions to see results. These are usually spread 4 to 8 weeks apart. This goes especially if you have darker skin, deeper scars or if you opt for a less intense treatment to avoid downtime after each session.

After each appointment, it can take time to see the effects a laser has had on your skin. You won’t have instantaneously smooth skin. But you’ll likely get there, slowly.

To help encourage your skin’s restorative processes, topical products may be recommended for daily use. These can include things like a retinol, to help smooth your skin and get rid of pigments. It will be important that you follow a regular, disciplined skin care routine, if you want to see effects sooner.

A doctor may also recommend a ‘mixed mode’ approach to removing your scars. You should remain open-minded to these other solutions, even if they are not what you had in mind. Some scars may do better with injection treatments, like fillers or cortisone, to fill dents or break up the excess collagen. Or, perhaps minor cutting surgeries will be needed. These can be used in combination with laser treatments, for a more effective result. Each case will be different, however.

Keep in mind that, in the end, scars can’t be totally removed. But, they can be greatly reduced in appearance. Your end result will be based on how your own body responds to any treatment – whether with lasers or not.

Yes, a lot of the effectiveness can be dependent on the qualifications of the practitioner doing the procedure. However, even the best-of-the-best can’t guarantee how your body will react to lasers, surgery, injections or skin care for scars.

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You can follow strict before and after care procedures to avoid complications

The success of laser scar revision depends a lot on what you do before and after treatments. A doctor may recommend that you use (or stop using) certain skin care products for a week or two before being ‘zapped’ by a laser. This can prepare your skin for faster healing afterwards, and can avoid side effects.

Afterwards, you’ll need to keep the area clean, and continue using skin care products as instructed by your doctor. You’ll also need to stay out of the sun, while always wearing high-grade, non-comedogenic sunscreen (even if you are staying indoors on cloudy days).

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You are not prone to developing keloids or raised scars from skin trauma

Some people are prone to developing raised scars. These are either hypertrophic scars, or keloids. This is when your skin produces too much collagen, as it tries to heal from an injury. In these cases, it may not be wise to undergo laser treatments. The intentional injury from lasers may cause more harm than good.

A doctor will be able to determine whether laser treatments are right for your case, even if you do develop raised scars.

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You are healthy, not taking medications and don’t smoke

If you take certain medications, whether topical or oral, you may need to stop using these for a while before and after laser treatments. For example, most acne medications should be paused to be able to receive laser skin resurfacing. Blood thinners (including alcohol, supplements and painkillers) can also make it harder to heal after laser procedures. You will need to stop using them for this treatment.

Smokers, or those with health conditions that affect blood flow and healing, may not be eligible for this procedure.

During your doctor consultation for scar revision, it will be important to reveal your entire health history, including allergies and supplements or prescriptions you take.

Also, this procedure typically requires an anaesthetic, since it can be painful. If you are allergic to common anesthetics, you may not want to proceed with this type of treatment for scars.

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You don’t have an existing skin condition alongside your scar

If you are suffering from skin conditions like dermatitis or psoriasis, laser treatments may need to wait until these other issues can be addressed.

If you get cold sores easily, medications may need to be taken for a while before treatment, to prevent them from popping up (especially if you will be treated on the face).

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You have the budget to undergo laser treatments

In B.C., MSP does not cover the cost of aesthetic scar revision using lasers. It is unlikely that private insurance carriers will cover this procedure, though you can always ask.

So, in most cases, the patient seeking to clear up their scars will be paying for this procedure out-of-pocket. And, like we mentioned above, more than one treatment may be needed. Or, alternative solutions and skin care products may need to be added to the ‘mix,’ to get you the results you want.

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Are you interested in laser scar removal? Go with a qualified, experienced medical clinic for the job

As a concluding word, we will say that if you are interested in laser scar removal, and believe you are eligible for treatments, you should seek a qualified doctor to do it. There can be many laser clinics out there, but not all of them will have a doctor on staff, let alone a doctor leading the clinic in a medical setting. Lasers can cause adverse side effects, especially when they’re not used properly. So, it is important to seek an experienced, medically-run laser clinic for scar reduction. 

It also will help if the clinic you choose has a doctor available to do other types of scar revision on you. For example, if you need specific, long-lasting dermal fillers for your indented, atrophic scars, not any doctor can do this. It requires special training. So, if your provider has multiple treatments available to cover up your scars, you may get better results. That’s because they will not be limited to one or two offerings, which may not be enough for your case.

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