The wound-healing process begins with inflammation, moves to tissue formation, and ends with modifying specific factors in the anatomy such as collagen. Scars occur when the wound-healing process is disrupted by biological factors such as too much collagen or depleted collagen.
Refined since the introduction of lasers in the 1980s, the laser scar removal technique today can reduce the appearance of keloid scars, hypertrophic scars, and atrophic scars, which have the following characteristics:
- Keloid Scarring: Firm, raised, and reddish-purple scars that extend beyond the initial wound area and builds over time.
- Hypertrophic Scarring: Firm, raised, and pink scars that remain within the initial wound area and possibly naturally regress over time.
- Atrophic Scarring: Depressed pin-like pockets in the skin that can result from skin conditions or diseases such as acne.
During laser scar removal treatments, the laser is moved along the scar. This vaporizes or removes a layer of skin and exposes a more natural-looking skin layer, which heals over time to minimize scar appearance.
Numerous types of lasers are available, each of which has unique benefits:
- The CO2 and Fraxel laser is best suited for acne scarring
- The Er:YAG laser system is best for treating scar edges and mild acne
- The 585-nm pulsed dye laser (PDL) is often used to treat hypertrophic and keloid scars
Acne is one of the most common skin diseases in the United States. It is estimated that 60 million Americans suffer from acne and 20 million suffer from it badly enough to cause scarring. Acne scarring is the result of inflammation in the lower layer of the skin called the dermis which causes the collagen to become deformed or scarred resulting in depressions in the skin.
Acne scars are typically classified into boxcar, ice pick and rolling scars. Lasers are a commonly used modality in the treatment of acne scars. Laser resurfacing has long been used in the treatment of acne scars. Traditional resurfacing lasers like CO2 or erbium can cause improvement in acne scars but require 1-2 weeks down time. Non ablative lasers such as SmoothBeam and CoolTouch, do not remove skin but at best are minimally effective in the treatment of acne scars.
A new resurfacing procedure, named fractional resurfacing or Fraxel is currently the most effective laser in the treatment of acne scars. Dr. Rokhsar has been instrumental in the development of this laser having worked on a prototype device and has discovered its effectiveness for acne scars. Dr. Rokhsar has published the first study on treatment of acne scars with fractional resurfacing and has developed the parameters for use of this laser in the treatment of acne scars on prototype device. This laser resurfaces the skin gradually, 20-30% at a time, which allows for rapid healing while eliminating the risk of rawness associated with traditional laser resurfacing procedures. The zones of thermal laser damage serve as a stimulus for collagen production filling in the pitted appearance of acne scars with your own collagen.
In a study conducted by Dr. Rokhsar, the Fraxel laser can result in improvements of up to 50% in the appearance of acne and surgical scars. Dr. Rokhsar will tailor the procedure for to your skin depending on the type of acne scars which you may have. He may recommend subcision in addition for rolling scars as well as combining the Fraxel resurfacing procedure with punch excisions for ice pick scars.
Treatments are typically done every 2 to 4 weeks Scars on any body surface area can be treated with the Fraxel laser, although scars on the face respond the best. Patients have to be aware that there is no cure for (acne) scars but that the Fraxel Laser in Dr. Rokhsar’s hands can result in significant improvement in the appearance of acne scars, far superior to any other procedures.
Dr. Rokhsar is a recognized national and international authority on the use of lasers, and in particular the Fraxel laser for the treatment of acne and other scars.