Adapted from Laser

Treament of Traumatic
Scars With an Emphasis
on Ablative Fractional
Laser Resurfacing
Consensus Report by
Anderson et al.


Non-Ablative Fractional Lasers
Haedersal (2009) showed significant improvement of wound texture at
4 and 12 weeks post treatment
Taudorf (2015) showed overall appearance, thickness, and pliability of
hypertrophic and atrophic wound was improved at 6 months, with
hypertrophic scars being less improved.
Limited depth of penetration of non-ablative fractional lasers
Settings for Ablative Fractional Lasers
Haedersdal (2009) showed scar treated with high density micro-
columns had significant color and texture improvement compared to
control
Bowen showed treating burn scars with ablative fractional with
energies enough to create pinpoint bleeding (treating full-thickness
scar) at first meeting Require lower depths on following meeting to
penetrate remaining scars
Levi (2016) showed that using laser energy so that 50% of the
columns developed pinpoint bleeding Decrease pain, tightness, and
pruritus
Other Lasers and Light Devices
(Hultman) showed with intense pulsed light 80% of patients reported
improvement in coloration of scar tissue
Combination of lasers showed significant improvement in VSS and
North Carolina 4P Scar Scale
Pulsed dye laser Erythema and edema
Intense pulsed light Dyschromia
Ablative fractional laser Hypertrophy and contractures
Radiofrequency Devices
Remodeling collagen and re-epithelialization of surface with complete
repair of epithelium in 7 days
Beneficial for treatment of burn scar hyperpigmentation
Lasers in Pediatric
Ablative fractional lasers and pulsed dye lasers are significantly
beneficial for pediatric population
Ablative frational laser therapy on 2 year old girl with contracture burn of
hand Improved active ROM 1 month post treatment
Pediatric patients treated with split-thickness skin grafts with pulsed dye laser
therapy Reduced vascularity, pigmentation, scar height, and increased
elasticity
Adverse Effects of Laser Treatment for Burn
Scars

Minor Moderate Severe

Most common: Hypo/hyperpig New scar formation
Blister, pain, mentation after laser
erythema treatment
Edema, infection, Less common Uncommon
ecchymoses
Long durations of
laser treatments
Conclusion
Laser therapy is effective for treatment of burn scars
Improve burn scars appearance, pigmentation, vascularity,
pliability, and thickness
Safe and effective in all age groups
Different types of laser and light sources may be used
for treatment Depends on scar type and thickness
Intense pulsed light for dyschromia
Pulsed dye laser for erythema
Ablative fractional lasers for hypertrophic scars
Laser treatment has good safety profile
Multimodal with traditional therapies