How Laser Treatments Can Help Fade Your Scars

Ever since I had my first dermatologic surgery back in junior high, I've had (and been self-conscious about) my scars. I have one prominent scar on my collarbone that spans several inches from 6 or 7 stitches, and several others. It's one of those things that has bothered me less over time since, thankfully, scars do fade, but they will always be there in some way. Fast-forward 10 plus years or so, and after more preventative skin cancer procedures I'm left with fresh new scars. And these ones tend to bother me more than the others. Thanks to them being new, they're dark and raised and I just wanted them to go away.

As a beauty editor and writer, I love diving into research, so I began looking into the best scar treatments. Long gone are the days when your only option for treating scars is Mederma (an over-the-counter scar gel). Now treatment for scars ranges from solutions as simple as slapping on a silicone bandage or gel to going to a specialist for advanced laser scar therapy. Yep, laser therapy isn't only for tattoo or hair removal anymore -- it can also be used to fade older scars, and it's a technique that has grown in popularity in recent years in the dermatology and plastic worlds.  Here are the ins and outs of laser therapy, including who can use it, how much it hurts, and popular alternatives for fading scars.

What is laser therapy for scars and how does it work?

"Laser treatments work by targeting pigments and collagen layers within the skin. When the lasers find these targets, they superheat them, creating a controlled micro-injury to the skin that stimulates the body's natural healing processes," says Dr. Dendy Engleman, a board-certified dermatologic surgeon at Shafer Clinic Fifth Avenue in New York City.

Once you have a scar that is healed enough (which you'll need to ask your doctor to approve), you can begin considering more aggressive forms of scar treatments -- such as laser therapy -- to help diminish the appearance of a scar. You may have heard of lasers for beauty treatments such as hair removal or certain facial treatments, but lasers are also used to reduce the color, appearance and texture of scars. 

Depending on your scar, a specialist may use several types of lasers to do a treatment. Typically, laser treatments for scars will require multiple sessions, spaced out over several weeks or months. So you will need to consider timing and cost when you discuss the treatment with your doctor. For example, to treat the two scars on my abdomen, Dr. Engleman said it would require at least 4-5 sessions, and she would use two different lasers (one to treat the color first and another to treat the texture). 

Although I'm not done with my treatment sessions since they need to be spaced about a month apart, I've found the laser sessions to be quick and virtually painless. Again, it takes time for the full result to show so I can't speak to what it will ultimately look like, but I'm happy with the progress so far on the color -- I'm noticing that the darker red color is beginning to fade. 

The most common laser treatments for scars 

Picosure laser treatment 

A picosure laser treatment is a safe option that is great for treating highly visible keloid (aka thick and/or raised) types of scars. It works by essentially targeting the scar and removing those layers of skin without damaging any other skin around it. 

"This treatment also helps stimulate collagen production and produces new underlying skin cells to reveal younger-looking skin and minimized blemishes (like scars). In each session, layer by layer of damaged skin is removed to reveal the healthy skin beneath," explains Dr. Engleman. 

Fractionated skin resurfacing 

"This is a great non-invasive laser treatment that creates microscopic columns of injury to specific target areas of the skin," says Dr. Engleman. "This triggers the body's natural collagen rebuilding process ('neocollagenesis' in medical terms) which improves the skin's appearance, including helping to minimize scars. It does work for scars but tends to be less effective than picosure lasers."

Pulsed Dye laser treatment

"[Pulsed Dye laser treatment] is great for addressing red scars and can be started as early as 4 weeks post-surgery," says Dr. Engleman.

It's important to keep in mind that laser therapy is not a quick fix. It's a commitment that takes time and patience to see the full results. "Usually, several laser treatment sessions are needed (about three to five). The results of laser therapy also improve with time. So in total, it can take several months to see ideal results," says Dr. Engleman. 

Does laser therapy hurt?

Using laser therapy on my scars is my first experience with lasers for skin, so I can't compare it to say, laser hair removal or a laser resurfacing facial. But what I will say is that I was surprised (in a good way) by how easy and painless the laser sessions are. I've heard people describe the laser sensation as "like a rubber band snap," but if anything, the sensation felt like a cooling snap, but definitely not painful. The sessions are also very quick (1-2 minutes max for the actual laser-on-skin part), although I have only tried one type of laser so far. 

There is also no lingering sensitivity post-laser session and you can resume normal activities. Dr. Engleman did call out avoiding any active ingredients (such as retinol or acids) on the area post-laser -- which is not a problem since I don't apply those types of products to my body normally but would be more of a challenge if the scar was on my face. 

Should you get laser therapy? 

Aside from the cost (laser sessions can range anywhere from $400 to $1,000 and up per session) and the time commitment over several months, there are other factors to consider if you're thinking about laser therapy for treating your scar. 

First, according to the American Academy of Plastic Surgeons, people with darker skin tones are more likely to get hyperpigmentation after using lasers. For this reason, you may need to talk to your doctor to see if you are a good candidate for lasers, and if not, there are alternative options available to you (see below). Other factors that may disqualify you as a good candidate for laser therapy include active acne, deep wrinkles or sagging skin, per the American Academy of Plastic Surgeons. 

Alternative options to lasers

If lasers are not an option for you due to cost, time or other factors that may disqualify you as a good fit, there are several other in-office and home treatments you can try to improve the appearance of your scar.

Chemical peels

"Deep chemical peels can be effective for resurfacing skin and reducing the appearance of scars, although this tends to be less effective than laser treatments and takes longer," says Dr. Engleman. "In my practice, I have treated patients who could not undergo laser treatments (as laser treatments can cause harm to people with deeper skin tones) using a series of professional chemical peels performed in-office," says Dr. Engleman. 

There are options for treating scars at home with boxed chemical peels (Glo Skin Beauty is one example Dr. Engleman mentioned) but she recommends consulting your dermatologist first, especially if you scar is larger and more visible.

Botox

"While it has not been fully studied, there is a growing interest in the use of Botox for scar improvement (and hopefully, one day, scar prevention). One well-designed study showed impressive results in improving the appearance and texture of scarred areas treated with Botox," says Dr. Engleman. "Other studies are being conducted to investigate its potential benefits for treating hypertrophic scars and keloids as well, which seem promising."

Over-the-counter scar products 

There are a ton of products out there for treating scars, and the one that several derms have mentioned as the most effective are the silicone-based scar treatments. These come in several forms (including a patch or sheet that you apply to the scar and a liquid or gel form that you apply and let dry). 

Can you prevent scars from surgery? 

"Scar formation involves multiple factors, some controllable (like how skilled the medical professional performing the surgery and stitches is) and some uncontrollable (your genetics, and in some cases, the size and depth of the wound)," says Dr. Engleman. "In general, the sooner a wound is stitched and the more skilled the professional who is performing the operation, the better the wound will heal and the smaller the scar should be. However, genetics does play a significant role as well," says Dr. Engleman.

According to Dr. Engleman, one of the most important things you can do to first prevent scars from being more aggressive than necessary is to choose a trusted surgeon (ideally someone who has a background in plastic surgery). Simply put, the ideal way to treat a scar is to have one that's not darker, more raised or more textured than it has to be in the first place. Of course, especially in cases of surgeries that are unplanned or from emergency situations, it's not always possible or in your control. And even then, you don't always get a say in who your surgeon is due to financial, insurance, or geographic limitations. 

Bottom line: if you have the chance to do some research on a surgeon and ideally, do a consult with them, Dr. Engleman recommends asking your doctor or surgeon these questions:

• About how long should it take for the wound to heal?
• Will you need to remove the stitches, or will they dissolve or come out on their own?
• Will I need to come in for a post-procedure checkup, and if so, how long after the surgery?
• Based on the size and depth of the incision, how prominent do you expect the wound to be? How about the scar?
• Is there anything I can do to reduce the size and visibility of the scar (what kind of products, care, etc.)?
• Will the scar ever fade?
• Have you performed similar procedures before, and what was the result?