Scar Treatments using “Lasers”

It’s funny today. No matter what the condition, everyone thinks that a “laser” is available and is best. In most cases, this is not so, but in many cases, laser treatments are available.

There are many different types and causes of scars: traumatic, post-surgical, and acne scars to name a few. Well, there is not one treatment that is best for all types of scars. So, when it comes to scars, you need to have a lot of tools at your disposal in order to get the best result. For example, here is a list of treatments that I perform regularly for scars:

  • CO2 laser ablation
  • Dermabrasion (not to be confused with microdermabrasion)
  • TCA peels
  • IPL (intensed pulsed light)
  • Topical treatments (i.e. silicone gel sheets, 5-FU), which can be combined with other treatment modalities
  • Surgical scar revision
  • Electrodesiccation
  • Dermal and/or subdermal fillers
  • Subcision

What is not on the list:

  • Microdermabrasion – studies have shown that there is virtually no benefit unless one reaches the dermis( pinpoint bleeding), at which point it is a dermabrasion and not microdermabrasion. This modality can be combined with chemical peels, which does offer benefit.
  • Microneedling – although there may be some benefit, the cost-benefit ratio is poor (high cost for minimal, if any, benefit). This is frequently recommended as there is minimal risk.

In short, the treatment of scars requires experience and skill. More and more frequently, I perform post-operative treatments to reduce the appearance of scars before they fully form (i.e. 10-14 days after facial surgery). But, most scars that are treated are from acne and/or trauma.

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New scar treatment for thick scars

Tranilast 8% liposomal gel was shown to be effective in treating scars from cesarean sections. Patients were asked to treat half of their scars with this gel and the other half with placebo. Patients were much more satisfied with the Tranilast side.

Unfortunately, this treatment has not been compared to other treatments, including steroid injections and silicone gel sheets, but at least gives another option for patients with thick scars

Can your phone really diagnose melanoma? Not so fast!

According to an study published in JAMA Dermatology which evaluated 4 smartphone applications that analyze photographs to identify malignant melanoma, the apps were able to make the diagnosis of malignant melanoma between 6.8% to 98.1% of the time.  The app that was found to be most effective sends the photographs to a Dermatologist for evaluation. What is important to remember is that smartphone apps are not classified as medical tools but as educational devices and clearly do not replace the need for a professional opinion.