Papers of The 1st Japan Scar Workshop

21. The Possibility of Laser Treatment for Keloids or Scars

Aoki R
Department of Plastic and Reconstructive Surgery, Nippon Medical School, Tokyo, Japan

Even though it is commonly believed that keloids or scars can be treated with laser, there is not much scientific evidence. A PubMed search revealed that only thirty articles on the effectiveness of laser for those conditions are available. The articles published before 2000 were mainly on CO2 lasers and those after 2000 are on dye lasers. According to the authors’ experience, dye lasers are not effective enough to treat scars. Recently the concept of fractional photothermolysis was introduced and “Fraxel” was developed. This laser aims at treating aging skin, however, we utilize it to treat scars. As hypertrophic scars tend to decrease in size spontaneously without any treatment, it is difficult to assess the effectiveness of the treatment alone. Therefore we attempted to cure matured scars in order to assess the effectiveness of this new device. Fraxel irradiates glass-YAG laser 2000 shots/cm2 to the maximum. The old irradiated skin is replaced by newly reformed skin. So we assumed that if we used this laser for scars, the scar tissue can be replaced with normal skin. We have presented three clinical cases. Case 1 was a 24-year-old male complaining of acne scar on the cheeks. Case 2 was a 43-year-old male with old elevated scars on the anterior chest wall. Case 3 was a 24-year-old female with burn scar of the face. These 3 cases presented good result after Fraxel treatment. Even though we experienced only a few cases and the period was short , the results suggest that Fraxel can improve skin condition, and even scar tissue is improved to normal skin.
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