Laser scar removal: types and mechanism of scar formation, laser principles, advantages of the technique



From the appearance of scars on the face and body no one is immune. The formation of such aesthetic defects after weight gain or pregnancy can still be prevented with the help of various cosmetics (although not always effective), but sometimes it is impossible to protect yourself from injuries and mechanical damage to the skin.

Until recently, the only option to get rid of scars was an expensive plastic surgery, but now the global medical and cosmetological practice has included laser removal of scars, in which everything happens painlessly, quickly and safely.

In general, such technologies play a huge role in the treatment and elimination of various aesthetic and dermatological problems. The most attractive feature of laser radiation is the possibility of focusing in a given area, which allows a specialist to influence certain structures and layers of the epidermal tissue. The doctor can control the power of the pulses, the distribution of their energy and the time of exposure, sufficient for a number of thermal, mechanical or photochemical processes in the skin.

The basis of the action of laser radiation on a different type of scars is the ablation mechanism. This term is understood as the elimination of a portion of living tissue under the direct influence of laser radiation. The degree and depth of ablation are determined by the wavelength and other parameters of the generated pulses, and the coefficient of radiation absorption by a specific type of tissue from which the scar is formed.

And although such technologies have been used in medicine since the end of the last century, in cosmetology, lasers have been used relatively recently to remove scars. Initially, carbon dioxide CO2-laser was used for ablation techniques. The wavelength of the radiation it generated was sufficient for absorption with water (even with its small concentration - within 10–15%) contained in the epidermis. The use of such a device gave good, predictable results, but often caused various side effects: redness (up to 9 months), infection, hyper- and hypopigmentation, a long rehabilitation period.

Therefore, at present, solid-state lasers (neodymium, erbium) are more often used to eliminate scars and scars. After exposure to pulses of this kind, healing takes place quickly and there are no traces on the skin. But on the other hand, such radiation penetrates to a shallow depth compared to a carbon dioxide laser, which limits the range of its application. However, for aesthetic purposes, the parameters of such devices are sufficient.

Anatomically, the scar on the skin is a region of connective tissue. According to the structure, functions, water content, collagen and elastane, these cells are significantly different from the normal epidermis. It may blend in color with the surrounding skin, but may rise above its surface or, on the contrary, form a kind of hollows and pits.

A scar is formed at the site of extensive skin damage and subsequent inflammatory process. During the week after the injury, granular tissue gradually appears, the edges of the epidermal cover slowly contract. In the absence of provoking factors (secondary bacterial infection, excessive physical activity and repeated injuries that can lead to further damage to the skin), the wound is gradually delayed to form a narrow thin cord of connective tissue. In some cases, cosmetic seams are used to speed up the process.

In the next 20 days, coarse-fiber collagen fibers are synthesized at this site. The color of the scar acquires an intense pink hue, as the area of ​​injury continues to be abundantly supplied with blood. Subsequently, the collagen bundles acquire a specific structure and are arranged in accordance with the localization of the scar. The volume of incoming blood decreases, some of the small vessels of the subcutaneous tissue die, the scar becomes more dense and solid, brightens.

Depending on the appearance, size and cellular structure, scars are of several types:

• normotrophic , almost invisible in appearance, in color and structure only slightly differ from the surrounding skin, in accordance with the medical classification do not apply to pathological scars;
• atrophic , usually formed in the skin stretching or the previous inflammatory process (acne, chickenpox, shingles, etc.), sometimes these scars are formed when abnormal and traumatic removal of moles, warts, papillomas, they can vary in shape and size, have different clinical and morphological features;
• hypertrophic , characterized by intense bright pink or paler color, noticeably protrude above the surface of the skin, most pronounced within 2 years after injury, then decrease slightly, unlike other scars can be easily noticed using laser resurfacing, chemical peeling , etc .;
• Keloids are characterized by itching, soreness under pressure, the exact mechanism of the formation of such scars is not fully known, some experts associate them with a malfunctioning cellular immunity, such scars are difficult to reduce, in some cases the risk of the opposite result is high - keloid scars can increase and become more noticeable.

Stretch marks are one of the most common atrophic scars. These are noticeable changes in the skin, usually in the form of strips of various colors (from white to bright red). The main reason for this is prolonged overdistension of the fibers of the epidermis, as a result of which collagen fibers break.

As a result, healthy tissues are replaced by connective scar. In the acute stage of the formation of stretch marks celebrate the inflammatory process with concomitant infiltration of blood vessels. In chronic epidermis and collagen fibers are thinned, the structure of elastin is disturbed.

Removal of scars with a laser has several advantages over invasive plastics and the use of drugs, these are:

• Safety The parameters of the laser radiation is adjusted so that the effect was carried out only on the pathological connective tissue of the scar. At the same time, healthy skin does not suffer at all.
• The speed of the . The duration of the procedure varies depending on the size of the scar, but it rarely exceeds 30–40 minutes.
• Painlessness Usually, a laser scar removal session is performed under local anesthesia, thus eliminating the likelihood of bacterial complications.
• Efficiency . The technique has a pronounced result, but in some cases it may take several procedures to achieve the desired effect.
• Short rehabilitation period . The session is carried out in a cosmetology clinic, after which the patient can go home or to work.
• Versatility . In this way, you can remove scars even in a hard-to-reach place.

However, laser scar removal has its drawbacks. For many patients, the cost of such a method of getting rid of scar tissue is decisive. Depending on the size and type of scar, the equipment used, the cost of one session is from 30 to 100 dollars.

How to get rid of scars: used devices, factors determining the further result of the procedure

The effect of laser radiation on the skin and body has been thoroughly studied. However, each person is unique; therefore, the effectiveness and the likelihood of complications of such a scar removal technique are sometimes difficult to predict.

The result, which will have a laser correction of scars, is influenced by such factors:

• Skin tone . The impulses are absorbed by melanin, the coloring pigment of the epidermis, therefore, carrying out the procedure in patients with a dark skin tint can provoke a burn.
• The presence of chronic dermatological, viral or other diseases . Often, the procedure of laser scar removal provokes herpetic eruptions, exacerbations of dermatitis. Experts associate these symptoms with impaired cellular skin immunity.
• General condition of the patient . A weakened body after an operation or a long-term illness may react in an unpredictable way to laser exposure.
• The location of the scar relative to the blood vessels . Sometimes it is not easy, or even impossible, to remove traces from a cut or wound, since there is a high risk of bleeding, especially in patients with disorders of the hematopoietic system.

That is why it is better to carry out the procedure of getting rid of scars in a completely healthy person, or in the stage of deep remission of chronic diseases. To do this, it is recommended to undergo a series of examinations, to pass blood and urine tests.

The procedure for removing visible scars is carried out in several ways:

• laser resurfacing is intended for large-sized scars, the essence of the technique consists in the gradual removal of the connective tissue of the scar, layer by layer;
• fractional photothermolysis , often used to eliminate the symptoms of post-acne, stretch marks, traces of transferred chickenpox, as opposed to polishing, this method increases collagen and elastin synthesis, saturation of the epidermal layer with water, which contributes to leveling the topography of the epidermal cover.

As a rule, carbon dioxide laser is practically not used in modern cosmetology salons.

The most common types of devices are:

• erbium laser, used for grinding;
• Neodymium laser is more used to perform the procedure of photothermolysis, since such a device has a greater variability of tunable parameters.

Cosmetology services for laser removal of skin stretch marks, which are practically not amenable to conservative therapy and, moreover, to various folk remedies, are in the greatest demand. By a similar procedure resorted to women after childbirth, a sharp and rapid weight loss. The main objective of the pulse effect is the alignment of the skin structure, the normalization of metabolic processes and the water balance of the skin. Usually, after a session, the area of ​​exposure becomes red and edematous, then these symptoms disappear.

On the face, the scars mainly appear as a result of the active course of acne (or its improper treatment). They are localized in the area of ​​increased secretion of the sebaceous glands (on the forehead, chin, "T-zone"). If you are interested in how to get rid of scars, then to eliminate them use a neodymium laser. It has a minimal effect on the skin, rarely causes complications, but complete healing of the skin of the face takes several weeks.

Removal of facial scars: preparation for the procedure, possible contraindications, follow-up care

Special preparation for the procedure is not required. You must first visit the doctor, who will exclude contraindications. The only thing is not recommended to expose the area where the scar will be removed under the rays of the sun or tanning lamps. In addition, you need to warn the beautician when taking any medication, as some drugs have the property to increase the photosensitivity of the skin.

The procedure is carried out in several stages:

1. The application of the drug for local anesthesia, before the start of its action, takes 15–20 minutes.
2. Treatment of the pathological site of scar formation with a laser pulse with predetermined parameters.
3. Applying a regenerating ointment or serum to the skin.

Laser removal of scars on the face and body has a number of contraindications, it is:

• pregnancy and breastfeeding;
• non-active active course of diabetes mellitus;
• malignant lesions of the skin and internal organs;
• active course of dermatosis;
• bleeding tendency;
• increased photosensitivity of the skin;
• allergic to agents used during the procedure.

In some patients, exposure to laser radiation can cause a number of reversible complications:

• increased body temperature;
• hyperemia;
• puffiness;
• itching in the treatment area.

The skin after the removal of scar connective tissue requires special care. Of course, it is impossible to completely refrain from water procedures, but the water temperature should not be too hot. You can not visit the pools, saunas and baths for 1-2 weeks, apply decorative cosmetics, alcohol-based products on the treated skin. For the fastest tissue regeneration, it is recommended to use external ointments and aerosols containing panthenol.

Laser removal of scars on the face and body is a modern method of dealing with aesthetic skin defects. Often, a similar procedure is carried out to eliminate the effects of surgical intervention. Such cosmetology treatment is safe, does not require a long recovery, hospital stay, suits most patients.