Carbon dioxide or Erbium lasers are used on a variety of scars to carefully remove a controlled amount of the damaged outer layer of skin. It leads to the repair of the surface layers and can stimulate new collagen formation. Collagen provides structure and strength to our skin.
Skin resurfacing can soften the scar, even out discolouration and produce a smoother and tighter appearance.
For acne scarring, lasers have largely replaced earlier resurfacing techniques such as chemical peels and dermabrasion.
New treatments using "non-ablative" lasers to stimulate new collagen production do not damage the top layer of the skin and may be used for soft, indented scars.
Plasma resurfacing seems to not produce the hypopigmentation (bleaching) associated with resurfacing with lasers and deep peels.
Plasma resurfacing uses high-energy nitrogen plasma to cause the top layers of skin to shed and create a new surface for the skin.
Unlike laser resurfacing, the old skin surface stays in place until the new layer grows underneath, so no open wound is created (unless it is scratched off). The new skin continues to transform for months afterwards.
The new collagen formation has a more natural layout compared to that following laser resurfacing and peels.
To date, there has been no incidence of hypopigmentation of the skin, which had been a significant problem with the sort of deep resurfacing required to treat acne scarring.
Fractional laser treatment
Fractional laser treatment, sometimes also known as fractional resurfacing, is a treatment for improving skin texture and blending-in imperfections such as acne scarring.
Beams of laser light penetrate pixel-fashion very deeply into the skin causing remodelling in all layers down to the depths of the scars. Treatment may be 'ablative' where there is vapourisation of these pixels of tiwwue or 'non-ablative' where no wound is created.
A series of treatments is required, each causing redness and swelling for up to a week for the non-ablative treatment and longer for the ablative treatment. The full skin surface is not removed, unlike previous laser resurfacing techniques. Special ointments or skin care may be advised following ablative treatment; they may not be required for the non-ablative treatment. Regional treatments are also possible as the skin is not abnormally lightened as can occur with other resurfacing techniques.
The treatment is usually conducted after anaesthetic cream has been applied for quite some time (over an hour) or local anaesthetic has been injected. Some treatments may require sedation.