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- The skin’s normal wound healing process involves coagulation, inflammation, proliferation and remodeling.
- Hypertrophic scars and keloids occur when the skin’s normal wound healing process goes away. Further, they more commonly occur in ethnic skin.
- There are multiple techniques used to treat these scars, and recent advances in laser therapy have made lasers a practical alternative.
The skin is a primary barrier for protection and is often submitted to damage from surgical procedures, burns, trauma, infection, or inflammation. The skin has an incredible capacity to renew and repair itself through a process called wound healing, in which a cascade of mechanisms result in scarring.
The treatment of hypertrophic scars and keloids is challenging due to high recurrence rates and adverse side effects. Previous methods for treatment have included surgery, cryotherapy, electrocautery and desiccation, dermabrasion, intral- esional corticosteroids, 5-fluorouracil, and radiation. In terms of lasers, Ablative CO2 and Erbium:YAG lasers were used for hypertrophic scars.
- Pre-operative management includes obtaining a detailed history and examination of the patient’s scars, and if any prior therapy has been done. The area for treatment should be cleaned thoroughly and topical anesthetic may be used for comfort. It is important to take a picture of the scar before therapy to track its progress and note any side effects that may occur.
- Laser therapy involves appropriately calibrating and setting the laser parameters. It may be used alone or in conjunction with intralesional medical therapy. Multiple treatments are needed to obtain better results.
- Postoperatively, the patient should avoid the sun and keep the treatment area clean and protected.