Laser options abound for treating burn, trauma scars
Key takeaways:
- Burn and trauma scars can be extensive and difficult for patients.
- Jill S. Waibel, MD, gives pearls on how to best approach these cases.
ORLANDO — Innovations in treating burn and trauma scars in recent years include updated laser technology, giving practitioners options to help in these difficult cases, according to a speaker here.
“When I look at a scar, I think about un-coloring a picture. What do I want it to look like when I’m done?” Jill S. Waibel, MD, medical director and owner of Miami Dermatology & Laser Institute, medical director at Miami Cancer Institute, subsection chief of dermatology at Baptist Hospital of Miami and assistant voluntary professor at University of Miami Miller School of Medicine, said during a presentation at the American Academy of Dermatology Annual Meeting. “Dermatology has really created this entire field, and we can now take a burn and trauma survivor and in 20 minutes change their life. It’s really rewarding work.”
Ablative fractional lasers, which were originally made to eliminate wrinkles, were the biggest innovation in the field, according to Waibel.
“The ablative fractional laser has several mechanisms of action. It stimulates new collagen, it stimulates the heat shock protein pathway, it changes the cytokine,” she said.
Additionally, second generations of these ablative lasers, pulsed dye lasers and carbon dioxide (CO2) lasers continue to be the go-to for burn and trauma scars, which often require a step-by-step combination approach.
Waibel approaches scar treatment like “going out to dinner” with appetizer, main course and dessert steps.
Beginning with pulsed dye, intense pulsed light or broadband light lasers for red or early scars, nonablative fractional laser for atrophic scars and thulium or 1470 nm lasers for hyperpigmented scars, she then goes to fractional ablative erbium and CO2 lasers and finishes with laser-assisted drug delivery.
She also highly recommends silicone gel compression for all patients, beginning 48 hours after treatment.
“If you are in front of someone who is suffering, you have the tools at your disposal to alleviate the suffering and this is the best you’ll do to treat patients,” Waibel said.