Laser Skin Resurfacing
Laser resurfacing is a technique used to reduce acne scarring by “selective phototheromolysis.” This concept employs the use of specific energy fluence, wavelengths, and laser time, in order to reach specific dermal and epidermal layers. Two different types of popular ablative lasers are the C02 (10,600 nm wavelength) and Er:YAG (2940 nm wavelength) lasers. These lasers penetrate deeper than superficial skin resurfacing lasers such as Pulsed Dye Lasers, which are commonly used for skin discoloration and other superficial blemishes.
Acne Scar Reduction
Once acne vulgaris is adequately controlled medically and new lesions are no longer developing, attention can be turned to addressing the cosmetic affects of atrophic scarring. Multimodality treatment is typically most often employed to reduce the appearance of acne scarring. Typical treatment options include primary scar excision, laser therapy, chemical peels, microneedling, dermaroller treatment, dermabrasion, and temporary/permanent filler injections.
Acne vulgaris is a disease that is common in adolescent populations, with severe lesions frequently causing cosmetically unappealing scars on the face. The pathogenesis of scar formation from acne is thought to be from an altered healing response to the inflammation caused in the skin, which can negatively affect collagen’s ability to regenerate. Acne scarring most commonly results in atrophic scarring, to include boxcar, ice pick, and rolling scars. Scars, in addition to causing a surface defect, may also be hyper or hypopigmented.
The Sciton Erb:YAG laser is an ablative laser, the chromophore (affected cell component) of which is water. The depth of tissue vaporized is roughly 3-5 micrometers. Using the monitor display, the provider can adjust the ablation and coagulation depth. After resurfacing, the skin may become scabbed and weep, and it is important to keep the skin hydrated with a hydrated healing ointment. The epithelial surface will regenerate at around 1 week, but redness may persist for up to 3-4 weeks. The Sciton Erbium laser causes less heat damage than other CO2 lasers, which can reduce the postoperative social down time required for redness to resolve.