Atrophic scars can occur on the skin after any kind of injury (burns, cuts, severe acne). Unlike hypertrophic and keloid scars, atrophic scarring results from a lack of sufficient collagen and other connective tissues. The wound isn’t completely filled in – so the scarred area is not quite flush with the surrounding skin. The scar tissue itself is usually pale and soft. These scars don’t generally cause any physical discomfort. However, they can be disfiguring if they are particularly large, numerous, or if they appear on the face.
Ablative fractional resurfacing (AFR) is one laser technique that is being explored for its ability to restore skin that is marred with atrophic scars. Like non-ablative laser and dermabrasion techniques, it works by causing minor damage to dermal tissue. Then, as the healing process begins new collagen is formed in the surface and mid layers of the skin. Ideally, enough dermal collagen will be produced to fill in the scar and improve the texture and coloration of the affected skin.
For mild acne scars, an excellent outcome could leave the skin looking normal and unscarred. For moderate to severe scars (such as those resulting from surgery), simply fading the scars and making them less noticeable would be considered an acceptable result.
Scar Study Shows Promising Results
In one small study in 2007, a dozen women with atrophic scars resulting from trauma or surgery (not acne) underwent a sequence of 3 AFR treatments. Their results were tracked for 6 months. Before and after evaluations were carried out by both researchers and patients. In addition, 3-dimensional maps were created to permit changes in scar tissue volume and depth to be measured more objectively. In all, improvements were reported in pigment, skin texture, and volume. Scars were raised an average of 35.6% making them more level with the surrounding tissue. The actual amount of atrophic scar tissue present was reduced by about 38% – apparently being replaced with normal tissue.
The researchers chose the fractional laser because it causes less disruption and damage to the skin than a traditional ablative laser. This promotes faster healing with fewer side effects. At the same time, it allows deeper penetration of the skin to stimulate collagen production far below the surface. The patients in this study did experience mild to moderate side effects such as swelling, redness, discoloration, tiny broken blood vessels, and oozing/crusting. No patients had scarring as an adverse reaction to the treatment.