For individuals with deeply pigmented skin, there is often a high risk of coloration changes after an injury or inflammation affects the skin. Sometimes, skin ends up with darker patches. However, lightening (hypopigmentation) is another common result. With many skin conditions, the normal coloring will return after treatment with topical medications or simply after enough time has passed for healing to occur. Scarring and lightening that occurs as an inflammatory response may require additional treatment. Laser scar removal is one approach that has been used with some success.
This laser emits a single wavelength of light in the UV-B range (found in sunlight). In one study conducted in 2004, thirty one patients received multiple treatments with the 308-nm excimer laser over a period of several months. The laser was used on a low setting to reduce the skin-reddening side effect of the treatment. It took about 9 treatment sessions for these patients to achieve the desired level of pigment correction.
Unlike many dermatologic studies, this one didn’t rely on the opinion of either the doctor or the patient to measure improvement. The investigators decided they needed more objectivity. “Blinded” third party observers reviewed photos of the treated sites and rated them for how well the scar tissue or stretch marks matched the surrounding skin. These observers noted an improvement of 60-70% compared to the untreated control sites. A colorimeter was also used to analyze the level of repigmentation. This device showed that the treated skin was a 100% match for the surrounding skin.
Unfortunately, the results didn’t last. Maintenance treatments are required to keep the skin dark. This isn’t surprising since UV-B radiation exposure is basically a form of tanning. However, dark skinned individuals did maintain their results longer than those with light skin. The study researchers anticipate that ongoing laser scar treatment would be needed every few months to keep the hypopigmentation at bay.
The Fraxel 1550-nm laser was used in a study involving just 7 patients in 2007. Six of these patients enjoyed an improvement of more than 50% in repigmentation. It took between 2 and 4 treatments spaced a month apart to achieve this effect. The results were reviewed by physicians who were not involved in providing the treatment. Their assessment was similar to the satisfaction level reported by the patients themselves. The overall skin texture in the treated areas appeared to improve as well. Besides some minor swelling and redness, no side effects were reported. The results lasted longer than 3 months.
Both of the studies listed above are too small to make sweeping conclusions. However, they do point to additional options patients with dark skin tones can discuss with their dermatologist for laser scar removal.