There has been a lot of progress in scar treatment. Certianly, the use of “fractionated” laser has been a game changer. Since its original use in 2004, there has been change in the way we approach scars, thanks to leading innovators such as Victor Ross, M.D. and Nathan Uebelhoer, D.O. at the Naval Medical Center in San Diego. The new approach can be called “HELD FASTER” which means High Energy, Low Density, Fractional Ablative Scar Treatment at Rehabilitation. Some of the most rewarding work has come in the treatment of scars that are restrictive in nature, many of which may occur in burn patients and in our Wounded Warriors. HELD FASTER has had a predictable benefit in these restrictive scars, especially if treated within the first 6 months of an injury. Most of the work done has focused on the CO2 laser.
As for scar revision in westchester, we have seen some excellent results with an Erbium laser, which has a different wavelength than a CO2 laser, but essentially both lasers target water in the skin. I have had good results in patients with depressed facial scars that are decades old, as well in scar treatments that can be followed in “Chrissy’s Story” in my newsletter.
Recently, I had treated a scar that was the result of a bad facial infection several years ago. This was a case in which the laser was not my first choice. You see, scars are very sensitive to changes in their environment, this according to Dr Donelan at Mass. General Hospital. Now, scar “rehabilitation” is superior to scar “excision” in most circumstances. However, sometimes the skin tension associated with the scar needs to be relieved before I use a laser. Decreasing the scar tension seems to change the skin environment in a beneficial way. There are numerous procedures, with a “Z Plasty” being quite popular.
Better than any scar treatment is the prevention of unfavorable healing. Patients and Physicians both need to understand and interact on wound care better and physicians need to emphasize that the care does not stop when the bandage is placed on the wound.