Fractional Resurfacing Offers Hope for Those With Burn Scars
Burn victims are left with the scars of their injury and until recently there were few effective treatments available. Fractional lasers such as Solta Medical’s Fraxel and the UltraPulse from Lumenis have now provided hope for burn patients, and for treating other scars as well.
“Since the fractionated lasers have come out, we have actually been really pushing those devices to see where we can get with burn scars,” says Dr. David Verebelyi. “Before, our only tool for treating scars was injection of Kenalog with steroids, pulsed dye lasers and then maybe resurfacing with a full CO2. Now we can get that tissue to really remodel at a much deeper level by using some of the fractionated lasers. Right now, we’re optimizing those treatments looking at everything from high density pulses and high fluency pulses, trying to get the best bang for the buck with those.”
Dr. Verebelyi says that he is also able to treat the scars of those with darker skin tones with fractional resurfacing, but the technology of choice depends on what kind of scar is being treated. “For superficial scars, the sublative stuff works a little bit better. For the atrophic scars, we tend to use a little bit deeper procedures. You always have to worry about discoloration, it doesn’t matter what the skin color, but any of those limiting factors normally don’t last more than a few months.”
The number of treatment sessions needed varies based on the severity of the scar. As Dr. Verebelyi describes, “Anywhere from 3-5 is pretty average, but it depends on the clinical end point that you want, and how thick the scar is. A traumatic burn scar might take more than 5 treatments whereas an acne scar might take three.” What treatment a patient receives also determines how long it is before a patient can expect to see their final result. “For lighter treatments, you know, those things will continue to remodel for at least 3-6 months. But, it will look pretty good after a few weeks. For deeper treatments, redness can last 90 days and then you might remodel as long as a year.”
There is very little pain associated with the fractional procedure. “The level of pain – it’s virtually painless. What we do with our patients, we use a topical ointment, put it under occlusion, which basically means we stick it under a piece of Saran wrap for a couple of hours. My patients do great with that. Nobody rates the pain at above a 1–2 out of 10. The recovery time on those – you might have to put some ointment on them for about a week but that’s about it. Most patients we treat about every month, about every 4 weeks we see them back for another treatment.”