Laser treatment has emerged as a leading option for removing scars. Lasers direct heat at small areas of scar tissue, decreasing blood supply and destroying the irregular tissue.
This procedure is well-tolerated and causes few side effects, but it should only be performed by a board-certified dermatologist (skin specialist) and facial plastic surgeon. Though effective, it typically takes multiple treatments to see complete results, and this therapy may not be appropriate for everyone.
This photo contains content that some people may find graphic or disturbing.
How the Treatment Works
Laser treatment for scars works by heating up and destroying abnormal cells that form scars and rerouting blood flow. Lasers emit specific wavelengths of light to do this.
For example, a laser with wavelengths of 585 to 595 nanometers (nm) is effective for shrinking visible blood vessels. Dermatologists and facial plastic surgeons use lasers with longer wavelengths (up to 10,600 nm) to treat thickened skin.
Laser treatment for scars typically requires multiple treatments to destroy the abnormal tissue and fade the scar.
Cost and Finding a Provider
Some insurance plans cover laser treatment for a scar if you experience symptoms like pain and sensitivity, making it a medical necessity. However, because many scars are considered cosmetic rather than medically necessary problems, laser therapy is often not covered by insurance.
According to the American Society of Plastic Surgeons, the average cost of laser treatment for scarring is about $1,830. However, how much you pay out-of-pocket for laser therapy varies widely.
Factors like the scar severity, the healthcare provider and their practice, the use of anesthesia, and the number of treatments needed can all influence cost.
Procedure Types
There are several types of laser procedures for treating scars, each with specific applications, advantages, and disadvantages. Your dermatologist and facial plastic surgeon will help you determine the best approach.
Ablative Laser Resurfacing
Ablative lasers work on the epidermal (outer) and dermal (middle) layers of skin. This approach (known as laser resurfacing) relies on longer wavelengths of light to heat up, destroy scar tissue, and promote new collagen growth. It is typically reserved for deeper scar tissue.
Pulsed carbon dioxide (CO2) lasers were the first used for scars; though effective, they have a greater risk of adverse side effects, such as oozing and crusting.
An ablative option that doesn’t penetrate as deeply and may cause fewer side effects is the erbium:yttrium–aluminum–garnet (Er:YAG) laser.
Non-Ablative Laser Resurfacing
Non-ablative lasers act primarily on the dermal layer of skin to stimulate collagen growth. This technique relies on laser wavelengths between 1,440 and 1,550 nm and is the preferred option for shallow scars compared to ablative techniques. It is more appropriate for shallower scars than ablative resurfacing.
Including pulsed-dye lasers (PDL), intense pulsed light (IPL), neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers, diode lasers, and others, non-ablative laser resurfacing tends to cause fewer adverse side effects than ablative approaches.
How to Prepare
Laser treatments for scars are well-tolerated. If your dermatologist or facial plastic surgeon has determined you’re a good candidate for treatment, they’ll give you instructions on preparing, such as:
- Avoiding excessive sun exposure, sunbathing, or tanning beds for two weeks before the appointment
- Steering clear of chemical peels or injections of collagen for two weeks before treatment
- Keeping the scar clear of perfumes, deodorants, or irritants before treatment
- Avoiding skin products with retinol (vitamin A) or glycolic acid for two to four weeks before treatment
- Treating or taking medications to prevent cold sore formation
- Not smoking for at least two weeks before treatment
What to Expect
Laser treatment results are not immediate. With non-ablative lasers, therapy may take multiple treatments—anywhere from several a week to a few months—and it may be combined with other cosmetic approaches.
Laser treatments can cause pain. With ablative approaches, the dermatologist may first inject an anesthetic to ease discomfort. Before applying the laser, they’ll also carefully clean and disinfect the targeted area. They may apply ice or other methods to cool the skin between laser pulses.
Recovery
Recovery times from these treatments vary depending on the severity of your scar and the type of laser used. It can take several weeks to a month or more to see complete results, and there may be some temporary side effects and post-treatment issues.
Here’s what you can expect after laser treatment for scars:
- The timeline to return to work and normal activities can vary depending on the type of laser.
- You can expect redness or discoloration in treated areas for four to eight hours after treatment.
- You may experience stinging or a sunburn-like pain for several hours after; use a cold compress to ease symptoms.
- You may experience swelling in treated areas, which typically resolves within a couple of days.
Post-Laser Therapy Skin Care
Avoid using makeup or moisturizer on affected areas for the first 24 hours after therapy—or until any stinging, redness, or skin discoloration subsides. Afterward, apply moisturizer to treated areas twice a day throughout the course of treatment and for up to three months after the final session. Protect treated areas from ultraviolet (UV) rays by wearing sunscreen or UV-protective clothing.
Do the Scars Disappear Completely?
Laser treatments for scars can manage associated symptoms—especially pain and sensitivity—but they cannot entirely remove the scar. Instead, these therapies replace more severe scars with less visible ones. They can also help alter skin pigment to make discoloration less noticeable.
How successful laser therapy is for scars depends on several factors, including the severity of the case and the timing of treatment.
Studies have noted that earlier interventions—within days, weeks, or months of injury or surgery—improve overall results. Though there are variations based on the laser type, researchers have developed treatments to reduce the appearance, skin thickness, and discoloration of scars with multiple laser treatments.
Risks and Side Effects
Laser treatments for scars are minimally invasive and relatively safe. However, you can expect some side effects, and the treatments carry some risks. These include:
- Stinging, itchiness, and redness in treated areas, which is usually temporary
- Darkening of the skin (post-inflammatory hyperpigmentation, which is typically temporary)
- Hypopigmentation (permanent discoloration of the skin)
- Burns, additional scarring
- Infection
- Crusting
- Milia (small white pimple-like bumps)
Who Should Avoid Laser Treatment?
Before your appointment, your healthcare provider will evaluate your scar and ensure you are a good candidate for laser treatment. While this treatment is appropriate for most people, it may not be for everyone. Speak to a healthcare provider about the best options to manage and treat your concerns.
Laser Treatments and Darker Skin
Darkly pigmented skin contains more melanin (the substance that gives skin color). When treated with lasers, darker pigment absorbs more light from lasers, which can increase the chances of complications like scarring and permanent skin discoloration.
Other Ways to Get Rid of Scars
While laser treatment for scarring has grown in popularity, it isn’t the only option. Other therapies to manage scarring include:
- Corticosteroid injection: Injections of corticosteroids into raised or swollen scars can help shrink them.
- Cryosurgery: Sometimes used alongside other treatments, cryosurgery involves applying very cold temperatures to destroy scar tissue.
- Pressure therapy: This involves using bandages or compression garments to apply pressure to an injury to prevent scarring (especially if caused by burn) and avoid recurrence after surgery.
- Radiation: Another method of destroying and managing scar tissue, X-rays shrink scar tissue by disrupting cell activity.
- Silicone gel: You can apply silicone as a sheet or ointment. Silicone shrinks the size of an existing scar, softens skin, reduces swelling, and eases other symptoms.
- Surgery: Often reserved for complex cases, dermatologic surgeons carefully cut away scar tissue.
Summary
A standard, often first-line approach to removing scars is laser resurfacing. With this treatment, laser light is directed to the affected tissue to stimulate collagen growth, reducing the size of scars and easing symptoms. This minimally invasive treatment is well-tolerated, though it can cause side effects like stinging and changes in skin color. This treatment may not work well for everyone; a healthcare provider can help determine if you are a good candidate for laser treatment.