CO2 Laser Treatment for Scars: What You Need to Know

Vaporization laser

Hello, I had a car accident at the end of September two years ago, which left me with two scars on my chin.
I have undergone corticosteroid injections, cryotherapy, and dye laser treatments.
The most recent treatment was a combination of carbon dioxide (CO2) laser and dye laser.
However, it seems that the scars are getting larger with each treatment.
While the scars have become flatter, they are still not completely smooth.
When I smile, the two sides of my chin appear uneven, and there is some abnormal tissue.
The doctor suggested trying the CO2 laser this time, and if it doesn't work, they may need to excise the scar and remove the underlying tissue.
I'm concerned about whether this will leave more scars.
If I don't undergo that type of surgery, will continuing with the CO2 laser be effective? Will it completely heal? Could it further damage my skin? I have been feeling a continuous expansion sensation, and this injury has been present for over a year without much improvement.
Please help me with these questions, thank you!
Additionally, the doctor mentioned that I need to protect my skin from sun exposure after the laser treatment, but I also need to apply medical tape, which needs to be changed every two to three days.
How can I reapply sunscreen on the skin covered by the tape? And how do I remove it? If I only change the tape every two days, won't that harm my skin? I'm confused about this.

Also, after a recent trip where I accidentally got sunburned, I have a few sunspots on the side of my face.
What should I do to remove them? Should I focus on moisturizing, use a spot treatment cream, try Duke's L-ascorbic acid, or apply the Avene regeneration and nourishing cream?

niang, 10~19 year old female. Ask Date: 2005/08/31

Dr. Lu Daokuan reply Plastic Surgery

Complete wound maturation may take 1 to 2 years.
You might be doing too much, which may not necessarily be beneficial.
It would be advisable to consult a physician experienced in scar management who is also patient, to discuss further steps.
At 19 years old, if you are developing spots after sun exposure, it could indicate a tendency for freckles.
Using L-ascorbic acid (Vitamin C) and applying sunscreen every morning can lead to improvement in 1 to 2 months.

Reply Date: 2005/08/31

More Info

CO2 laser treatment is a well-established method for addressing various types of scars, including those resulting from accidents or surgeries. However, it is essential to understand both its potential benefits and risks, especially in your case, where you have experienced mixed results from previous treatments.

Understanding CO2 Laser Treatment
CO2 lasers work by delivering focused energy to the skin, which vaporizes the outer layers and stimulates collagen production in the deeper layers. This process can help flatten raised scars, improve skin texture, and reduce discoloration. However, the effectiveness of CO2 laser treatment can vary based on several factors, including the age of the scar, the type of skin, and the specific characteristics of the scar itself.

In your situation, it seems that while the scars have become flatter, they are still not completely even, and you are experiencing a sensation of expansion. This could indicate that the scar tissue is still maturing, which can take 1-2 years. It’s also possible that the treatments you have undergone may have led to some irritation or inflammation, causing the scars to appear more prominent.

Risks and Considerations
1. Potential for Increased Scarring: While CO2 lasers can improve the appearance of scars, there is a risk that they may cause further irritation or scarring, especially if the skin is sensitive or if the treatment is not performed correctly. It’s crucial to have a skilled practitioner who can assess your skin type and the nature of your scars before proceeding.

2. Surgical Intervention: If the CO2 laser treatment does not yield satisfactory results, your doctor may suggest surgical excision of the scar tissue. This procedure can remove the scar but carries its own risk of creating a new scar. The new scar may be less noticeable, but it will still require time to heal and mature.

3. Ongoing Treatment: Continuing with CO2 laser treatments may be beneficial, but it’s essential to allow adequate time between sessions for healing. Over-treating can lead to skin damage and may not provide the desired results.

Post-Treatment Care
After CO2 laser treatment, protecting the skin from sun exposure is critical. Your concern about using sunscreen while having adhesive tape on the skin is valid. Here are some tips:
- Sunscreen Application: If your doctor has advised you to use adhesive tape, it’s best to apply sunscreen around the edges of the tape. You can also use a physical sunscreen that contains zinc oxide or titanium dioxide, as these are less likely to irritate the skin.

- Changing Dressings: If you need to change the adhesive tape, do so gently to avoid disturbing the healing skin. After removing the tape, you can apply a thin layer of sunscreen to the exposed areas.

Addressing Sunspots
Regarding the sunspots you mentioned, using a combination of treatments can be effective. Here are some options:
- Hydration: Keeping your skin well-hydrated is essential for overall skin health. Use a gentle moisturizer that suits your skin type.

- Brightening Agents: Products containing ingredients like Vitamin C (such as the Duke L-ascorbic acid you mentioned) can help brighten the skin and reduce the appearance of dark spots over time.

- Exfoliation: Gentle exfoliation can help remove dead skin cells and promote new skin growth, which may improve the appearance of sunspots.

- Consultation with a Dermatologist: If the sunspots persist, consider consulting a dermatologist for targeted treatments, such as chemical peels or prescription creams.

Conclusion
In summary, CO2 laser treatment can be effective for scar management, but it requires careful consideration of the risks and benefits. It’s essential to work closely with a qualified healthcare provider who can tailor the treatment plan to your specific needs and monitor your progress. Additionally, proper post-treatment care, including sun protection and hydration, is crucial for achieving the best results. If you have ongoing concerns about your scars or skin condition, don’t hesitate to seek a second opinion or further consultation with a specialist.

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