Laser Treatments for Acne Scars and Keratosis: What You Need to Know

Q: Laser Treatments for Acne Scars and Keratosis: What You Need to Know

Hello： Based on your description, your condition seems to be more aligned with post-inflammatory hyperpigmentation. <br>Generally, the pigmentation on the body takes a longer time to fade, ranging from a few months to several years. <br>Since the circulation in the body and limbs

Can laser treatment be used for keratosis pilaris and acne scars?

Hello, I have brown scars on my body caused by squeezing pimples and keratosis pilaris on my arms.
These scars have been present for over seven years, and the color is still very noticeable, resembling brown spots like freckles.
I would like to know if these are considered hyperpigmentation or scars.
I have undergone treatments with glycolic acid, which helped to lighten new acne scars, but there has been no significant improvement on the older scars.
Could you please advise on which laser treatments can help reduce the color of these scars so they become less visible, and what post-treatment care would be relatively easy? Thank you.

Li, 20~29 year old female. Ask Date: 2012/07/15

Dr. Lin Xinpeng reply Dermatology

Hello: Based on your description, your condition seems to be more aligned with post-inflammatory hyperpigmentation.
Generally, the pigmentation on the body takes a longer time to fade, ranging from a few months to several years.
Since the circulation in the body and limbs is not as good as that on the face, you may consider starting with gentler methods such as applying whitening creams, using alpha hydroxy acids for chemical peels, or opting for laser treatments like photorejuvenation or diode laser to reduce melanin.
However, it is crucial to avoid overly aggressive treatment regimens and to undergo procedures under the guidance of a qualified dermatologist.

Reply Date: 2012/07/15

More Info

When it comes to treating acne scars and keratosis, particularly those that have persisted for over seven years, it's essential to understand the nature of your skin concerns. The brownish spots you described, which resemble freckles, are likely a combination of post-inflammatory hyperpigmentation (PIH) and possibly some scarring. PIH occurs when the skin darkens after inflammation, such as from acne, and can take a long time to fade, especially if the skin has been traumatized repeatedly.

For treating these types of discolorations, laser treatments can be highly effective. There are several types of lasers that can help with both pigmentation issues and textural irregularities associated with acne scars:
1. Fractional Laser Treatments: These lasers, such as Fraxel, work by creating micro-injuries in the skin, which stimulates collagen production and helps to improve skin texture and tone. They can be particularly effective for both acne scars and pigmentation. The fractional approach allows for quicker healing times compared to full-field lasers, making them a popular choice for many patients.

2. Pulsed Dye Laser (PDL): This laser specifically targets blood vessels and can help reduce redness and improve the appearance of pigmented lesions. It can be beneficial for treating post-inflammatory hyperpigmentation as well.

3. Q-Switched Lasers: These lasers are effective for targeting pigment in the skin. They can help break down the melanin in the skin, which may help lighten the brown spots you are experiencing.

4. Erbium YAG Laser: This laser is effective for resurfacing the skin and can help with both pigmentation and textural issues. It is less aggressive than CO2 lasers, making it suitable for those with sensitive skin or those who want a shorter recovery time.

In terms of post-treatment care, it is crucial to follow your dermatologist's recommendations closely. Generally, after laser treatments, the skin may be sensitive and require specific care to promote healing and minimize complications. Here are some common post-care tips:
- Sun Protection: After any laser treatment, your skin will be more sensitive to the sun. Using a broad-spectrum sunscreen with an SPF of 30 or higher is essential to protect the treated areas from UV damage, which can worsen pigmentation.

- Moisturization: Keeping the skin well-hydrated is vital for healing. Use gentle, non-irritating moisturizers to help maintain skin hydration.

- Avoid Irritants: For a few days post-treatment, avoid using products that contain retinoids, alpha hydroxy acids (AHAs), or other potentially irritating ingredients. These can exacerbate sensitivity and irritation.

- Gentle Cleansing: Use a mild cleanser to wash your face, avoiding scrubs or exfoliating products until your skin has fully healed.

- Follow-Up Appointments: Regular follow-ups with your dermatologist are essential to monitor your progress and make any necessary adjustments to your treatment plan.

In conclusion, while laser treatments can be highly effective for reducing the appearance of both acne scars and pigmentation, it is essential to consult with a qualified dermatologist who can assess your specific skin type and concerns. They can recommend the most appropriate laser treatment and provide personalized post-care instructions to ensure the best possible outcome. Remember that patience is key, as significant improvements may take time and multiple sessions.

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