May 16, 2000 -- Chemical peels? Dermabrasion? Laser resurfacing? When you begin looking for ways to improve the acne scares on your face, what's the best option for you?
Laser resurfacing may hold promise as a new treatment for acne scars, but patients need more information before making a choice, according to a recent report in the British Journal of Dermatology.
"I had two dermabrasions that didn't improve my [acne] scars, but there's a big difference since laser surgery," says Mercedes Rezvanpour, 36, who underwent the laser resurfacing procedure in March.
Rezvanpour's dermatologist used the YAG laser, even though it takes longer to heal. After surgery, she applied moist bandages hourly and saw the doctor daily.
"It was scary at first, because my face was so swollen," Rezvanpour says. "But in two weeks, I was wearing sunscreen and makeup again." She advises taking at least two weeks off from work to heal.
"Lasers actually burn the face to create a new skin surface, but there's almost no information about how patients perceive the procedure or how it affects their lives," says lead study researcher Rachel Jordan, a research fellow at the University of Birmingham in the United Kingdom.
Jordan reviewed 16 research studies on laser resurfacing for facial acne scars. There were no standard measures for scar improvement or patient satisfaction, but the findings suggest that the procedure is up to 90% effective and is more precise than dermabrasion, in which a rough, abrasive edge is used to remove scars, and chemical peels, in which chemicals remove layers of skin to remove scars.
Lasers are named according to the source that creates the energy beam. Different lasers are more useful for certain procedures and skin types. For example, the Erbium:YAG laser is better for improving darker skin.
Most of the studies Jordan looked at tested the effectiveness of the carbon dioxide laser, although results were similar with the YAG laser. In all cases, a new skin surface formed within 10 days, and redness lasted for about two months. Up to 45% of the patients had temporary changes in skin color, but infections were rare.
U.S. dermatologists say outcomes are determined by scar depth and patient expectations. "Laser resurfacing is most effective for shallow scars that can be stretched with the fingers," says Atlanta dermatologist Sunila Walia, MD, who has done hundreds of full-face resurfacings with the carbon dioxide laser.
Walia tells WebMD that patients can expect a 50% to 80% improvement, but should allow 18 months for complete remodeling. Deep or "ice pick" acne scars can be treated in several ways before or during laser resurfacing, and board-certified dermatologists and plastic surgeons are likely to have the best results.
So what's the cost? Full-face laser resurfacing ranges between $4,000 and $8,000, depending on local demand. Fees are lowest in the Southeast and highest in the Northeast, and managed care companies usually consider the procedure to be cosmetic, so insurance coverage is rare.
But even with its out-of-pocket cost, it's still a good option, according to Rezvanpour. "Downtime and inconvenience are nothing compared to the benefits of scar reduction, because having more confidence improves just about everything," she says.
- Laser resurfacing burns the face to create a new skin surface and reduce acne scars, but complete remodeling takes 18 months.
- Up to 45% of all patients have temporary changes in skin color, but infections are rare.
- The procedure is up to 80% effective for shallow scars, but deep scars can be treated before or during laser resurfacing.