Your Questions
Your Questions
Q: Dr. Eppley, I am interested in laser scar revision. I unfortunately was diagnosed with a sarcoma in my abdominal wall and had resective and reconstructive surgery two months ago. I’m just looking into options to help make my scar look as normal as possible. I was researching laser scar revision and I came across your website and thought you could help with the treatment. I’m just looking at all options at this point. I know now is a bit early since I just had surgery, but I want to continue to stay as proactive as possible and I want to know all my options moving forward. I have attached a picture of my abdominal scar.
A: Thank you for sending your abdominal scar picture. This is an early scar which fortunately is fairly narrow. It is still very red and is not close to eventual scar maturation. (when the redness of the scar will face) So certainly there will be some improvement in the appearance of the scar by the pure passage of time. When it comes to any form of scar therapy, however, now is the time to act not later. Scar treatments have their best effect between 3 weeks and 3 to 4 months after surgery…not a year later. So your looking into scar treatments now is the appropriate time. The best scar treatment at this time is going to be fractional laser scar revision treatments. A series of three laser treatments spaced 4 to 6 weeks apart is my scar therapy approach followed by intervening topical silicone gel applications. These are treatments that can be done in the office under topical anesthesia. While will never make your scar completely disappear, laser scar revision will make it look better in the long run than just natural healing in its own.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I have just read a few artcles from Dr Eppley and I would value his opinion on my scars. I had fractional laser treatment for three scars on my right cheek. Afterwards, unfortunately, I developed an infection as my skin would not heal and there was bleeding underneath. I could not get the area to heal so I ended up contacting a specialist out of the country who diagnosed it s fungal. I was treated with antifungal medications and it healed within a few weeks. While it healed, it developed a lumpy shiny texture. I then underwent intense pulsed light therapy and topical steroids to help the skin recover. This did help. After a while I was recommended to have more fractional laser treatment for further improvement. Despite having good results so far, I thought I could get even better. Unfortunately the settings may have been too strong and things became ten times worse. My right cheek has every imaginable scar and the texture is horrible, just like a burn. I am now having PDL and smoothbeam for one year with very mimimal improvement and I more recently had a PDT treatment which I am not sure if it helped as I am still very red. I seem to have exhausted everything and am now without any hope of looking normal again. Do you have any suggestions.
A: While I have not seen what your cheek looks like, it would be fair to say that the numerous laser and light treatments have ended up making the skin area act more like a scar than normal skin. All of these therapies, laser or light, produce a thermal insult on the skin. And just like burn skin, it will be more sensitive to just about anything you do. Unless…you give the skin area an adequate time to recover without doing anything including topical steroids. An adequate time is at least a year with leaving it alone. While that will understandably seem like an eternity, particularly when it is on your face, it is the best thing to do if ever you are going to do any more therapy that might ultimately be effective. Sometimes patients keep searching for the next light or laser treatment that will be the ‘magic’, when the real magic in some scars is time. I think it time to sit back and let the area fully recover and then re-evaluate.
Dr. Barry Eppley
Indianapolis, Indiana