Are patients satisfied with laser scar treatment ?
Satisfaction is generally linked to a visible improvement in the scar, but varies depending on the type of scar and the laser used.
Studies assessing fractional lasers for acne scars show that many patients report being satisfied after treatment. However, satisfaction is not identical with every technique and does not mean that the scar has disappeared.
One patient may be satisfied because their scars are shallower or their skin looks more even. Another may consider the result insufficient if their initial aim was to achieve perfectly smooth skin.
Reviews should therefore be interpreted in relation to the result expected before treatment.
Why are some patients satisfied with laser treatment ?
Patients satisfied with laser treatment generally find that their scars are less visible, even though they do not disappear completely.
Depending on the type of scar and the laser used, treatment can reduce the depth of some depressed scars, make the skin surface more even or improve its texture. When a scar has persistent redness, a laser targeting the vascular component can also reduce its colour.
The scar may thus become less visible from a distance or under certain lighting. However, the result depends on the problem being treated : a laser used to remodel a depressed scar does not work in the same way as a laser intended to reduce redness.
The American Academy of Dermatology points out that laser treatment can make a scar less visible, but cannot make it disappear completely.
Why does laser treatment not produce good results on some scars ?
Negative reviews of laser scar treatment are mainly associated with results falling short of expectations, treatment poorly suited to the scar or recovery that is more demanding than expected.
Laser treatment cannot make a scar disappear completely. Disappointment may therefore arise when the expected improvement is too great compared with what is actually possible.
The result also depends on the type of scar and the laser used. A deep scar may not improve sufficiently with laser treatment alone, while a poorly chosen laser may fail to act on the scar's main characteristic. Some scars require several sessions or a combination of different techniques.
The result should not be assessed too early either. After certain laser treatments, skin remodelling continues after the session and improvement appears gradually.
Finally, redness, crusting and recovery time may be more significant than the patient anticipated and influence their assessment of treatment.
A negative review can therefore have several explanations : insufficient results, unrealistic expectations, unsuitable treatment or recovery considered too significant.
What are the reviews of laser treatment for acne scars ?
Reviews of laser treatment for acne scars vary because its effectiveness depends on the type, depth and shape of the scars. Superficial scars generally respond better to fractional laser treatment than very deep scars or those tethered to underlying tissues by substantial fibrosis.
Depressed acne scars may be ice pick, boxcar or rolling scars. These scars differ in shape and depth and therefore do not respond to laser treatment in the same way. Several types of scars may also be present on the same face.
Fractional laser treatment can improve skin surface contours and texture and reduce the depth of certain atrophic scars. When a scar is very deep or highly fibrous, laser treatment alone may be insufficient and require a combination with another technique.
Differences in reviews can therefore partly be explained by the characteristics of the scars treated. A patient with superficial scars may achieve satisfactory improvement with laser treatment, whereas a patient with deep scars may be disappointed if laser treatment is used alone.
Is laser scar treatment painful ?
The pain experienced depends greatly on the type of laser and the intensity of treatment.
Ablative fractional lasers, particularly CO₂ and erbium, can cause a sensation of heat or burning during the session despite the use of topical local anaesthesia.
Non-ablative fractional lasers generally involve less significant recovery, but this does not mean that they are completely painless.
A recent meta-analysis comparing fractional CO₂ and Erbium lasers for atrophic acne scars found no significant difference in satisfaction between the two technologies. However, Erbium was associated with less pain and shorter periods of redness and crust formation.
Satisfaction therefore also depends on the accepted balance between treatment intensity, discomfort and recovery time.
Do scar treatment results vary depending on the laser used ?
Reviews differ depending on the laser used because the technologies do not all act on the skin in the same way and do not cause the same level of discomfort or the same recovery time.
An ablative fractional laser creates microzones of ablation in the skin and generally causes more significant recovery effects. A non-ablative fractional laser heats microscopic areas of the dermis without removing the skin surface, generally with milder recovery effects.
Results and recovery effects also vary according to the laser wavelength and the settings used during treatment.
Two lasers can therefore achieve comparable results and satisfaction levels while causing different pain levels and recovery times.
A review of “laser treatment” is therefore difficult to interpret if the technology used is not specified.
Can online reviews of laser scar treatment be trusted ?
A testimonial can describe one patient's experience, but cannot predict another person's result.
An online review rarely specifies the depth and type of scars, the patient's skin phototype, the laser used, its settings or the number of sessions performed.
Two apparently contradictory comments may therefore concern very different medical situations.
Reviews are mainly useful for understanding certain practical aspects of the experience : pain experienced, extent of redness, duration of recovery effects or personal perception of the change.
They are much less reliable for determining whether a particular laser is indicated for your own scar.
How can you know whether laser treatment is suitable for your scar ?
To know whether a laser is suitable for a scar, the scar and skin must first be examined : the choice of treatment depends on the type of scar, its depth, its surface contours, its colour and the patient's skin phototype.
A depressed scar, a raised scar and a predominantly red or pigmented scar are not treated with the same laser. The depth and age of the scar are also taken into account to determine the result that can be achieved.
The skin phototype helps assess, in particular, the risk of pigmentation changes after laser treatment. All these factors help select the appropriate technology and explain the expected recovery effects and the number of sessions that may be necessary before treatment.
In Geneva, the consultation therefore determines whether laser treatment is actually indicated, which type of laser to use and what improvements can reasonably be expected.
Other patients' reviews cannot predict your own result : for a comparison to be valid, you would need the same type of scar, similar depth, a comparable skin phototype and treatment with the same laser and a similar protocol.
What do studies say about the effectiveness of laser scar treatment ?
Scientific studies show that fractional lasers can improve certain scars, particularly atrophic acne scars, but that the result depends on the type of scar and the laser used.
There is particularly extensive evidence for depressed acne scars. Systematic reviews and meta-analyses report improvements in scar surface contours and appearance after fractional CO₂ or Erbium laser treatment. The result varies particularly according to scar depth, the number of sessions and the laser settings.
More intense treatment is not necessarily preferable. It may produce greater improvement, but also cause more pain and redness and require longer recovery. Less aggressive treatment generally involves milder recovery effects, but may require more sessions.
Studies therefore confirm that laser treatment can reduce certain scars, but cannot make them disappear completely and is not suitable for every scar. The choice of treatment depends particularly on the type and depth of scars, the skin phototype and the recovery effects the patient is willing to accept.
Article written by Dr Valeria Romano
Dr Valeria Romano supports each patient with a comprehensive approach to the aesthetics of the face, body and intimate areas, and to skin and hair quality. Every treatment is based on a personalised medical assessment.
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