Use of Lasers in Wound Healing: How to Best Utilize Laser Technology to Prevent Scar Formation
Purpose of Review
The purpose of this review is to evaluate the efficacy of early intervention in wound healing on scar formation across multiple scar types and progressions. The types of scars consist of hypertrophic, atrophic, keloid, and contracture scars. The sources of scarring include inflammatory diseases (e.g., acne), surgery, burn, and trauma.
Minimal published research has been done regarding laser treatment in wound healing. Some studies have found promise in minor treatment of surgical wounds but few have sufficient clinical relevance. Recently, further studies have been conducted including examination of aggressive laser treatment in burn and trauma victims. Results have been positive and raise the question of which wounds would benefit from treatment.
Early intervention with laser treatment is a promising path in wound healing to prevent scarring. While more research remains to be done, emerging studies and practices provide increasing support for its use as a viable and potentially life-changing treatment for many patients.
KeywordsLasers Wound healing Early scar intervention Scar treatment Pulse dye laser Ablative fractional laser
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Wulkan et al. Treatment of traumatic hypertrophic scars with 2940mm fractional ablative Er:YAG: a pilot study. Accepted. Pending Publication. Google Scholar
- 5.•• Waibel JS, Rudnick A. Comprehensive treatment of scars and other abnormalities of wound healing. Adv Cosmet Surg. 2018;1(1):151–62 This article provides a thorough description of wound sources and the types of scarring that can develop. It describes scar formation on a microscopic level and in-depth modes of management based on the way scar tissue forms and evidence-based treatment strategies. CrossRefGoogle Scholar
- 7.Gold MH, Berman B, Clementoni MT, Gauglitz GG, Nahai F, McGuire M, Mustone T, Pusic A, Sachdev M, Waibel J. Updated international clinical recommendations on scar management: part 2—algorithms for scar prevention and treatment. Dermatol Surg. 2014;40:825–831. https://doi.org/10.1111/dsu.0000000000000050.
- 8.• Gauglitz, et al. Therapy of scars with lasers. Hautarzt. 2018;69(1):17–26. https://doi.org/10.1007/s00105-017-4072 This article provides an in-depth look at the way scars form and the impact they can have on patients both physiologically and emotionally. It highlights areas in need of further investigation despite the significant progress we have made in the field of scar treatment.CrossRefPubMedGoogle Scholar
- 11.• Sander, et al. A combined in vitro imaging and multi-scale modeling system for studying the role of cell matrix interactions in cutaneous wound healing. PLoS One. 2016;11(2):e0148254. https://doi.org/10.1371/journal.pone.014825 This study provides a highly detailed explanation of wound healing on a physiological and mathematic level. It introduces possible models to predict pathways of skin reformation in order to better understand a poorly understood process and take steps towards informing the way we address wound healing in the future. CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Waibel JS. Fractional devices. In: Nouri K, editor. Handbook of lasers in dermatology. London: Springer; 2014.Google Scholar
- 24.Zgavec, B. Stopajnik, N. Clinical and histological evaluation of Er:YAG ablative fractional skin resurfacing. J Laser Health Acad. 2014(1);01–06. ISSN 1855-9913.Google Scholar
- 26.Waibel JS, Hivnor C. Resurfacing. In: Nouri K, editor. Handbook of lasers in dermatology. London: Springer; 2014.Google Scholar
- 30.• Karmisholt, et al. Early laser intervention to reduce scar formation—a systematic review. J Eur Acad Dermatol Venereol. 2018;32(7):1099–110. https://doi.org/10.1111/jdv.14856 This review summarizes early research into early intervention of laser treatment to mitigate scar formation. This is an important developing field that is gaining traction as the future of scar treatment.CrossRefPubMedGoogle Scholar