Dr. Sam Lam Plastic Surgery Forum

Hi Dr. Lam,

What kind of laser is the best for flattening and removing redness for little, raised scars that are caused by external stitches remaining in the skin for too long after a surgery? Would CO2 or Erbium laser be an effective option?

And typically how many sessions are necessary to completely lower the scar to skin level?

What kind of laser is the best for flattening and removing redness for little, raised scars that are caused by external stitches remaining in the skin for too long after a surgery? Would CO2 or Erbium laser be an effective option?
IF THE REDNESS IS EARLY AND THE SCARS ARE ONLY SLIGHTLY RAISED, THEN KTP OR PULSED DYE LASER WORK VERY WELL TO CONTROL THE THICKNESS AND REDNESS. CO2 AND ERBIUM CAN SMOOTH SKIN OUT BUT COULD WORSEN REDNESS IF THE SKIN IS ANGERED OR THINNED AND WORSEN ANYTHING RAISED. I WOULD OBVIOUSLY HAVE TO SEE THIS IN PERSON TO KNOW BUT IN THEORY CO2 AND ERBIUM COULD ACTUALLY BE DETRIMENTAL.

And typically how many sessions are necessary to completely lower the scar to skin level?
YOU MIGHT NEED 5-FU TO DISSOLVE HYPERTROPHIC SCAR ALONG WITH LASER IN COMBINATION. HARD TO SAY, SOMETIMES 2 TO 4 ROUNDS.
best,
sml

You mentioned that is the redness is early then PDL/KTP would be good. By "early," did you mean something like 2 weeks post-op? What kind of time range would be considered as early enough for effective treatment with these two lasers?

And what if a stitch mark is over a year old? Would dermabrasion / microdermabrasion be better in this case?

to be honest, the ktp/pdl would probably be effective in any stage to manage redness. however, it is usually used "early" (first 6 months) to manage the redness that is associated with early wound healing. i have used it in raised, red angry scars even a year out with good results. if it is red, dermabrasion, etc. could worsen things. again, i would have to see it in person to make that determination more accurately.

Thanks for taking the time to answer my Q's, Dr. Lam! =)

my pleasure.