Laser-Based Therapies for Scar Management

Laser-based interventions have emerged as pivotal tools in the modulation and remodelling of pathological scars, including hypertrophic scars and keloids, which arise from aberrant wound healing and excessive collagen deposition. These approaches exploit selective photothermolysis to target vascular components, collagen fibres or pigment anomalies within the scar matrix, thereby promoting neocollagenesis, reducing fibrosis and improving pliability and appearance. Ablative fractional lasers create microscopic columns of tissue ablation to stimulate dermal remodelling, while non-ablative devices deliver thermal injury without epidermal disruption to encourage collagen contraction. Advances in laser wavelength selection, pulse modulation and combination therapies have broadened the scope of clinical applications, from burn-induced scar reduction to cosmetic refinement of postsurgical and traumatic scars. Global significance lies in enhanced functional recovery, relief of pruritus and pain, and improved self-esteem. Practical implementation necessitates precise parameter optimisation and patient-specific protocols to balance efficacy with minimal downtime and risk.

Research from Nature Portfolio

Recent studies have demonstrated the safety and efficacy of an intralesional 1470 nm bare-fibre diode laser for the treatment of hypertrophic and keloid scars. Using a minimally invasive optical fibre delivery system, practitioners achieved a mean reduction in scar thickness of over 27% alongside significant decreases in blood perfusion and pigmentation. Objective assessments—including ultrasonography, cutometry and perfusion imaging—corroborated a 37–42% improvement in composite scar scores, with no reports of hypo- or hyperpigmentation, infection or recurrence. This work underscores the potential of targeted intralesional laser energy to modulate scar volume and vascularity while preserving epidermal integrity.

Laser-Based Therapies for Scar Management publication trend

The graph below shows the total number of articles in laser-based therapies for scar management across all publications each year (not limited to Nature Index journals).

Technical terms

Fractional laser: A device emitting laser beams in pixelated columns to ablate micro-zones of tissue, stimulating healing and collagen remodelling.

Ablative laser: A laser modality that vaporises the epidermis and part of the dermis to trigger extensive wound healing and neocollagenesis.

Non-ablative laser: A laser that heats the dermis without removing the epidermal layer, inducing collagen contraction and remodelling with minimal downtime.

Keloid: A pathological overgrowth of scar tissue that extends beyond the original wound boundary due to excessive fibroblast activity.

Hypertrophic scar: A raised scar contained within the wound margins, characterised by excessive collagen deposition and prolonged inflammation.

Stromal vascular fraction (SVF): A heterogeneous cell population derived from adipose tissue, rich in regenerative cells that promote tissue repair and angiogenesis.

References

1. Treatment of hypertrophic scars and keloids using an intralesional 1470 nm bare-fibre diode laser: a novel efficient minimally-invasive technique. Scientific Reports (2020).
2. Efficacy of fractional CO2 laser in combination with stromal vascular fraction (SVF) compared with fractional CO2 laser alone in the treatment of burn scars: a randomized controlled clinical trial. Stem Cell Research & Therapy (2023).
3. Sequential and Combined Efficacious Management of Auricular Keloid: A Novel Treatment Protocol Employing Ablative CO2 and Dye Laser Therapy—An Advanced Single-Center Clinical Investigation. Cosmetics (2023).
4. Synergistic Sequential Emission of Fractional 10.600 and 1540 nm Lasers for Skin Resurfacing: An Ex Vivo Histological Evaluation. Medicina (2022).