Scarring is a common concern for many patients, whether due to surgery, trauma, acne, or burn injuries. Scars can be abnormal in texture, color, and can have a loss of surface der – matoglyphics. Early reports have shown more than 75% clinical improvement in erythema, induration, and texture after a single treatment with the Fraxel 1550 nm. At mid-infrared wavelengths, deeper blood vessels are able to be accessed while simultaneously inducing dermal remodeling.[27] Microvasculature destruction occurs due to the high water content of blood, and direct thermal trauma [26].
Fractional photothermolysis also has shown some success in treating hypopigmented scars. An initial pilot study [28] looked at seven patients with hypopigmented scarring, mainly due to inflammatory acne. Six out of seven patients saw marked (51-75%) clinical improvement after two to four treatments (pulse energies of 7-20 mJ, total densities of 1,000-2,500 MTZ/cm2). Another study [30] saw 25-50% clinical improvement in 91% of patients with mild to moderate atrophic facial scars after a single treatment, while 87% of patients receiving three treatments saw at least a 51-75% improvement.
Fractional resurfacing may help improve hypopigmentation by causing normal melanocytes from the surrounding tissues to migrate and repopulate the newly resurfaced tissue to blend and minimize the appearance of the scar. Atrophy is likely to improve through dermal collagen remodeling that occurs after treatment [28].