This book addresses the management of scars using lasers and light. The authors provide a comprehensive overview of the current laser modalities and the science and evidence behind them. They also present various treatments, including those using carbon dioxide lasers, Erbium:YAG lasers, pulsed dye lasers and Q-switched lasers. The book includes detailed information on the treatment of burn, acne, keloid and hypertrophic scars, as well as discussions of the complications of laser treatments and ethical and medico-legal issues.
Scars have many causes, including trauma and burns, but also medical treatments themselves - scars are an inevitable consequence of most surgery. There have been significant advances in laser and light technology over the last decade, and the management of scars with a variety of lasers has been adopted both in traditional healthcare settings and in the cosmetic sector. Edited by a respected burns and plastic surgeon, this book is a valuable resource for a variety of clinicians including dermatologists, laser practitioners, physiotherapists and occupational therapists, burn care professionals, as well as multidisciplinary teams working with patients with scars of all aetiologies.
Author(s): Kayvan Shokrollahi
Publisher: Springer
Year: 2020
Language: English
Pages: 113
City: Cham
Preface
Acknowledgements
Contents
Contributors
About the Author
Introduction to Lasers and Their Use in Scar Management
1 Principles of Laser–Tissue Interactions
2 Scar Characteristics Commonly Amenable to Laser Therapy
3 Providing a Laser Scar Service
Further Reading
Pathophysiology of Scarring
1 Wound Healing and Scarring
1.1 Hypertrophic Scars
1.2 Keloid Scars
1.3 Atrophic Scars
References
Decision-Making for Safe and Effective Laser Treatment: The Laser Test Patch
1 Introduction
2 General Principles of Performing a Test Patch [1]
3 Safety and Effectiveness of Test Patching in Relation to Treating Scars
4 Conclusion
References
Laser Strategies for Complex Scars: Experience from Establishing a Supra-Regional Laser Service for Burns and Complex Scarring
1 Introduction
2 Treatment Population
3 The Laser Test Patch
4 Indications for Treatment
5 Pigmentation
5.1 Clinical Examples (Figs. 5, 6, and 7)
5.2 Summary (Pigmentation)
6 Scar Erythema and Telangiectasia
6.1 Summary (Vascular Laser Treatments for Scars)
7 Keloid Scars
7.1 Vascular Lasers for Keloids
7.2 Ablative Lasers for Keloids
7.3 Clinical Examples
8 Hypertrophic Scars and Contour
8.1 Ablative CO2 Laser
8.2 Laser Resurfacing
8.3 Summary: Ablative and Fractional Laser for Scars
9 Laser Depilation for Scar Folliculitis and Heterotopic Hair Growth
10 Acne Scarring
11 Summary
References
Carbon Dioxide Laser Treatment for Scars
1 Introduction
2 Review of the Evidence
2.1 Hypertrophic Scars Including Burn and Surgical Scars
2.2 Atrophic Scars
2.3 Contracted Scars/Range of Motion
3 Early Treatment/Scar Prevention
4 Treatment Methodology
5 General Instructions for Laser Operation
6 Laser Specifications
7 Clinical Examples
7.1 Case #1
7.2 Case #2
7.3 Case #3
8 Discussion
References
Pulsed Dye Laser Treatment for the Treatment of Hypertrophic Burns Scarring
1 Introduction
2 Review of the Evidence
2.1 Pulsed Dye Laser for Hypertrophic Scars
2.2 Early Intervention
2.3 Previous Studies
3 Treatment Methodology
4 Case Example
4.1 Lasers Settings
5 Discussion
References
Further Reading
Long-Pulsed 1064-nm Nd:YAG Laser Treatment for Keloids and Hypertrophic Scars
1 Introduction
2 Laser Therapies for Keloids and Hypertrophic Scars
3 Indications and Limitations of Long-Pulsed 1064-nm Nd:YAG Laser for Keloids and Hypertrophic Scars
4 Treatment Settings of Long-Pulsed 1064-nm Nd:YAG Laser for Keloids and Hypertrophic Scars
5 Follow-Up of Keloids and Hypertrophic Scars
References
Intense Pulsed Light (IPL) Monotherapy for Scars
1 Background
2 Keloid and Hypertrophic Scarring
3 The Use of IPL Alone
4 IPL Treatment Combined with Intra-Lesional Steroids
5 IPL Treatment Combined with CO2 Laser
6 IPL vs. Other Treatment Modalities
7 Complications Reported with IPL
8 Conclusion
References
Nd:YAG Laser and Intense Pulsed Light (IPL) in the Treatment of Hypertrophic and Keloid Scar
1 Introduction
2 Intense Pulsed Light
3 Nd:YAG
4 Treatment Methodology/Regimen
5 Clinical Examples
6 Discussion
References
Laser Management of Acne Scars
1 Introduction
2 Review of the Evidence
3 Treatment Methodology
3.1 Non-laser–Based Treatments
3.2 Laser-Based Treatments
3.3 Ablative Lasers
3.4 Non-ablative Lasers
4 Clinical Examples
4.1 Ice-Pick Acne Scars
4.2 Rolling Acne Scars
4.3 Hypertrophic Acne Scars
5 Discussion
References
Strategies for Keloid and Hypertrophic Scars with Lasers
1 Introduction
2 Examining the Evidence
2.1 Pulsed Dye Laser (PDL)
2.2 Nd:YAG
2.3 Ablative Lasers: Carbon Dioxide (CO2) Laser and Er:YAG
3 Treatment Methodology
4 Clinical Examples
5 Discussion
References
‘Acid Attack’ Scars: Strategy for Scars from Assaults Using Corrosive Substances
1 Scar Folliculitis and Hair Removal
2 Erythema and Hypertrophic Scars
3 Pigmentation
4 Keloid Scars
5 Atrophic Scars
Further Reading
Photodynamic Therapy for the Treatment of Scars
1 Keloid Ex Vivo Studies
2 Hypertrophic Ex Vivo Studies
3 Evidence for PDT in Keloid Scarring
4 Evidence for PDT in Hypertrophic Scarring
5 Conclusion
References
1550-nm Erbium:Glass and 1927-nm Thulium Non-Ablative Fractional Lasers for the Treatment of Burn Scars
1 Introduction
2 Review of the Evidence
3 Treatment Methodology
4 Clinical Examples
5 Discussion
References
Laser Depilation in Scar and Burn Management: Scar Folliculitis, Heterotopic Hair Growth, and Keloids
1 Heterotopic Hair Growth
1.1 Pseudo-Folliculitis and Scar Folliculitis
1.2 Which Laser?
2 Keloid Scars
2.1 Clinical Examples
3 Summary
References
Informed Consent for Laser Therapy in Scar Management
1 Introduction
2 Legal and Ethical Issues Relevant to Consent
3 Obtaining Consent in Laser Scar Management
4 Informed Consent in the Laser Treatment of Cutaneous Scarring
4.1 Burns and Blisters
5 Consent Pitfalls
6 Conclusion
Further Reading
Legal Cases
Complications Including Scarring Caused by Lasers
1 Treatment of Scars Caused by Lasers
Further Reading
