Thank you for your question!
In the question, the photos you submitted, you state that you’re 20-years-old, you
are dealing with a two and half inch vertical scar under your eye and the cheek area which
you’ve had since you were 5 years old from an accident.
And that you underwent CO2 laser about 6 weeks prior and you are experiencing some redness
and you noticed that the scar is less deep and you are using SPF sunscreen to basically
protect the skin.
You’re basically asking about redness and what to expect further.
Well, I can certainly give you some guidance.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon practicing in Manhattan and Long Island for over 20 years and I have
considerable experience with the original CO2 laser, the erbium laser and now, fractional
CO2 laser which I use routinely in my practice.
So I’m going to offer you some insight in a way I think when I look at someone like
yourself and the way I suspect your doctor was thinking as to the strategy for you.
So to begin with, when you describe a scar, a scar can be a depressed scar like yours
which means in dips below the skin level or it can be an elevated scar and goes about
the skin level.
So in your situation, what it looks like is that you have is a depressed scar and what
your surgeon intended to do is to basically provide you with a more reduction of the contrast
between the depth of the scar and the adjacent skin by doing an ablative procedure.
Now there is also some potential collagen generation from the thermal energy into the
depth of the scar so that you can actually get some elevation of the depressed part of
the scar even though from my experience, that’s really not something that happens that much
from just the use of a laser.
Redness after a thermal injury, which is what a laser is, can go on for weeks or months.
I think that what you have to get from your doctor is some idea of what to expect but
it is not unusual for someone to have redness six week out.
I basically explain to my patients is that you’re red or pink mostly in the early part
and then it fades and you can still have pinkness for a couple of months but it just fades more
and more.
Now, it is routine for me to combine the use of laser with the use of platelet-rich plasma
(PRP).
I have found that in the effort to help advance the healing process, platelet-rich plasma
has a lot of value in my hands when I do fractional CO2 laser and there are often times when I
actually combine the treatment of the scar with a PRP injection or maybe even use a combination
of platelet-rich plasma and a hyaluronic acid filler with the laser at the same time.
There are more than a few ways to address these types of problems but I think that you’re
probably on the right track now that you’ve seen an improvement.
So I think it’s very important, as your doctor recommended, to protect your skin and
try to avoid secondary hyperpigmentation where the skin gets darker from incidental sun exposure
and that’s the role of the SPF plus, I always explain to my patients, think of this fresh
new skin as baby skin.
So you want to protect it.
You want to protect it very well.
So I think you’re on the right track based on this limited amount of information but
I think you could also follow-up with your doctor.
Just get some ideas of what to expect and see how things look as time goes on.
There will probably be some indication for other things that you can consider as the
healing process continues but in the meantime, just maintain communication with your doctor
so that you could at least optimize the results of this procedure.
So I hope that was helpful, I wish you the best of luck and thank you for your question!