Laser treatment of hypertrophic scars, keloids, and striae.

Lasers are now being used successfully to improve various types of scars and striae. It is not only imperative to properly categorize the type of scars and striae present, but to determine which laser or lasers can best treat them. A 585-nm flashlamp pumped pulsed dye laser is preferred for the treatment of hypertrophic scars, keloids, and striae distensae. CO2 laser vaporization of scars that are proliferative, such as hypertrophic scars and keloids, is not advised due to the high rate of recurrence or worsening. When properly used, lasers can effect the best clinical responses in hypertrophic scars and keloids ever observed. Future laser technologic advances as well as the addition of concomitant lasers or other treatments may enhance clinical results. It appears evident that by promoting the remodeling phase of wound healing, abnormal scarring may be prevented or improved. Laser surgery may best be able to accomplish this by triggering regression of blood vessels and, therefore, fibroblasts within the scar. By so doing, further deposition of connective tissue may be halted.