Anyone with burn scars or passionate about improving them will be aware of the story of the Berns triplets. The three identical, stunning 30-year-old young women were burned in a house fire when they were 1 ½ years old. The Today Show, ABC’s 2020, People magazine, Glamour magazine, and multiple Internet sites have all told the story of how, after 20 years of living with their burn scars, the triplets found dramatic burn scar improvement after being treated with fractional ablative laser.
Normal healing and maturation of burn scars
The amount of burn scarring depends on the depth of the burn injury into the skin. A superficial burn wound heals with re-growth of the superficial skin layer, the epidermis. This results in minimal or no scarring, and with occasional changes in the coloration of the new skin layer. A deeper burn injury destroys the cells in the skin that allow the re-growth of the epidermis. When this happens, the burn wound tends to remain open for a longer period of time but will eventually heal by the laying down of scar and shrinkage of the burn wound. These deeper burn wounds result in severe burn scarring and contractures, the tight scars that restrict the movement of joints and distort the normal position of anatomic structures such as the mouth and eyelids. It is these scars that are long-lasting, often permanent reminders of the burn experience.
As with all scars, burn scars tend to “fade” with time. There is a gradual cycle of building up of scar and breaking down that occurs simultaneously causing a process called “remodelling” of the scar. This remodelling process proceeds for years, but the greater part of the process occurs within the first two years after the burn injury and initial scar formation.
How does Fractional Ablation laser therapy work?
Laser is a word derived from the following scientific description: Light Amplification by Stimulated Emission of Radiation. In simple terms, laser generally refers to light energy of a single frequency of light which is concentrated in a beam. In medicine lasers are used to create a specific therapeutic response by transforming light into heat. In the case of the burn scar the laser vaporizes the old scar and creates a wound, resulting in new healing.
Carbon dioxide laser is absorbed by water in tissues causing damage or vaporization of the tissue depending on the amount of energy in the laser light.
Ablation is a term used to describe total removal of the target tissue or substance when the energy of the medical laser is strong enough to vaporize it. The tissue is literally gone. When used in a superficial manner, it can remove layers of skin.
Whereas traditionally, laser light has been delivered as a single beam, recent developments have demonstrated how the laser light can be delivered broken up into multiple small beams. So rather than a single beam, the same amount of energy is delivered “fractionated” into a number of smaller beams.
Factional ablative laser
Fractional ablative laser can best be understood as a beam of light that is broken into a number of tiny laser columns of CO2 laser that drill multiple tiny holes into the tissue at which it is directed. The tissue in which it is directly absorbed is totally destroyed, resulting in what one can picture as multiple micro-tunnels into the tissues. Surrounding each one of these tunnels there is injured scar from the heat that caused the vaporization of the tissue that used to be in each tunnel. Surrounding the injured scar is normal scar which still remains intact.
The fractional ablative laser treatment therefore results in a new injury to the scar tissue in which some of the scar has been totally removed and some injured. Within these micro-injuries to the scar, all of the previous mechanisms of wound healing and scar maturation begin over again with subsequent new remodelling of a burn scar. We think that this process stimulates new remodelling deep in scars which, in some cases, might have been dormant for years. When this deep fractional ablative laser treatment is combined with the widely used superficial fractional ablative laser resurfacing, not only is the deep portion of the burn scars improved by new remodelling, but the superficial appearance of the scars can be improved as well. Fractionation of the laser beam promotes faster healing and less downtime
Laser treatment of burns scars does require commitment and patience. Treatments are done at 6 weekly intervals and the number of sessions necessary is dependent on the area to be treated, the initial depth of injury and the body’s response to the treatment. At Intimate You we see it as an honour to work with people affected by burns scars on their healing journey and will always endeavour to give realistic assessments in the framework of clients’ treatment goals. As with all our treatments, care between and after treatments is second to none and our doctors are available on our hotline 24h a day to give as much support as is needed.