KATHIE, Lebanon, N.H.: I have a friend who was burned over 80 percent of her body with lye two years ago. Can the laser treatment help decrease the scarring of chemical burns?
WAIBEL: The Lumenis Ultrapulse laser has been used to treat many types of scars -- surgical, acne, traumatic and burn scars. Although I do not believe any clinical trials have been done in the United States studying the Lumenis Ultrapulse Total FX treatment with chemical burn scars, I would recommend you get a consultation with a local board certified dermatologist or plastic surgeon laser expert.
TOM, Eagan, Minn.: I have some keloid/acne scars on my chest and back. ... Can this laser treatment help surface-level and raised-type keloid scars?
WAIBEL: We believe scars are best evaluated and treated with combination therapy. Keloid scars have been improved with the Lumenis Ultrapulse laser, pulsed dye laser, fractional non-ablative laser and steroid injections. We frequently treat the scars with more than one therapy. I tell my patients it is a "work in progress" and that you must evaluate the next best therapy after each treatment.
SIERRA, San Diego: I'm curious about these treatments. How did your skin react? Do you have a tendency to keloid? I was burned when I was 2 years old, and throughout all of my surgeries I've seen minimal results since my skin is so sensitive.
WAIBEL: Burn scars are highly variable in terms of tissue affected, the severity of the burn and resultant complications. Lasers improve the appearance of scars but cannot completely "remove" the scar. Multiple treatments may be needed to gain maximal improvement. The skin is red and swollen about one week after treatment. To my knowledge there have not been worsening of scars but every patient's scar and healing are unique.
LYNETTE, Marshall, Wis.: Since these treatments would probably not be covered by my health insurance plan, what is the cost for these treatments? On average, how many treatments does it take to achieve a noticeable difference in the texture of the scar? Would the laser treatment(s) have any adverse affects on muscles and tendons?
WAIBEL: Unfortunately, we currently do not have CPT (Current Procedural Terminology) codes for laser resurfacing of burn scars and therefore these cannot be submitted to insurance. This is being worked on at the national level to determine how burn patients can best be supported. At this time laser treatment of burn scars is considered cosmetic. Price range would be a few hundred to a few thousand dollars depending on the percentage of skin treated. With every treatment of laser on burn scars there is usually improvement in color and texture of scars. Often, combination treatment with other lasers and intralesional kenalog is needed. I usually tell patients [to] expect three to five treatments but perhaps [they] will need many more. It is a work in progress. At the appropriate settings to treat the skin, the laser beam does not penetrate to muscles and tendons and to my knowledge there have been no adverse events reported on muscles and tendons.