Fractional laser skin treatment is associated with a relatively low complication rate. Side effects and complications observed in this study were temporary and did not result in long-term or significantly severe sequelae (e.g., scarring).

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Keloid and hypertrophic scars have affected patients and frustrated physicians for centuries. Keloid and hypertrophic scars result from excessive collagen deposition, the cause of which remains elusive. Clinically, these scars can be disfiguring functionally, aesthetically, or both. A thorough understanding of the pathophysiology and clinical nature of the scar can help define the most appropriate treatment strategy. Although many articles have been published on the management of hypertrophic and keloid scars, there is no universally accepted treatment protocol. Prevention of keloid and hypertrophic scars remains the best strategy; therefore, those patients with a predisposition to develop excessive scar formation should avoid nonessential surgery. Once a scar is present, there are many treatments from which to choose. Hypertrophic scars and keloids have been shown to respond to radiation, pressure therapy, cryotherapy, intralesional injections of corticosteroid, interferon and fluorouracil, topical silicone or other dressings, and pulsed-dye laser treatment. Simple surgical excision is usually followed by recurrence unless adjunct therapies are employed. Biologic agents that are directed towards the aberrant collagen proliferation that characterizes keloid and hypertrophic scars might be an important addition to the current armamentarium of modalities in the near future.

BACKGROUND Patients with atrophic scars commonly seek treatment for their removal but are often concerned about the prolonged recovery, short‐lived results, and/or ineffectiveness of available therapies. A novel treatment using a 1,550‐nm erbium‐doped fiber laser to induce fractional photothermolysis of treated skin has been used to resurface photodamaged skin but has not been studied previously in patients with atrophic scars to determine its effectiveness for this condition. PURPOSE To determine the effectiveness and safety of 1,550‐nm erbium‐doped fiber laser treatment on atrophic scars. METHODS Fifty‐three patients (skin phototypes I–V) with mild to moderate atrophic facial acne scars received monthly treatment with a 1,550‐nm erbium‐doped fiber laser (Fraxel, Reliant Technologies Inc., San Diego, CA). Clinical response to treatment was determined at each treatment visit and 6 months after the final treatment session by two independent assessors using a quartile grading scale. Side effects and patient satisfaction were monitored at each follow‐up visit. RESULTS Clinical improvement averaged 51% to 75% in nearly 90% of patients after three monthly laser treatments. Mean improvement scores increased proportionately with each successive laser session. Clinical response rates were independent of age, gender, or skin phototype. Side effects included transient erythema and edema in most patients, but no dyspigmentation, ulceration, or scarring. CONCLUSIONS Atrophic scars can be effectively and safely reduced with 1,550‐nm erbium‐doped fiber laser treatment.

Noninvasive radiofrequency bulk dermal heating of skin can achieve safe and effective tissue tightening of the cheeks and neck. Although tightening continued to be evident 6 months after a single treatment, the longevity of clinical results has yet to be determined.