Self-Harm Scars – laser removal

  • Best Results4-10 sessions
  • Treatment Recovery1-7 days
  • Procedure Time5-15 minutes
  • Skin SpecialistDermatology nurse
  • Duration of ResultsCan be permanent
  • AnaestheticNumbing
  • Back to Work0-3 days
  • Cost$-$$

Self-Harm Scars - laser removal

Cutting or self-harm scars are common, occurring in over 10% of adolescents and young adults. Lasers can reduce the stigmata of cutting scars & can help blend these scars in with the surrounding skin. Lasers can target colour, mainly red, or help scars blend into the surrounding area.

FactsFacts on Lasers for Cutting/Self Harm Scars

  • Lasers are best used on early cutting scars
  • Vascular lasers are spaced 2-4 weeks apart
  • Vascular lasers can reduce redness & help remodel collagen
  • Fractional lasers can help with early & established cutting scars
  • Examples of fractional devices include Fraxel, LaseMD, & CO2 devices
  • The aim of laser is to treat both colour & contour of self-harm scars

What is the aim of treatment?

The aim of any scar treatment is to improve colour & contour. If both are achieved, the scar will be less visible. Lasers can achieve both, however there are specific clinical features that determine what is the best pathway.

In the context of self-harm – cutting scars, another unique aim is to remove the patterning of parallel cuts & scars associated with the perception of cutting scars. Read the section on surgical procedures to understand more about how I achieve this.

What can lasers achieve?

Lasers are great at treating colour changes, in particular red. White scars do not respond to lasers as the pigment cells (known as melanocytes) are reduced. White scars are more complex to treat. They may require surgical intervention (see the section on surgery).

Lasers can help bend in some scars by treating the surrounding skin. Additionally, lasers can help increase uptake of anti-inflammatory steroid drops & reduce the height of scars. This improves skin contours.

What can lasers not achieve?

Deep & wide scars are beyond the reach of lasers. Deep cuts that enter the bottom dermal layer of skin will not be improved with lasers. These scars are best treated with surgery & in some cases skin grafting.

As a guide, palpable scars, scars wider than 2.75 mm & depigmented scars will respond less to lasers. Exceptions do apply; however, it is impossible to tell who will get an excellent result.

What can be done about red self-harm scars?

Vascular lasers including V Beam Prima, Perfecta & Laser Genesis can help reduce redness. They are most effective for early scar management. Treatments are painless & not associated with any downtime. A series of 4 to 8 sessions is typically required, over a period of 4 to 8 months.

If scars are raised, vascular lasers can be combined with silicone sheeting or anti-inflammatory drops & injections. 

Davin’s Viewpoint on the use of lasers for cutting scars

Lasers are useful for-

  1. Treating redness in early self-harm scars. They can also reduce the palpability & soften hypertrophic & keloid scars. In this situation, early scar remodelling can reduce the need for more invasive procedures such as surgery.
  2. Lasers are also useful for blending in surrounding skin. Fractional lasers including thulium & CO2 are best.
  3. Lasers can also reduce the width & improve colour for scars that are less than 2.75 to 2.5 mm in width.

The rate limiting factor of lasers is the depth of scars. It is impossible to gauge the actual depth of the cut, in the future imaging maybe useful (think high resolution ultrasound). Lasers, though useful, are not effective in all cases of cutting scars.

Unfortunately, Medicare does not recognise self-harm – cutting scars as a medical condition, hence laser treatments are not subsidized (however can subside scaly patches on the knees and elbows for up to $7500 per annum). The mind boggles.

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