First-Hand Experience: A Guide to Laser Treatment for Burn Scars

I never planned to resume treatments on my scars. I was burned 55 years ago, 65% third degree, and endured countless surgeries as a child, teenager, and young adult. Exhausted and receiving diminished results, I stopped having surgeries in my 20s. Goodness knows, I didn't miss them. I thought I was done forever with burn care.

Several years ago, however, I read an article about the new laser treatments for burn scars in this very magazine. I was intrigued that the lasers could improve even very old scars, like mine. Hesitantly, I arranged a consultation with a new surgeon, never guessing this meeting would mark the beginning of 23 new laser procedures. Knowing that many in the burn community are interested the laser treatments, I thought I would share what this experience has been like for me, a fellow burn survivor.

laser for burn Scars

When I get lasered, it is a whole-body treatment due to my extensive scarring. If you have a small burn, you may have a different experience. For example, I must receive general anesthesia prior to the procedure. Some patients do not have anesthesia, if they have a small scar. I imagine this could be painful, but for me, the general anesthesia removes all physical pain.

In many ways, the anesthesia and IV have been the hardest parts. Because I was burned decades ago as a four-year-old, I have vivid memories of being put to sleep against my will. My veins are old, tired, and scarred, so IV insertion has been a painful nightmare. Happily, my burn team has been sensitive to these issues. The nurse anesthetist connected me to the vascular access team team, who now install my IV using ultrasound imagery, reducing insertion time and pain.

The actual laser treatment takes about an hour. I wake up gradually. Sometimes there is pain upon waking, but the nurse will give extra pain medication through the IV. Then it is a matter of clearing from the anesthesia, getting up, and returning home.

recovery from laser treatments

That first groggy day is like other days recovering from anesthesia. I don't have any more pain. There are some initial bandages on the wounds, but they peel off painlessly by nighttime. I coat the wounds with a steroid cream, which reduces the discomfort, and then I try to get some sleep.

Days two and three are the worst. The lasered skin heals in stages. First it becomes super red and hot, like the worst sunburn you ever had. Then, it turns bone-dry and itchy. (You know, that old burn itch that drives you crazy.) Just like always, I can't scratch, or it will hurt the skin. The itching lasts about four days; the only thing that relieves it is coating the wound with Aquaphor (a lotion similar to Vaseline). Aquaphor effectively coats the wound and reduces the dryness. However, it isn't pleasant to coat one's entire body with Vaseline. It is particularly nasty trying to sleep like this, my Vaseline-coated face sticking to the pillow. It makes me feel like a beached wet seal.

Besides the redness and the itch, the lasered skin looks odd. Imagine row after row of tiny little dots, in a grid pattern, marching down your scars. The lasered area looks like this for a couple of weeks. Each tiny dot is a laser wound. The laser re-injures the scar, but in a regular pattern, hitting so deep into the scar that when it heals, the scar regenerates more smoothly and evenly.

The lasered skin covers over with tiny little scabs. After about a week, the top layer of the scabbed skin peels off, revealing bright pink skin underneath. None of this hurts, but it does look weird. After two or three days, I can cover the scabs and redness with makeup. That reduces the odd appearance, but still doesn't look great. (Plus, it is tough to get makeup to stick on top of that layer of Aquaphor).

I'm unable to shower or bathe for two days after the laser. It feels great to hose off the surgical remnants and the Aquaphor. However, as soon as I step out of the shower, the lasered skin turns extremely dry and itchy, so I slather on another coat of Aquaphor. Suffice it to say, I don't wear any nice clothes during the recovery time.

I experience swelling and water retention for a week. Due to the wounds and swelling, I tend to avoid making social plans or going out for five days after my laser. If I didn't have facial scars, or if I was less extensively burned, I might feel comfortable going out sooner. I can work (remotely) after two days.

Every Recovery is different

One important thing to know about the lasers is that it takes a while for the results to emerge. The skin regrows from deep down, so it takes weeks before you can fully see how much the laser has helped. Another thing to know is that lasers do not make scars disappear. The scar tissue remains, but it has an improved appearance. The results of my 23 (and counting!) lasers vary. My arms and legs look somewhat better. The scars are less ridged and feel much softer to the touch.

The breathtaking results have been on my face and neck. All my facial scars have flattened and smoothed out. It used to be that my facial scars were slightly raised off my face. Now they lie evenly and are much less prominent. Many of the scars are now easily hidden with makeup.

For over 50 years, the first thing anyone would notice about me would be the scars on my face. Like many survivors, I was bullied, taunted, and mocked as a child. Even as an adult, people stare at me. Now, thanks to the lasers, many people don't immediately notice that I am burned. I am not ashamed to be scarred, but it is a relief to blend in a bit more.

Every burn survivor is unique, with their own story, trauma history, pain tolerance, economic resources, and work responsibilities. I feel lucky to have access to this state-of-the-art treatment. I'm sure the treatment isn't for everyone, but I encourage those of you who are interested to seek a consultation with a burn care specialist. It has made a world of difference for me.