At our current level of understanding, scars are an unavoidable result of disruption of the integument following trauma and other sources of injury in the postnatal period. Millions of people worldwide suffer from diminished quality of life due to varying degrees of disfigurement, functional impairment, and psychosocial comorbidity. Scars also represent a significant financial burden to the healthcare system at large. Substantial momentum currently exists in scar research associated with innovative techniques and devices devoted to treating scars. In order to properly ascertain and compare responses to various therapies, accurate and reproducible qualitative and quantitative assessments are vital. At least 10 different scar assessment scales and tools have been created to date in an attempt to quantify scar severity. However, a “gold standard” scar scale still does not yet exist. A major limitation of most scar scales is their focus on a relatively narrow group of individual subjective and objective features, while failing to address the overall cosmetic, functional, and psychological sequelae. Herein, we provide a brief review of current scar assessment scales, discuss some of the major advantages and limitations of each, and introduce several characteristics that might be addressed in a new “gold standard” scar scale. The assessment and treatment of scars, particularly large traumatic scars, is frequently a multidisciplinary effort. The creation of an “ideal” scar scale will undoubtedly require input from therapists, surgeons, dermatologists, and other professionals alike. Semin Cutan Med Surg 34:28-36 © 2015 Frontline Medical Communications
Patients frequently present to dermatologists for the treatment of vascular lesions, including
facial telangiectases, diffuse redness, port wine stains (PWS), hemangiomas, and leg
veins. There are many laser and light devices that can be used with excellent results. This
article summarizes the available platforms that are commonly used for the treatment of
superficial vascular lesions. Newer devices and techniques are highlighted with respect to
the unique characteristics of individual lesions.
Semin Cutan Med Surg 27:276-284 Published by Elsevier Inc.
Lasers frequently are used by dermatologists for their multiple aesthetic applications, but
they also can be used to treat a variety of medical dermatology conditions. Conditions such
as acne vulgaris, psoriasis, and vitiligo can all be successfully treated with laser, thereby
providing the patient with additional therapeutic options. Lasers have also been used for
years to improve the appearance of scars. The newer fractionated lasers have been
especially effective in enhancing the clinical outcomes of scar revision.
Semin Cutan Med Surg 27:285-291 © 2008 Elsevier Inc. All rights reserved.
Laser and intense pulse light procedures, once limited to physician offices and operating
rooms, have become increasingly available at a variety of nonmedical sites such as spas.
State regulations as to whom can perform these treatments varies greatly across the United
States and, thus, in some states, the operators of these devices do not have any significant
additional medical or laser knowledge more so than the patients who receive treatment.
Although serious complications of laser treatments occur, they are rare when the procedure
is performed correctly. Currently, there are 2 light devices approved by the Food and
Drug Administration for home hair removal on the U.S. market, and several other companies
are expected to release products in the near future. There are two home laser devices
marketed for hair loss. As these light-based devices become smaller, safer, easier to use,
as well as cheaper to manufacture, direct use by patients will increase. Results from home
use devices are impressive but still inferior to office-based lasers and light devices. It is
likely that home lasers and intense pulsed light devices will eventually receive other
indications because many of these devices use wavelengths similar to currently available
office based equipment.
Semin Cutan Med Surg 27:292-300 © 2008 Elsevier Inc. All rights reserved.
Chronic, nonhealing ulcers are a frustrating therapeutic challenge and investigation of innovative therapies continues to be an important research pursuit. One unique and newly applied intervention is the use of ablative fractional lasers. This technology has recently been employed for the treatment of hypertrophic, disfiguring and function-limiting scars, and was first shown to induce healing of chronic wounds in patients with persistent ulcers and erosions within traumatic scars. Recent reports suggest it may be applicable for other types of chronic wounds as well. The mechanism of action for this modality remains to be elucidated but possible factors include laser-induced collagen remodeling, photomicrodebridement and disruption of biofilms, and induction of a proper wound healing cascade. Semin Cutan Med Surg 34:37-41 © 2015 Frontline Medical Communications