Scars are a natural part of healing, but they can leave lasting physical and emotional effects. Burn scars, trauma scars, surgical scars, acne scars, and self-harm scars may result in skin that is red, thickened, tight, or discoloured. These changes can limit movement, cause itching or pain, and affect confidence.
Modern laser scar therapy has transformed scar management. By targeting redness, pigmentation, and thickened tissue, lasers help restore comfort, function, and appearance. At our Sydney clinic, we use advanced platforms — DermaV vascular laser, non-ablative fractional lasers, and ablative fractional lasers including the UltraPulse® Alpha CO₂ laser by Lumenis and the new UltraClear® cold fibre system — as part of personalised, multimodal care plans.
How Laser Treatment for Scars Works
Every laser is defined by its wavelength, which determines which structure (chromophore) in the skin absorbs the energy:
- Haemoglobin (blood vessels) → redness and vascularity
- Melanin (pigment) → brown discolouration
- Water in tissue → structural thickening and collagen
The principle of selective photothermolysis allows laser energy to be directed precisely at problem areas while sparing surrounding skin.
A major breakthrough came with fractional laser technology. Instead of treating the entire skin surface, fractional lasers deliver energy in a grid of microscopic beams, leaving untreated skin between columns. This accelerates healing while stimulating collagen production and scar remodelling.
Fractional lasers may be:
- Non-ablative – heat the tissue without removing it, gentler with shorter downtime.
- Ablative – vaporise microscopic columns of scar tissue, producing stronger remodelling but usually with longer downtime.
Burn Scar Treatment With Lasers
Burn scars are often thick, red, and contracted, leading to symptoms such as itch, pain, and restricted movement. For many years, surgery was the mainstay of treatment. Today, laser therapy provides a less invasive, evidence-based alternative — either as a standalone treatment or in combination with surgery. Research has shown that lasers can complement reconstructive procedures, reduce the extent of surgery required, and significantly improve functional and cosmetic outcomes.
- Vascular lasers (e.g., DermaV or PDL): Target excess blood vessels to reduce redness, vascularity, itch, and sensitivity.
- Fractional ablative lasers (e.g., UltraPulse® Alpha, UltraClear®): Remodel thickened scar tissue, restore pliability, reduce symptoms, and improve movement across joints.
- Combination therapy: The best outcomes often come from integrating multiple modalities. Vascular lasers can address redness, fractional lasers improve structure, and laser-assisted drug delivery (LADD) enhances penetration of medications into the scar. These approaches are frequently combined with surgery, silicone, pressure therapy, and occupational therapy as part of a tailored plan.
International guidelines recommend laser therapy as a first-line treatment for many burn scars, with strong evidence supporting its ability to improve both the appearance and function of scar tissue.
Targeting Specific Features of Scars
Most scars involve a mix of changes — redness, pigmentation, and altered structure. Different lasers are chosen accordingly:
- Redness (erythema, vascularity): eg PDL or DermaV treat excess blood vessels, reducing redness and irritation.
- Pigment disturbances: Q-switched or picosecond lasers target brown discolouration and colour mismatch.
Structural changes:
- Non-ablative fractional lasers improve texture and flexibility with several days of downtime.
- Ablative fractional lasers (CO₂, erbium, and UltraClear®) are the most effective for thick, contractile scars, but recovery may take weeks depending on the depth and extent, but can also be used to address the scar colour.
Because scars are complex, the best results often come from combining different modalities within the same treatment plan.
Laser-Assisted Drug Delivery (LADD)
One unique advantage of ablative fractional lasers is that the microscopic channels they create allow medications to penetrate more effectively. This technique, called laser-assisted drug delivery (LADD), has been shown to improve outcomes in pathological scars.
Medications may include:
- Corticosteroids
- 5-Fluorouracil (5-FU)
- Or others
LADD enhances scar softening and flattening, often reducing the need for repeated injections.
Beyond Lasers: The Multimodal Approach
Scar management is rarely achieved with a single treatment. At our scar clinic, laser therapy is integrated into broader care plans that may also include:
- Surgical scar revision – reshaping or releasing contractures, often followed by laser resurfacing.
- Silicone therapy – tapes, gels, or sheets to reduce thickening and improve texture.
- Pressure therapy – particularly valuable in burn scars, helping flatten and remodel tissue.
- Occupational and physiotherapy – essential for maintaining mobility and preventing contractures.
- LPG Endermologie® medical – mechanical tissue mobilisation that improves lymphatic flow, reduces tissue tension, and supports scar remodelling.
This multimodal approach, aligned with international recommendations, ensures that every aspect of a scar — from redness and thickness to mobility and comfort — is addressed in a comprehensive and personalised plan.
Keloid Scars: A Special Case
Keloids are one of the most challenging scar types. They grow beyond the original wound, often remain inflamed, and can worsen if treated incorrectly.
Lasers can be helpful, especially when combined with LADD, but settings and timing must be chosen with great care. Over-treatment of an inflamed keloid can trigger further growth. For this reason, keloid treatment should only be carried out by specialists with extensive experience.
The UltraClear® Cold Fibre Laser
In December 2024, the UltraClear® cold fibre ablative fractional laser became the first of its kind to be TGA-approved in Australia. Unlike traditional CO₂ systems, UltraClear delivers energy at 2910 nm with a “cold” profile.
Clinical advantages include:
- Comparable results to CO₂ in scar remodelling
- Reduced pain during treatment
- Shorter recovery periods
- Lower risk of pigmentary changes, particularly in darker skin types
What Patients Can Expect
Treatment is individualised, but patients can generally expect:
Sessions: Usually several (3–8), spaced weeks apart.
Anaesthesia: Options include topical, local, sedation, or general anaesthesia, depending on scar size and sensitivity.
Downtime:
Risks: Temporary redness, pigmentary changes, or mild outbreaks of milia/acne. While many patients experience reduced pain and itch, some may notice temporary increased sensitivity after treatment.
Results: Improvements in colour, texture, pliability, and comfort typically evolve over months as collagen remodelling continues.
Anaesthesia: Options include topical, local, sedation, or general anaesthesia, depending on scar size and sensitivity.
Downtime:
- Non-ablative fractional lasers → several days of redness, swelling, or peeling.
- Ablative fractional lasers → longer recovery, sometimes weeks, depending on depth and extent of treatment.
Risks: Temporary redness, pigmentary changes, or mild outbreaks of milia/acne. While many patients experience reduced pain and itch, some may notice temporary increased sensitivity after treatment.
Results: Improvements in colour, texture, pliability, and comfort typically evolve over months as collagen remodelling continues.
Why Choose Our Clinic?
Scar treatment requires careful planning. At Scarless -The Clinic our Sydney Scar Clinic, we:
- Base care on international guidelines and published evidence.
- Offer a range of laser platforms tailored to redness, pigment, and structure.
- Integrate surgery, silicone, pressure therapy, and occupational therapy where needed.
- Maintain international research collaborations, ensuring access to the latest technology and knowledge.
Conclusion: The Role of Laser Scar Therapy
For many people, laser treatment for scars is not just about appearance — it’s about restoring movement, reducing discomfort, and rebuilding confidence.
- DermaV vascular laser targets redness and itch.
- Fractional ablative lasers, including Ultrapulse® Alpha CO₂ laser and the new UltraClear®, remodel thick, restrictive scars.
- Laser-assisted drug delivery enhances outcomes in resistant cases.
- Multimodal care ensures a holistic, tailored approach.
While all procedures carry some risks, when performed by experienced experts within evidence-based protocols, laser scar therapy is one of the most powerful tools in modern scar management.