Overview of Energy-Based Devices for Scar Treatment

Conclusions

• Energy-based devices are an important part of scar management because they can substantially improve appearance, symptoms such as pain and itch, and functional limitation from contracture.
• Treatment selection should be based on scar features such as erythema, texture/tightness, pigment, tension, and whether the scar is mature or unstable.
• Pulsed dye laser is especially useful for erythematous scars, while fractional ablative or non-ablative lasers are better for textural change and tightness.
• Pigmented scars or traumatic tattoos can often be improved with nanosecond or picosecond lasers.
• Microneedling and radiofrequency microneedling are useful non-laser alternatives, particularly when reducing post-inflammatory hyperpigmentation is important.
• Combining multiple modalities during one treatment course often produces better results than using a single device alone.
• Scar improvement can begin early after injury and does not necessarily require waiting a year, although treatment timing should be individualized.
• Most scar treatments improve scars rather than erase them completely, so expectations should be set accordingly.
• Laser-assisted drug delivery and adjunctive therapies such as silicone, compression, therapy, and surgical release can enhance outcomes in selected patients.
• These treatments can be used in children and in patients with different skin tones, with appropriate adjustments and attention to safety.
• Post-treatment care is usually manageable and pain is often limited, making outpatient treatment feasible for many patients.
• Optical coherence tomography may become useful for measuring scar depth and tailoring laser settings more precisely in the future.