Treatment for Burn Scars

Fractional CO2 laser treatment is one type of treatment for burn scars. Laser treatments can smooth out scars and improve their texture and flexibility. It can also reduce pain or itching. Laser is an optional therapy, however it may help to minimize your scarring.

How Does CO2 Laser Treatment Work

Fractional laser therapy makes really small wounds in the skin that the body can heal quickly. These small wounds reduce the amount of scar tissue development. These changes can make scars look more normal.

Keep in mind, however, that fractional CO2 lasering will never completely remove the scar.

After CO2 Laser Treatment

Right after scar treatment, your skin may look darker, lighter, or red. This may last for several months after treatment. You will also have some crusting, bruising, swelling, and/or scabbing for one to two weeks following a treatment. 

Your treatment team will change the wound dressing daily using an ointment called Aquaphor. They will also apply a non-stick dressing material and secure it with gauze and netting.

Number of Treatments

While you may notice changes to your scar after one treatment, it may take multiple treatments to make noticeable changes. You will wait at least four weeks between each of your treatments. After six to 10 treatments, you will see the best result possible from CO2 laser treatment.

Anesthetic

For your treatment, we will apply a topical and/or injectable anesthetic. For some cases, we may do the treatment in the operating room. For these treatments, we will use other medications. We will decide where you will get your treatment during your laser consultation visit.

Bringing Family & Friends to Treatment

Please do not bring your family and friends to your treatment (except to drop you off and pick you up).

Exception: A patient fewer than 14 years of age may have a parent/caregiver present. Patients 14–18 years may choose if they would like a parent/caregiver present. 

Everyone present in the procedure room, including the patient, will be required to wear eye protection.

Insurance for Laser Therapy

We will check that laser therapy is a covered benefit by your insurance. We will get prior authorization before starting any treatments.

What to Expect at CO2 Laser Treatment

Before Treatment

For four to six weeks before your treatment, keep out of the sun. Do not use tanning beds or tanning creams on your scars.

Starting one week before your treatment, do not apply any steroid cream, astringents, or irritants (Retin-A, glycolics, or toners) to your scars. After your treatment, talk to your treatment team about when you can begin using those products again.

Up until one day before your treatment you can use non-perfumed lotions.

Tell your provider if you:

  • have a history of cold sores or shingles.
  • are taking medications that thin your blood.
  • have a history of previous laser or skin treatments.

Schedule a ride home after your treatment. In our clinic your treatment should take about two and a half hours. You may be at the hospital longer if your treatment is done in the operating room.

Use a cool compress on the lasered area for comfort. You can put wet washcloths in a plastic bag and freeze them as well.

Day of Procedure

  • Take a shower before you leave home. Use non-perfumed soap.
  • Eat a light meal before your appointment.*
  • Arrive at the office prepared:
    • Remove any jewelry near the treatment area.
    • Clip, not shave, hair near the treatment area.
    • Take your prescribed medications before your arrival. We will let you know if you need to bring additional medications.
  • Wear a button-down shirt. It may get stained with topical ointments in clinic.

If you are receiving treatment on your face, wash it before you come. Remove makeup, sunscreen, and lotion. Do not wear contacts; please wear your glasses.

You will probably not be able to wear your compression garments for one week after treatment

*If your treatment is being done in the OR, you will get specific instructions about eating or drinking before your treatment.

Recovery After the Procedure

Return home and rest.

  • Use a cool compress (prepared washcloth packs) to help with burning and swelling. Optional: Use diluted vinegar solution for comfort (one part vinegar, two parts water, mixed in a spray bottle).
  • Do not pick, scratch, or scrub the treated area. Allow flakes of skin to fall off on their own.
  • Take over-the-counter Acetaminophen (Tylenol) or Ibuprofen (Motrin), as your treatment team directs for pain.

Days 1–3 Post Treatment 

  • Gently clean your skin with non-perfumed soap.
  • Rinse with cool water.
  • Apply Aquaphor, non-stick dressing, gauze, and netting.

Day 4–7 Post Treatment 

  • Gently clean your skin with non-perfumed soap.
  • Rinse with cool water.
  • Apply Aquaphor, non-stick dressing, gauze, and netting to any areas that remain open.

Day 8 Post-Treatment

Resume the treatment care you did previously, including wearing your compression garments.

Find a Burn Specialist

Verified burn center certification

Verified Burn Center Experts

Why does it matter that we are a verified burn center? The American Burn Association and the American College of Surgeons designed a rigorous review program that ensures verified centers offer the best care for their patients. This includes the whole patient experience from the time of injury through rehabilitation.

It also means we meet the highest quality of care available because we meet these high quality standards. The standards are for personnel qualifications, facilities resources, organizational structure, and medical care services.