Laser Resurfacing for the Management of Periorbital Scarring

Abstract

Laser (light amplification by the stimulated emission of radiation) skin resurfacing is currently one of the most widely adopted technologies in facial rejuvenation. While most often used for aesthetic purposes, lasers also have applications in the management of scars. Since the introduction of the CO₂ laser for skin rejuvenation in the 1990s, the last three decades have seen significant growth in the number of laser devices available to the physician. More recently, promising alternatives to light-based resurfacing technologies have emerged that include radiofrequency and intense focused ultrasound. To help the physician navigate the most current laser technologies as they apply to periocular scars, this review discusses the available treatment modalities, pre-treatment assessment of periorbital scars, treatment selection, and reported outcomes and complications. The recommendations described herein are based on published literature and the authors' experience in an academic oculoplastics practice.

Keywords: Periorbital scarring; ectropion; laser assisted drug delivery; laser resurfacing.

Figure 1.

Post-surgical scars occurring in the periorbital region: (A) a well-concealed surgical incision within the lid crease following upper eyelid blepharoplasty; (B) a surgical scar above the brow following a direct browplasty procedure; (C) prolonged ecchymosis and dyspigmentation of the lower eyelid skin following a canalicular laceration repair; (D) hyperpigmentation of eyelid skin following complex repair of a lower eyelid avulsion; (E) dyspigmentation and hypertrophy of skin following a Hughes tarsoconjunctival flap and bipedicle flap to reconstruct the lower eyelid years after excision of a basal cell carcinoma by an outside provider; and (F) lower eyelid ectropion in a patient with an underlying inflammatory dermatosis

Figure 2.

Appearance of a lower eyelid scar from a Hughes reconstruction before (A) and one year after laser resurfacing (B)