Can a prominent decades-old disfigurement ever really disappear? A dubious Kathy Buchanan tries out a new high-tech laser treatment
Every scar has a story. The 5cm whopper under my left arm harks back to 1983 when I was 12 years old. That’s when I dislocated my collarbone after falling off a precariously balanced chair. I remember the pain
and being unable to play netball, but more vividly I recall the rings of white cotton bandage placed around the top of each of my arms and pulled tightly across my back to get my collarbone back in place. I complained about the discomfort, but not nearly enough.
After a month or so, my mum noticed a deep, garish wound under the cotton surrounding my left arm. The bandage had cut through the skin towards the back of my left shoulder and left an open sore. Doctors said the site had begun healing itself and it was too late for stitches.
Eventually it did heal over, but the scar that remained was red, angry and bulbous. Growing up in Queensland meant that I lived in short-sleeved tops and bathers, so my scar was always apparent. For years I pretended it did not bother me, but it did really. I dutifully put vitamin E cream on it every night for months and have since spent many hundreds of dollars on various scar-healing creams. Nothing has ever made any difference.
Then, last year, a GP I was seated next to at a dinner party mentioned a new resurfacing non-surgical treatment – Fraxel laser – that supposedly could make scars less noticeable.
It sounded miraculous, but did it work? I decide to take a chance and make an appointment at The Facial Rejuvenation Clinic in Sydney.
Dr Garry Cussell, a cosmetic physician, walks me through the Fraxel treatment. Fraxel laser resurfacing is a relatively new procedure and was introduced in the US in 2004. It’s been used on around 2000 Australians since its launch here in 2005.
“Fraxel can be used to treat scars all over the body. Many women use it after breast augmentation or after caesareans. It can also be used for cosmetic reasons to improve facial scarring, pigmentation from sun exposure, wrinkles and post-acne scarring,” he explains as he shows me photos of “before” and “after” patients.
“The Fraxel treatment produces thousands of tiny but deep columns of treatment in your skin. These are known as microthermal treatment zones, which penetrate deep into the dermis. Cell renewal and healing occurs over several weeks and, with it, the old and pigmented epidermal cells are eliminated,” he continues.
Dr Cussell notices me looking at him quizzically. “Basically, the body’s own healing process creates new and healthy tissue to replace the old skin imperfections,” he adds. “In this case, that means your scar will become a lot flatter and the colour will fade into your normal skin tone and be lessvisible.” I’ve got to admit I’m sceptical about the process. After all, my scar is raised, thick, uneven and reddish against the rest of my pale skin.
Dr Cussell cannot predict exactly how many treatments I’ll need to eradicate the scar, but suggests five to seven sessions will produce a significant difference. Each ten-minute session will cost up to $250.Yikes!
Despite Dr Cussell’s sincerity – he forewarns me that the procedure will hurt – I still have my doubts. I want to know why I will need so many treatments. Dr Cussell explains that my type of scar will require at least five sessions, though some patients need as few as two or three. “You’ll also need to wait a month between treatments to give your skin a chance to shed old scar tissue and produce new collagen,” he says. “I promise you will see a big difference, Kathy.” I’m shown the Fraxel machine and even touch the metal tip. It is small enough to hold in my hand and looks harmless enough. I decide to book my first appointment. If it turns out to be a load of hype, I decide, I will simply cancel further sessions. I leave with a tub of numbing cream and a handful of brochures.
Three days later, 120 minutes after dutifully applying the local anaesthetic cream to my scar, I report for duty. After signing a consent form, I’m ushered into the procedure room and invited to lie on my stomach with my T-shirt pulled up to ensure Dr Cussell has easy access to the scar area. “OK. Ready, Doc!” I say and grit my teeth in preparation. When the Fraxel laser passes over my scar a few seconds later, it feels like an intense and admittedly painful case of pins and needles. It is manageable, but I imagine it could really hurt if
you were having a much bigger area treated.
And I am surprised by how loud it is. The laser makes a high-pitched di di-type noise, which in my case luckily lasts only about two minutes. Dr Cussell makes about eight passes over the treated area. All the time, the clinician is using something called a Zimmer cooler to blow cold air onto the treated area, reducing the heat in the skin.
When I ask why the Fraxel is hot, Dr Cussell says the laser head itself isn’t hot. It feels that way because it is delivering energy into the skin at a specified level to heat up fluid molecules that in turn stimulate collagen production.
Before going home, I rest in the recovery room for 20 minutes with an icepack to reduce swelling. At first I’m aware of a hot sensation under my arm, but after a few hours the memory of the procedure fades.
Two days later, I notice excess skin from the treated area literally falling off, and a small open wound appears. I panic and call the clinic.
“This is normal in your case, as the scar is a keloid,” Dr Cussell explains. He tells me the skin has begun to exfoliate through the natural healing process. “The cells are responding as though they’re injured. This is why this fractional procedure works so well. It forces the skin to rapidly repair itself with new, healthy cells.”
Encouraged to use a soothing hydrating lotion to treat the area ($50 for 118ml), I make an appointment for my second session, as advised.
By the next time I meet Dr Cussell, the scar area is still red, but flat for the first time since before my pre-teen accident. And the excess skin has disappeared.
Each subsequent treatment at roughly four-week intervals proves a breeze. I have to pinch myself as the scar gradually vanishes before my eyes. The scar area is typically red for a couple of weeks after each treatment, but dies down once I apply ointment a couple of times a day.
After my seventh and final treatment, I’m over the moon. It has taken seven months, but the results are much better than the sceptic in me had ever expected. It hits home a week after my final treatment. Stepping out
of the shower, I catch a glimpse of the skin under my left arm and unexpectedly feel a dozen hot tears falling down my face.
I realise I’ve lost a part of me I’ve hated for so long. I stride straight into my bedroom and put on my favourite strapless dress.
HealthSmart verdict
Quick; slightly painful; expensive; excellent long-term results.
What you need to know
Best results are achieved with a pre-treatment regimen of quality skincare products (get advice on this from your doctor). You must apply a small amount of numbing cream two hours before treatment and every 30 minutes after. Cover the area with plastic wrap to prevent the cream rubbing off and keep the cream refrigerated between use. Be aware that your skin may be sensitive post-treatment: use an icepack to reduce burning and redness. The clinic calls clients the day after to check on progress and to arrange a consulation for four days later, which includes exfoliation and moisturising treatments. Report any excessive pain immediately. The Fraxel procedure can be used on all skin types. For more information, call The Facial Rejuvenation Clinic on 1300 889935 or visit www.facialrejuvenation.com.au
