Functional Improvements

Uebelhoer and Shumaker have been employing ablative fractional laser technology for traumatic scars and other types of injuries at NMCSD since 2009. They were among the first and remain one of the most prolific users of the treatment — showing that not only cosmetic benefits, but also functional improvements can result from these treatments.

“Early on, we started very conservatively,” Uebelhoer said. “We used settings we knew would not hurt anyone, because we knew this was a new frontier. We started on a few individuals and saw them begin to move their hands better or their arms better. The timing of this improvement was too closely associated with the time we lased them to be just a coincidence of their scar rehab suddenly improving.”

Physical therapists told the dermatologists that patients who had reached a plateau in their rehabilitation suddenly showed dramatic improvements following the laser treatment.

The improvements can appear subtle, the dermatologists explained, but they make a big difference in terms of a patient’s quality of life.

One patient who had a blast injury to the lips and cheeks had difficulty putting large bites of food into his mouth. Within a few weeks after the treatment, he was taking big bites out of a hamburger.

Another patient had injured his hand while defusing a bomb. He’d lost several fingers, and the scar tissue on the remaining fingers was so tight that he was unable to bring his thumb and middle finger together.

“He said he couldn’t even get change out of his pocket,” Uebelhoer said.

Following several laser treatments, he was able not only to grasp things with those fingers but also to lift weights using that hand again.

“This gentleman has been able to go back onto full duty,” Uebelhoer said. “Though he’s missing fingers, he’s able to function enough to be on active duty again.”

Uebelhoer and Shumaker are quick to note that this treatment is in no way a replacement for surgery or existing scar rehab treatment.

“That’s critical to make clear,” Uebelhoer said. “This is not a monotherapy. We need physiotherapists and plastic surgeons. We’re just adding this little adjunct therapy.”

The treatment goes against some of the current treatment paradigms for traumatic scars. For decades, it’s been common practice to leave traumatic scars untreated until they have “matured,” which can take as long as a year.

“For people who were brought up with surgical training, there’s a rule of thumb that you let a scar mature before you do any procedural intervention,” Shumaker said. “And when we only had earlier iterations of laser technology and surgical treatment, that was true.”

Using ablative fractional laser technology before a scar has finished maturing has been able to change the trajectory of the scar for the better, the dermatologists pointed out.