Instant gratification comes with each treatment because you can kind of see it start to chip away and disappear.
Dr. Waibel was given the honor of being named “Person of the Week” on ABC World News Tonight with David Muir.
Dr. Jill Waibel is a leading dermatologic surgeon known for her extensive work treating patients who have suffered with burn and traumatic scars. Patients come to see her from all over the world with devastating and disfiguring scars to seek her advice and treatment.
Burn scars create a host of aesthetic and functional challenges. Burns not only destroy tissue, but they also hamper the ability of remaining tissues to respond to some treatments such as lasers. Additionally, loss of underlying tissues often results in contracture, or tightening of the skin over the wound, which can cause pain and restrict motion.
Post-burn scars usually develop a hypertrophic appearance – red, firm, raised and confined to the original wound’s borders. The complexity of severe burn scars requires a multifaceted approach that involves surgery and, increasingly, carefully selected and delivered laser therapies.
What are the signs of a burn scar?
Burn scars typically appear red and raised, and can be itchy and/or painful. Additionally, tissue contraction results in tightness of the overlying skin.
Who is most susceptible to burn scars?
Some of the most severe burn scarring affects soldiers returning from battle. The use of improvised explosive devices creates devastating wounds including burns. However, medical advances that have occurred over the past decade or so have meant that more soldiers are surviving these serious wounds, and they need reconstructive and dermatologic treatments. Proper post-burn care is also important to minimize scarring. Dr. Waibel has collaborated closely with military colleagues and works to help wounded members of our armed forces.
Before & After Burn Scar Photos
Early scar rehabilitation
After skin grafts and donor sites have healed, treatment focuses on maximizing wound-healing. This requires proper hydration of the wound, using water-based moisturizers and possibly silicone sheeting or other occlusive dressings. Compression garments are also commonly used in this phase. Research at MDLI shows the sooner a scar is lased the better the results. Typically we recommend waiting until skin is intact (epithelized) and begin treatment about three months post-injury.
Late scar reconstruction
Correcting excess tension across a burn wound may need laser and surgical procedures such as a Z-plasty, which uses a specific pattern of incisions to achieve functional and aesthetic improvements.
Waiting a year for a scar to “mature” used to be the standard of care for burn scars. Now, based on research done at MDLI, it is recommended to begin laser treatment as early as 2 to 3 months after the original injury. Fractional resurfacing can address discoloration, redness and textural irregularities. For thicker scars and scar contractures, ablative fractional resurfacing appears to be much more effective than non-ablative resurfacing. For red scars, your MDLI dermatologist may also recommend lasers typically used to treat vascular issues, such as the pulsed dye or IPL laser. If you’re undergoing multiple modalities in a single visit, treatments are combined carefully to avoid excess thermal injury. Typically, treatments should be spaced at least 6 to 8 weeks apart depending on the scar.
Post-laser therapy may include applying dressings such as a petrolatum-based ointment immediately after laser treatment. Patients should leave the ointment on for 1 to 2 days, then continue applying petrolatum-based ointment until 3 to 4 days post-treatment, when the wound is epithelialized (covered with new skin).
Patients with burn scars can undergo intralesional steroid therapy, which is usually done with triamcinolone, concurrent with laser therapy. Alternatively, applying a topical steroid immediately after fractional laser treatment allows the drug to diffuse into the pores created by the laser.