My Experience With Laser Treatments on Burn and Graft Scars
By Kris Flaten, M Div
Like so many of us who have had major body burns and grafts, I have scars, patterned with swirls, overlaid with diamonds of mesh, colored from deep red to white with edges hard and rough. Yes, I could accept them, grateful for life, but I wanted better. I wanted to be more comfortable. I wanted them to be softer, to have more movement, to be lighter in weight and color. Discouraged, I went to one last appointment, prepared to hear that there really weren’t any acceptable options. That outlook shifted when a physician’s assistant entered the room and said, “I wonder if laser treatments would help.”
Of course there were consultations, questions about insurance, as well as scheduling and transportation challenges. And I had questions about whether it would be worth it, how much pain there would be, whether I’d need to continue with compression garments, what kinds of risks were involved.
My burn sites were quite large—2 square feet of donor tissue were harvested for the grafts. They estimated I’d need 5 to 6 treatments for each of 4 areas of my body. I did the math and made a 1-year commitment to the process, which I started about 18 months ago.
The first treatment produced amazing results and each subsequent treatment has furthered that improvement. I am so incredibly grateful!
Before Laser Treatment and after 4-5 laser treatments
Don’t get me wrong—I will still have scars, very noticeable scars. But now instead of being tough like elephant hide, they’re much more like human skin. Now they stretch and move more easily and comfortably. Now both their coloring and weight are lighter.
It hasn’t all been easy—emotionally or physically. The treatments can be quite painful, sometimes like getting 4 or 5 bee stings in the same place and then 4 or 5 more just next to those, over and over across the scar. That pain doesn’t last long but it can be intense. It’s also not predictable; usually I don’t feel much through the grafts, but sometimes I do. The edges of the scars can be really sensitive. We’ve worked at and refined a pain management system: A couple of hours before the treatment I slather on a lidocaine/prilocaine prescription cream (EMLA) and then cover it with plastic wrap. About 20 minutes before the treatment, (usually in the parking lot) I take a pain pill. After the treatment, I may take another, but it’s usually not needed.
During the procedure, I wear goggles to protect my eyes. I am also given a hose to blow cold air on the site just after the lasering, which numbs the tissues and lessens the pain. After the treatment is completed, a steroid solution is wiped on. That can itch, even hurt a little. It needs to soak in for 3-4 hours so it’s covered with a Tegaderm dressing. Then comes the messy part: blood and fluids ooze for several hours. Then the new “wounds” close (usually without scabs). For the next few days, the area is a little swollen and more red, sometimes a little sore and/or itchy. Moisturizing is important—both for comfort and healing. The skin has to heal for 2 months before it can be treated again. I have experienced some fatigue with the treatments so I have learned that I need extra rest while my skin is healing.
The emotional part in some ways has been more difficult for me. During the treatment, I’m in the same physical position I was often in during hydrotherapy in the hospital, so those memories did come flooding back pretty intensely, especially at first. To help with my anxiety, I took lots of deep breaths and reassured myself a lot.
Often I smell the skin burning, particularly when the treatments are on my upper chest. We also end up blowing the tiny skin fragments off my face, similar to getting hair blown off after a haircut. The messy part has taken me back to those first months of daily wound care and the pain, itching, and fears associated with that. To be honest, after the first treatment I wasn’t sure I’d continue. But I’ve found that going through these treatments has actually been healing to those memories; with these treatments the experience is not as intense and it doesn’t last as long so my body is learning to expect an easier experience than the ones I had had in the hospital. And, as I’ve said, the benefits to my skin (and self-esteem) are really worth it!
Here’s my advice to others undergoing laser treatments:
- Ask lots of questions. There are many kinds of lasers, which can be set at different depths for different numbers of passes or overlaps. Some are faster than others. Be curious.
- Tell people what the treatments are like for you.
- Problem-solve with your providers, family, and/ or support system on how to make the treatments more comfortable and easier for you to tolerate. We are each different!
- Reward yourself after each treatment. (I often had a book I had looked forward to reading, or I would take myself out to a movie or lunch.)
- Ask for what you need. After the full treatment It was difficult for me to do the first dressing myself and get it on securely so I asked if I could come back (3-4 hours later, after the steroid had had time to soak in) and get some help with it. The medical staff was happy to work that in and doing so worked well for me. I left the dressing on for 24 hours, after which I was able to change it myself.
- Be gentle with yourself. I usually don’t plan anything else for the day I am being treated, then I’ll do thing as I feel up to them.
- Enjoy the results; encourage yourself and your skin.
Kris Flaten, M Div, of St. Paul, Minnesota, sustained a thermal burn injury on Dec. 25, 2012.