The primary mechanism of action is fractional photothermolysis. This process utilizes a 10,600 nm laser wavelength to create an array of vertical micro-treatment zones (MTZs) deep within the scar tissue. By inducing controlled micro-trauma in these specific columns while leaving the surrounding tissue intact, the laser triggers a rapid wound-healing response that breaks down disorganized scar tissue and stimulates the regeneration of orderly collagen.
Hypertrophic scars are defined by disorganized, rigid collagen bundles that create physical tension. The Fractional CO2 Laser addresses this by physically breaking these bundles through microscopic ablation, forcing the skin to remodel the dermis with new, flexible, and organized collagen structures.
The Principle of Fractional Photothermolysis
Creating Vertical Micro-Channels
Unlike traditional lasers that ablate 10,600 nm of the entire skin surface, the Fractional CO2 laser utilizes a filtration system to fractionate the beam.
This creates thousands of microscopic, vertical columns of thermal injury known as Microscopic Treatment Zones (MTZs).
Preserving the "Bridges"
Crucially, the tissue located between these vertical columns is left intact.
These bridges of healthy, untreated skin act as a scaffold. They allow for rapid re-epithelialization and significantly shorter healing times compared to fully ablative procedures.
How It Remodels Scar Tissue
Disrupting Fibrous Bundles
The core pathology of a hypertrophic scar is dense, chaotic collagen that lacks flexibility.
The high-energy laser pulses physically break up these disorganized collagen fibers. This immediately reduces the internal physical pressure within the scar structure.
Triggering a Biological Reset
The thermal effect within the MTZs causes "controlled local destruction" or micro-trauma.
This trauma signals the body to initiate a natural wound-healing cascade. It essentially tricks the body into restarting the healing process, but under controlled conditions.
Synthesis of Orderly Collagen
As the skin repairs the micro-channels, it does not replicate the old scar tissue.
Instead, the body deposits new collagen and stimulates the migration of normal epidermal cells. This new tissue is arranged in an orderly, parallel fashion, resulting in skin that is flatter, softer, and more elastic.
Synergistic Benefits: Laser-Assisted Drug Delivery
The "Micro-Channel" Pathway
Beyond thermal remodeling, the vertical channels created by the laser serve a secondary mechanical function.
These channels act as physical tunnels into the deep dermis.
Enhancing Topical Efficacy
Because the skin's barrier is momentarily breached in these specific zones, topical medications can bypass the stratum corneum.
This allows for significantly enhanced penetration of anti-scarring drugs (such as corticosteroids) directly into the target tissue, amplifying the treatment's effectiveness.
Understanding the Trade-offs
The Necessity of Multiple Sessions
Because the laser only treats a "fraction" of the skin surface at a time (leaving the bridges intact), the remodeling process is cumulative.
You cannot resolve a mature hypertrophic scar in a single pass; it requires repeated stimulation to achieve significant flatness and flexibility.
Thermal Injury Management
While "minimally invasive" compared to surgery, this is still a thermal injury.
The process relies on inflammation to trigger remodeling. Therefore, temporary post-procedure redness, swelling, and a recovery period are not side effects, but necessary stages of the mechanism.
Making the Right Choice for Your Goal
When evaluating Fractional CO2 laser therapy for burn scars, consider how the mechanism aligns with your specific clinical objectives.
- If your primary focus is restoring flexibility and range of motion: The laser's ability to break up disorganized collagen bundles and reduce internal scar pressure makes it the superior choice for releasing tension in rigid scars.
- If your primary focus is flattening thick, raised tissue: The micro-ablative effect physically vaporizes vertical columns of tissue, which directly reduces overall scar volume and thickness over time.
- If your primary focus is maximizing medical treatment: You should utilize the "Laser-Assisted Drug Delivery" capability, applying topical agents immediately after laser treatment to leverage the micro-channels for deep penetration.
By replacing chaotic fibrosis with organized collagen, the Fractional CO2 Laser converts a static, rigid scar into dynamic, remodeling tissue.
Summary Table:
| Mechanism Component | Action | Clinical Result |
|---|---|---|
| Fractional Photothermolysis | Creates 10,600 nm micro-treatment zones (MTZs) | Controlled micro-trauma without damaging entire surface |
| Tissue Bridging | Preserves healthy skin between MTZs | Rapid re-epithelialization and significantly shorter downtime |
| Collagen Remodeling | Breaks chaotic fibers; triggers new synthesis | Flatter, softer, and more elastic skin texture |
| Drug Delivery (LADD) | Creates physical micro-channels into the dermis | Enhanced penetration of corticosteroids and topical treatments |
Elevate Your Clinic’s Scar Revision Outcomes with BELIS
Transform rigid, hypertrophic scars into smooth, healthy tissue with BELIS professional-grade medical aesthetic solutions. Our advanced CO2 Fractional Laser systems are engineered specifically for premium salons and clinics, offering the precision needed to break down disorganized collagen and restore patient confidence.
Why Partner with BELIS?
- Advanced Laser Portfolio: From CO2 Fractional and Nd:YAG to Pico lasers and Diode Hair Removal.
- Comprehensive Care: Complement your laser treatments with our HIFU, Microneedle RF, and specialized skin testers.
- Full-Body Solutions: Integrate EMSlim, Cryolipolysis, and Hydrafacial systems for a complete aesthetic offering.
Ready to upgrade your practice with industry-leading technology? Contact us today to explore our equipment range!
References
- Nathaniel R. Miletta, Matthias B. Donelan. Fractional Ablative Laser Therapy is an Effective Treatment for Hypertrophic Burn Scars: A Prospective Study of Objective and Subjective Outcomes. DOI: 10.2139/ssrn.3294104
This article is also based on technical information from Belislaser Knowledge Base .
Related Products
- Fractional CO2 Laser Machine for Skin Treatment
- Fractional CO2 Laser Machine for Skin Treatment
- Cryolipolysis Fat Freezing Cavitation Lipo Laser Machine
- Pico Laser Tattoo Removal Machine Picosure Picosecond Laser Machine
- Cryolipolysis Fat Freezing Machine Cavitation Lipo Laser Machine
People Also Ask
- What are the expected benefits and skin improvements from CO2 fractional laser resurfacing? Reset Your Skin Today
- What is the primary function of a medical-grade Fractional CO2 Laser? Transform Skin Graft Scars with Advanced CO2 Tech
- What type of aftercare is recommended following a CO2 laser resurfacing treatment? Essential Recovery & Healing Guide
- Why is a 5mm spot size considered necessary for the laser treatment of Striae Distensae? Precision in Stretch Mark Removal
- Why is the ability to control large spot diameters essential for laser treatment of large-scale facial traumatic scars?
