2025 AAD Meeting: Innovations for Treatment of Burn and Trauma Scars
The use of lasers and energy-based device technology to treat different types of scars continues to evolve. Arielle N.B. Kauvar, MD, FAAD; Kristen Marie Kelly, MD, FAAD; Girish S. Munavalli, MD, MHS, FAAD; and Jill Waibel, MD, FAAD, explored the traditional and cutting-edge techniques for correction of erythematous, pigmented, hypertrophic, atrophic, acne, burn, and surgical scars, as well as complex scars from trauma, at the 2025 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Florida, from March 7 to 10.
Dr. Waibel, founder and medical director of Miami Dermatology and Laser Institute, spoke about the latest innovations for treating burn and trauma scars.
“There’s 3D printing coming for large burn scars and they’re in early clinical trials, which is super exciting,” Dr. Waibel said. “A burn patient can be in the lab, and they can print their own skin.”
Additional innovations Dr. Waibel explained include: “Smart scar monitoring wearables, there is going to be sensors that tell you when there’s too much tension and send you to the dermatologist office to laser it. There is going to be an artificial intelligence guided scar imaging of predicted models, and I do believe a lot of this is genetic, injury, and tension based but there’s other factors. We can start treating earlier if we see these scars developing. There are some silicone dressings that are nanoparticles.”
With the new innovations coming, Dr. Waibel said the best current option available in burn and trauma scars is the ablative factional laser, which was originally made for wrinkles.
“They vaporize the scar. It is the smallest wound the human body has ever seen and you take away the scar and it heals to almost normal,” Dr. Waibel said.
The ablative factional laser has seven mechanisms of action: it stimulates new collagen, stimulates the heat shock protein pathway, changes the cytokine, and normalizes the vascular pattern.
The algorithmic treatment approach involves assessing the scar type and severity before using a combination of conservative and potentially surgical modalities for treatment based on the scar characteristics and patient needs.
When approaching treatment for burn and trauma scars, Dr. Waibel follows a specific approach. When evaluating the burn or scar, if it’s red, she uses a vascular laser; if it’s white or atrophic, she uses a nonablative laser; and if it’s hyperpigmented, she explained, a thulium laser is needed. More serious burn and trauma scars need a “heavy hitter,” so she uses a fractional laser and follows up with laser-assisted delivery treatments.
Dr. Waibel tells Modern Aesthetics on a recent call with colleague E. Victor Ross, MD, they both agree that the old lasers work the best, but there are some 2.0 generations on the horizon.
Candela is rolling out the VBeam Pro which is the next generation of the pulse-dye laser next month at the American Society for Laser Medicine & Surgery conference.
“The pulse-dye laser was the first laser introduced into all medicine by Rox Anderson and John Parrish in the 1980s, and that really put dermatology on the map as the world’s experts in lasers,” Dr. Waibel said. “If you think of lasers, traditionally it was physicists and engineers, and we do need that team, it’s a team approach.”
The Solta Fraxel, which is owned by Bausch Health Companies Inc., is coming out with a 2.0 which Dr. Waibel said, “is very exciting because everyone loves the 1550nm and 1927nm non-ablative fractional and we’ve been waiting almost 20 years for an upgrade.”
Luminus created a 2.0 of the Gold Standard CO2 Ultra Pulse.
“I think these are very important and in most cases the laser technology is the same, but they’re making the ergonomics and the Gui, which is the graphic user interface, better,” Dr. Waibel said. “They’re also putting QR codes on for a new user, which I think is nice.”
Dr. Waibel left us with a teaser for what’s to come in the laser space.
“I’m working with several companies that are developing artificial intelligence laser products, that’s going to be exciting,” Dr. Waibel said. “That’s going to help us target things better, we’ll be better because the laser will be better.”