Questions to Ask Before Scar or Pigment Treatment

Why the questions matter

You have a scar or a patch of darker skin that bothers you, and you have booked a consultation or are thinking about it. It is easy to walk out with a price and not much else. A short list of questions helps you leave with a diagnosis, a plan and expectations you can trust. Keep the list on your phone so nothing slips your mind in the room.

The type of scar decides the treatment. AAD explains that raised scars, keloids and sunken acne scars are treated in different ways, and that dermatologists often use more than one treatment. AAD's guide to laser scar treatment adds that laser can make a scar less noticeable but cannot get rid of it. The American Society of Plastic Surgeons (ASPS) says the same about scar revision in general: a scar cannot be completely erased.

If you are not sure your scar is ready for treatment yet, start with is your scar ready for treatment. For a broad overview of laser scar care, see the complete laser scar removal guide.

What to tell the provider

A good consultation runs both ways. AAD advises telling the person treating your scar about your health, medicines and expectations, and ASPS lists similar topics for a scar revision consultation. Be ready to share:

• Every medicine and supplement you take. AAD notes that some may need to be paused before laser treatment, but only your prescriber should change a medicine.
• Whether you get cold sores, have diabetes or another medical condition, or smoke.
• Any recent tan or sunburn. AAD says a dermatologist cannot treat skin that is tanned or sunburned, because the laser could burn or discolor it.
• If your scars are from acne, every acne treatment you use now or have used in the last two years, as AAD advises.
• Past scar treatments and how your skin responded, including any history of keloids.
• Whether you are pregnant or planning a pregnancy.
• The result you hope for. AAD encourages being honest about what you expect from treatment.

When something else should come first

Sometimes the right first step is not scar treatment at all. If a spot is changing, bleeding or irregular, or if no one is sure what it is, a dermatologist's exam should come first, and possibly a biopsy. AAD notes that other skin conditions can look like a keloid, and that a dermatologist can take a small skin sample to check.

If you still have active acne, AAD advises getting breakouts under control before treating scars, because stopping acne reduces inflammation and helps prevent new scars. ASPS also lists having no active acne or other skin disease in the area as part of being a good candidate for scar revision.

Timing matters in another way, too. AAD notes that it can take months to see results from laser scar treatment, and you may notice little improvement at first. If you have an event in mind, raise it early so the plan is realistic.

What Laser Eraser treats, and how

At Laser Eraser, acne scars are treated with the PicoWay laser. Keloids are treated differently: with injections into the scar, not laser. You can read more on the acne scar removal and keloid scar treatment pages, and the scar removal page describes the practice's overall approach. If you have more than one concern, such as acne scars and dark marks, ask whether each will be treated the same way or differently, and in what order.

If you are considering keloid injections anywhere, ask what results are realistic and what side effects to watch for. AAD notes that keloids can be hard to get rid of, that some return after treatment, and that corticosteroid injections can leave light spots on darker skin. Not sure whether your raised scar is a keloid? The guide on keloid vs. hypertrophic scars explains the difference.

Consultations at Laser Eraser are free and no-obligation. A provider assesses the scar and gives an exact quote, and the site says providers can build in test spots when caution is warranted.

Questions about aftercare and follow-up

Treatment does not end when you leave the room. AAD notes that you will need to care for the treated area at home, and to protect it from the sun until it heals, because sun on healing skin can lead to another scar.

Ask, too, about anything you are told to do at home. AAD notes that silicone gel sheets usually need to be worn every day, often for months, and that research on over-the-counter scar products with onion extract, vitamin A or vitamin E is limited. Before you book, ask:

• What will the skin look and feel like in the first few days, and what is normal?
• What should I put on it, and what should I avoid?
• How should I protect it from the sun, and for how long?
• Who do I call if something looks wrong, and how quickly will someone respond?
• When is the next visit, and how will we judge whether it is working?

Red flags, cost and your next step

AAD's advice here is direct: if someone promises to treat your scar before providing a medical consultation, walk away. Be careful, too, with anyone who promises a scar will disappear, since laser can make a scar less noticeable but cannot remove it. Pressure to pay before your questions are answered is another reason to slow down.

Ask about cost and insurance in the same visit, so there are no surprises later. Scar treatment is often considered cosmetic, though a scar that limits movement or causes symptoms may be reviewed differently by some plans. Our guide on insurance, HSA and FSA rules explains what to ask your plan before you pay.

When you feel ready, bring this checklist and book a free consultation. Write the answers down, or ask whether you can take notes, so you can compare them later with a clear head.