What should you know about CO2 laser for hypertrophic scars?

A hypertrophic scar is raised and remains within the boundary of the original injury. CO2 laser can create controlled channels or remove surface scar tissue, which may improve stiffness, contour, or texture in selected cases. It does not suit every scar, especially one that is still actively enlarging, inflamed, infected, or behaving like a keloid.

Assessment includes the scar’s age, cause, firmness, colour, symptoms, and effect on movement. Redness, swelling, crusting, pigment changes, infection, and delayed healing can follow treatment. A clinician may recommend treating the scar itself, the surrounding skin, or combining approaches rather than relying on one session or one technology.

Bring details of how the scar formed and any previous injections, surgery, or laser treatment. [Fractional Laser Treatment](/treatments/laser-and-energy/fractional-laser-treatment/) may be discussed for texture or flexibility, while [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/) may be considered for selected raised scars. [Scar Revision Surgery](/treatments/surgical-dermatology/scar-revision-surgery/) and [Surgical Excision](/treatments/surgical-dermatology/excisional-surgery/) are different options with different trade-offs.

Follow wound-care instructions closely after treatment. Keep the area protected, avoid picking scabs, and attend reviews so the scar’s height, colour, and tenderness can be reassessed. Ask when pressure therapy, silicone care, exercise, or sun exposure can resume.

Report increasing warmth, pain, pus, spreading redness, fever, or wound separation. Arrange review if the scar rapidly becomes thicker, extends beyond the original wound, restricts movement, or develops persistent bleeding. Severe swelling or an allergic reaction after treatment requires urgent attention.

Is this definitely a hypertrophic scar rather than a keloid? Is it still active? Would laser, an injection, silicone care, or surgery address the main problem? How will you protect surrounding skin and judge whether treatment is helping?