Burn scars are often not just marks left on the skin, but traces that remain in the mind for a long time. The first question that comes to mind is, "My scar is old, can it still get better now?" To answer directly, it is reported that even old burn scars can be improved to be softer and lighter with consistent laser treatment.
Today, Yonsei Star Dermatology Sinchon will explain the Pinhole Technique, one of the burn scar treatments, exactly as it is performed here.
Folk Remedy of Puncturing with Needles Reborn as Laser
The roots of the Pinhole Technique surprisingly trace back to old folk remedies. There have long been anecdotal accounts of people softening burn scars by pricking the affected area with needles or similar objects.
While not a hygienically recommended method, many experienced that stimulating the scar with needles did make it somewhat softer. The Pinhole Technique using lasers is a modern and more scientific application of this principle.
How Does the Pinhole Technique Work?
The principle is simpler than you might think. When small holes are made in the scar at regular intervals with a laser, the hardened scar tissue gradually loosens over time.
The key difference between puncturing with needles and the laser Pinhole Technique lies in how sufficiently the scar tissue can be destroyed and stimulated.
While needles have a limited effect because they struggle to stimulate surrounding tissue, the laser Pinhole Technique not only creates larger holes but also delivers stimulation to surrounding tissue that is not visible to the naked eye.
Therefore, the laser Pinhole Technique is considered to have greater power to induce regeneration and is more advantageous for treating scars more evenly. If you are curious about the flow of the Pinhole Technique, it may be helpful to also review the Pinhole Alpha Treatment Guide and Mild Pinhole Guide.
Can Old Scars and Elderly Patients Be Treated?
Burn scars being old does not mean treatment is impossible.
In fact, among those who received burn treatment at Yonsei Star Dermatology Sinchon, there was an elderly patient in their 80s.
An 80-year-old man, active and fond of sports, showed his arm burn scar and expressed a strong desire for treatment. When asked if treatment was really necessary as it wasn't a severe scar, he replied, "It's a grudge that has built up over 80 years."
In the examination room, we are reminded time and again that the stress caused by burn scars affects all ages and genders. It is not uncommon for scar improvement to lead to emotional recovery. Information on burn scars in general can be found in the Burn Scar Symptoms Guide.
Why Laser Treatment, Not Surgery, Has Become Established
Surgical methods for burn scars have existed for decades. Representative examples include skin grafting and, at one time, skin expansion (a method of inserting a water bag under the skin to stretch it and then cover the area).
However, due to low satisfaction with the results, these surgeries are rarely performed nowadays. While surgeries were common twenty to thirty years ago, many more people now choose laser treatment.
A simple comparison of surgery and laser treatment is as follows:
| Category | Past Surgical Methods | Laser Pinhole Technique |
|---|---|---|
| Main Method | Skin grafting, skin expansion | Micro-hole formation in scars with laser |
| Incision Required | Incision needed | Non-incisional |
| Current Utilization | Rarely performed | Primary treatment direction |
For inquiries, please contact us via chat for burn scar treatment.
The Pinhole Technique Has Evolved to Pinhole 4.0
The idea for the Pinhole Technique at Yonsei Star Dermatology Sinchon was conceived over 20 years ago. Since then, the treatment method has been gradually upgraded through long-term treatment, leading to the current Pinhole 4.0.
While the initial Pinhole Technique involved making only one type of hole with a laser, the recent 4.0 method consists of the following:
- Forming deep and strong holes with a laser
- Adding more direct stimulation to the skin surface
- Simultaneously forming small, invisible holes
- Concurrently combining burn scar injections that soften the scar
By utilizing both laser and injections to treat scars in a complex manner, treatment responses are reported to appear faster than in the early stages. If you are curious about injection treatments that soften scars, you can also refer to the Triamcinolone Scar Injection Guide.
Are Facial Burn Scars More Difficult?
We are often asked if facial burn scars are more difficult to treat than those on other areas. The difficulty lies not in the result itself, but in the pain during the treatment process. The face is more sensitive, so pain may be felt more during the procedure.
However, the final treatment results are actually better for the face. The treatment goal is for the scar to be naturally covered with light makeup, and most cases are believed to lead to satisfactory results.
Here are some important points to remember when receiving burn scar treatment:
- Even old scars or elderly patients can attempt treatment.
- Consistent, long-term treatment is generally more beneficial for results than a single session.
- The face may experience more pain, but the results are generally good.
- Treatment responses may vary individually depending on the type and condition of the scar.
It is true that burn scar treatment remains a challenging area. However, satisfactory results can be expected with consistent treatment, so we recommend approaching it with sufficient time rather than impatience.
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Chief Director Lee Sang-Joo (MD, PhD, Yonsei University College of Medicine and Graduate School; Completed Dermatology Residency at Severance Hospital; President of the Korean Dermatological Association) Chief Director Lee Sang-Joo's Profile First Published 2024-09-19 / Last Reviewed 2026-06-16
This article is for general information purposes only, and individual treatment responses may vary. Accurate diagnosis and treatment plans should be determined through consultation with medical staff.