Scar Free Foundation-funded research on laser treatment for burn scars published in Nature Portfolio

Monday 29 June 2026

A team from the SMOOTH Trial at The Scar Free Foundation Centre for Conflict Wound Research have made a major new discovery, showing that CO₂ laser treatment can effectively “reprogramme” burn scar tissue at a cellular level. 

Now formally published in Nature Portfolio, the study reveals why some hypertrophic scars respond well to laser therapy while others do not, uncovering key biological differences within the tissue.

Importantly, the findings suggest that earlier intervention may trigger a stronger regenerative response, highlighting the critical role of timing in achieving the best outcomes for patients. 

Read the paper here

What happened during the laser therapy trial? Professor Janet Lord explains

Professor Janet Lord, co-director of The Scar Free Foundation Centre for Conflict Wound Research at the University of Birmingham (pictured above) describes how the team investigated the impact of timing and the biology of scar tissue:

• “One way to try and reduce scarring, for example after a burn injury, is to have laser therapy. However when is best to carry this out is unclear.
• Our research, funded by The Scar Free Foundation, revealed that the sooner the better. We found that those patients who had laser therapy and were less than six years from their injury, had the best outcomes”.

By studying patients at different stages after injury, the team was able to explore how the timing of treatment and the biology of the scar influence outcomes:

• “The Scar Free Foundation funded our study, which involved assessing the response to laser therapy in patients at various timepoints after a burn injury.
• Patients allowed us to take skin biopsies after the treatment to try and understand why some patients responded well to laser therapy, reducing their scarring, and others did not.
• This revealed that timing was important and the sooner laser therapy was done the better.
• Also when we analysed the type of cells that were in the scar tissue after laser therapy, we found that those patents that responded well had lots of cells with regenerative capacity, whilst those patients who responded less well had more inflammatory type cells.
• This research will help doctors to decide when to carry out laser therapy to give the best results for patients”

Read more in Nature Portfolio

What do the findings mean for patients?

After a serious burn, some people develop raised, thick scars known as hypertrophic scars. These can feel tight, itchy or painful, and may restrict movement.

While laser therapy is already widely used to treat these scars, until now it has not been fully understood whether the treatment works, or how it works, beneath the skin’s surface. 

In this study, researchers analysed skin samples from patients undergoing CO₂ laser therapy, examining the different types of cells within the scar tissue.

They found that scars are far more complex than previously thought, made up of a mix of cells linked to both inflammation and healing. 

Following treatment, cells associated with inflammation and stiffness became less active, while those linked to repair and regeneration became more prominent.

This suggests that laser therapy is not only improving the appearance of scars, but actively changing how the tissue behaves, helping it function more like healthy skin. 

These deeper biological changes help explain why patients often experience improvements in symptoms such as tightness, pain and discomfort, moving beyond surface-level effects to more meaningful, restorative healing.

The findings open the door to more targeted and personalised approaches to scar treatment in the future, as well as the potential to develop new therapies that focus on specific cell types within scar tissue. 

While further research is needed, this study marks an important step forward: helping us better understand not just that treatments work, but why they work, and how they can be improved. 

Huge congratulations to Prof Janet Lord, Prof Naiem Moiemen, Yvonne Wilson and Abdulrazak Abdulsalam MBBS, MSc, MRCSEd, FWACS(Plast), every clinician, and each patient, who have made these findings possible!  

Read about the SMOOTH trial

The study was undertaken as part of  The Scar Free Foundation Centre for Conflict Wound Research at the University of Birmingham. The Centre was funded by a grant from HM Government LIBOR Fines Fund, administered by the Armed Forces Covenant Fund Trust (AFCFT). 

The Foundation would like to thank AFCFT for their generosity and support of our conflict wound research.  

We’re so proud to support such impactful work – and it’s thanks to supporter generosity that we can fund life-changing research. If you’re interested in giving to fund world-leading research improving life for those with scars

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