Best option for removal of scars - laser or surgery?

Hello, my 15 year old daughter has some scars on her upper arm/shoulder area that are about 8 months old. They look pretty bad so I took her to the dermatolagist and they said we could try laser treatments. We've now done about 5 laser treatments and I don't see any real difference. Parts of the scar seemed to smooth out but the rest is raised/puffy and still pretty red. I kept asking him if surgery could be an option and he said that it would make a worse scar if we tried surgery. I don't think it could look much worse than they way it looks now. With her being a girl she's very self-conscious about it and won't wear tank tops or a bathing suit without covering up. My heart goes out to her. Is there anything else we could try? Is surgery to remove or fix the scars really out of the question? What other options are there? They are so noticable and ugly. Isn't there anything we can do to make them less noticable?
I'd like to get a few other opinions. Thank you so much.

[Howard Rosenberg, MD]

Scars of the upper arm and should are notorious for poor healing and thickened raised scars.  This is true of most people even if scars elsewhere heal well.  I believe that laser treatment for scars is minimal at best, as you have experienced.  On the other hand, surgical excision by a plastic surgeon and reclosure will probably not be very effective either.

The best alternative would be application of topical silicone gel sheeting designed for scar reduction.  Many drug store will carry this product or it can be ordered over the internet.  A second alternative would be steroid injections, but this can be painful and many require multiple injections for effectiveness.