Nobody likes ugly scars! Scars are especially noticeable if they are elevated or indented. Good examples are indented acne scars and elevated keloid scars. Everyone heals differently and why one person heals well and another doesn’t is something we are trying to figure out. In the meantime, we are learning more and getting much better at treating scars and making them better.
Scars are visible signs that remain after a wound has healed. They are unavoidable results of injury or surgery, and their development can be unpredictable. Poor healing may contribute to scars that are obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance.
Skin surgery procedures are meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture.
Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location. Your treatment options may vary based on the type and degree of scarring.
Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.
Scar Revision Procedures
Scar gels/ topical applications
New innovations are being made all the time to improve scar healing from all types of surgery and injuries. We are constantly changing our recommendations based upon our patient experiences and what is proven to work the best.
Once a scar becomes raised, most likely it is a hypertrophic scar or possibly a keloid. One of our first line of options is to inject the scar with medications that will shrink and improve the appearance of the scar. Sometimes one injection works but in most cases a series of injections are required.
Dermabrasion smooth’s out surface irregularities such as deep lines or scars by removing the topmost layers of the skin.
A vascular laser works by shrinking the blood vessels that feed the scar, thus improving the coloration of red scars. A CO2 laser can be used to make a scar smoother by reducing an elevated and/or irregular scar.
Laser Skin Resurfacing
There are two types of lasers used for reducing the uneven surface of scars: the CO2 laser is typically used for deeper scars, while the Erbium is used for superficial scars and deeper skin tones. Both lasers remove the topmost layers of skin, allowing new, smooth skin to form.
Sometimes it is obvious that the best solution is to cut the ugly scar out and close it precisely to get a much better scar. Depending on the location and size a Z-plasty or rearranging the tissue when closing the old scar site will make a big difference in the appearance.
Combining scar excision with Radiation Therapy
In a few patients with recurrent large keloid scars who have failed the above procedures combine scar excision with immediate superficial low dose radiation therapy has been very successful.