Scars have a variety of causes and a variety of appearances. No single treatment will give the best outcome. Typically several different treatments are used. There are two important principles to bear in mind before you consider treating your scars. Firstly, scars cannot be removed, although it maybe possible to improve their appearance. Secondly all treatments carry some risk of side effects.
A variety of scars
Acne and especially cystic acne can cause scarring on the face. Facial scarring is disfiguring, attracting unwelcome attention and negative attitudes. Acne scarring, however small, has the potential to cause major psychological difficulty. The scarring can be shallow depressions, deep ice pick type scars, or raised scars. In addition the scars are often tethered deep under the skin.
Burns and trauma scars can cover a wide area and may cause physical difficulties by restricting movement, as well as altering appearance. The skin appears melted and red.
Surgical scars are unavoidable when surgery is required. They often heal well and maybe nearly invisible. Their final appearance depends on the individual’s healing response, the site of the scar and whether there have been any complications.
Hypertrophic scars are raised and thickened and occur when the skin has repaired itself excessively. The thickening is limited to the border of the original wound. In keloid scars the thickening continues and spreads beyond the margins of the original wound. Keloids in particular can be very uncomfortable. Some parts of the body and some races are more prone to keloid scars. The original wound could have been very trivial such as a spot or insect bite.
A variety of treatments
The Fractionated CO2 laser has been a real game changer in the management of scars. It drills hundreds of tiny holes into the scar. These tiny perforations allow the scar to relax, taking the tension out of the scar. The skin therefore no longer tries to reinforce the scar with more collagen. The multiple tiny wounds also trigger a healing response, reactivating the skin’s repair mechanism causing remodelling of the scar. Any remodelling is slow and gradual, over months, and some people respond better than others.
The Pulse Dye Laser
Targets the increased blood supply in red scars making them paler softer and more comfortable.
Target persistent pigment in scars, such as road dirt in the wound or hyper pigmentation.
Can help flatten raised scars.
Subcision & Excision are small surgical procedures which can be performed under local anaesthetic. Excision cuts out and stitches a deep scar to replace it with a smaller less visible scar. Subcision releases the tethering under a scar. Z plasty is usually performed by a plastic surgeon and can be an important initial procedure to release tension in the scar.