Unfortunately, scars are a part of normal life and we all will get a scar at some point in our life. This may be a consequence of teenage acne, related to trauma or from a surgical procedure. Many these scars with time will settle to become a fine line that is well hidden and of no concern. However, for some they can become raised, itchy, unsightly, leading to a cosmetic deformity that cause people significant physiological distress. Treatment for scars has been difficult and unreliable to treat in the past. However, with modern techniques we can offer clients a wide range of treatments from simple topical treatments to more complex surgical scar revision procedures with excellent cosmetic results.
Types Of Scars
Keloid scars are the result from an abnormal, over-aggressive healing process with the scar tissue becoming thick, firm, raised and extends beyond the incision line. The scar can become painful and itchy which often causes people distress. It is more common on people with darker skin types and younger patients, with high risk sites being the earlobes, chest and shoulder region. These types of scars are extremely difficult to treat and often require a multi-modality scar treatment protocol.
Hypertrophic scars are frequently related to incisions which had poor healing, either because of wound infections or were under a moderate degree of tension. It results in a thick, firm, raised scar that doesn’t extend beyond the incision line. They are often called a keloid scar as they frequently look similar but are much easier to treat, often requiring more conservative measures.
Teenage acne that was severe and inadequately treated is the major cause for many adults suffering with adult acne scarring. There are many different subtypes of acne scars and they all require slightly different treatments. Therefore, to get the best outcome requires multiple treatments, with different modalities.
Treatment Options For Scars
Topical Silicone Therapy
Silicon sheets, massage, and taping have all been shown to help flatten raised scars if their use is regular and prolonged
Most raised or thickened scars will flatten with the use of injected corticosteroid.
Subscision / Dermal Fillers
Subcision is an excellent procedure for helping improve indented scars. A needle is inserted into the skin and swept back and forth to break up the internal scar tethering the skin inwards. Once the scar tissue is separated, the skin is free to lift up to its correct position. Many of these scars benefit the addition of dermal fillers beneath the scar to give full correction and laser resurfacing.
Fractional Laser Treatments
Fraction laser resurfacing of scars is an excellent option to treat many different types of scars, like acne and surgical scars. The fractional laser creates micro-columns of coagulation (damage) tissue that extends deep into the dermis without affecting the overlying epidermis. This triggers a wound healing process to replace the disorganized and compact scar tissue. Generating new healthy tissue, with improved colour and texture to result in smoother looking skin with greatly diminished appearance of the scar.
Typically, a series of 3 to 5 fractional laser treatments are recommended at monthly intervals.
Surgical Scar Excision
Sometimes re-excising all or part of a scar and re-suturing more carefully and precisely is the best management for a scar.