Scar Treatment 101: What Are the First Steps?

Scar Treatment 101: What Are the First Steps?Some people are lucky enough to have blemishes that do not leave a mark, while for most people, scars can make you feel self-conscious and embarrassed about the appearance of your skin. Children are particularly affected by significant scars, leaving them psychologically affected and suffering from long-term functional issues. The good news is that various treatments can remove or fade scars, helping you regain your self-esteem.

What Are Scars?

Scars are a part of a natural healing process that may result from surgery, burns, skin conditions (like severe acne), or injuries. When the dermis (thick layer of the skin) is damaged or injured, it repairs itself by growing new tissue which pulls together to fill in any gaps caused by the injury. A scar forms when the body forms new collagen fibers to fill the gap caused by an injury or damage. Once the scar tissues form, they form a different texture than the surrounding skin.

Some people are more prone to severe scar formation due to age or heredity. Some scars are barely visible, while others are painful and large. Typically, scars fade over a period of years depending on the wound size, location of the body, and the severity of the injury.

Types of Scars

Scars vary in size and shape. Treatment depends on the type and severity of your scar, so knowing the kind of scar you have is an essential component of successful treatment.

Keloid Scars
When the skin is injured, a keloid scar forms. A keloid results from an overly aggressive healing process that extends beyond the original injury or wound. The scar is formed by excess collagen under your skin, creating a smooth, hard growth that can be either dark red or pink in appearance. Dark-skinned and pregnant people are commonly affected by keloids. Injuries that can cause a keloid scar may include:

  • Chickenpox scars
  • Surgical incision sites
  • Vaccination scar
  • Acne scars
  • Ear piercing
  • Scratches
  • Burns

Some keloids can become flattered or shrink without treatment. Keloids can initially be treated by minimally invasive therapies such as silicone pads or sheets, injections, or pressure dressings. It may take at least three months for the treatment to work. Old keloids can be surgically removed or treated using cryotherapy, which uses extremely cold temperatures to freeze and remove abnormal scars using liquid nitrogen.

Acne Scars
Severe acne leaves your skin with scarring. These scars leave permanent, textural indentations ranging from deep pits to wavey or angular-looking scars. Acne scars are treated depending on the type of acne you have.

Hypertrophic Scars
These are thick, raised, red scars that do not go beyond the boundary of the injury. They are commonly mistaken for keloids. Hypertrophic scars result from wounds, surgical incisions, or burns. Treatment includes steroid injections to reduce inflammation, medication, freezing, surgery, silicone sheets (they flatten the scars), and lasers.

Contracture Scars
Severe burns lead to contracture scars that are often deep and tighten the skin, which may restrict movement. The scars may also affect muscles, nerves, and joint movement.

Scar Treatments

Scar treatments can make them smaller and less noticeable. There are a variety of treatments available, and your dermatologist or plastic surgeon may use one or a combination of treatments. This will be determined by the scar’s type, age, and size. It is also determined by whether the scar is causing pain or affecting mobility and your age. Scars cannot be wholly eliminated, but the treatment makes them less visible.

Topical Medications
These are first attempted before invasive options. Topical therapy helps promote healing and maturation of the scars by easing itching and discomfort. Over-the-counter, topical corticosteroids, anesthetic ointments, antihistamine lotions, creams, or silicone gel sheets, may help heal scars.

Laser Therapy
This is also known as laser skin resurfacing or laser scar revision. Laser treatments improve scars caused by cosmetic or reconstructive surgery, burns, acne scarring, skin cancer removal, or trauma burns. The treatment targets the blood vessels that reduce scar appearance. Laser treatment may be non-ablative or ablative. Ablative laser treatment destroys the outer layer of the scar.

Once the outer layer is destroyed, new, healthy skin regrows in its place. The laser light flattens and reduces the scar’s pain, itchiness, and redness. The therapy is noninvasive, with minimal risk and downtime. Healing takes 3 to 10 days. Laser treatments may cause skin darkening or lightening. Talk to your doctor about what to expect from laser treatment before starting treatment.

Dermabrasion
This is a common acne scar treatment that uses a high-speed brush or other instruments to remove the top layer of the skin to reduce the depth of scars. Dermabrasion softens and smooths the skin, diminishing the appearance of the scar. Healing can take up to three weeks.

Microdermabrasion
This is a less intensive type of dermabrasion involving using a handheld device to gently remove the skin’s surface. You may require more than one treatment. Microdermabrasion has no downtime.

Corticosteroid Injections
Multiple small injections are administered directly into your scar to make it flatter and smaller. They also reduce pain, local inflammation, and the itchiness of the scar. The injections are used to treat hypertrophic or keloid scars. Injections may be given at an interval of 4 to 6 weeks, depending on the scar and its response to treatment.

Pressure Therapy
This involves using an elastic dressing, bandage, or stocking to put pressure on the wound during recovery. The bandage pressure decreases the scar’s size and prevents it from forming. This type of treatment is best suited for fresh or new scars.

Chemical Peels
Chemical peels the superficial surface of the skin to treat mild scarring. The chemical solution dissolves the superficial layer of the skin, leaving it smoother and even in complexion. There are mild to deep chemical peels, of which the deeper ones produce better results but require longer recovery times. Chemical peels are best suited for people with a light skin complexion. Darker-skinned people can use a glycolic acid peel. It is essential to apply and reapply sunscreen daily and frequently since chemical peels make the skin highly sensitive and delicate to the sun’s ultraviolet rays.

Microneedling
Microneedling is also known as collagen induction therapy. The treatment involves using a handheld device that pricks the skin to stimulate collagen production. Collagen helps restructure the skin and reduce the appearance of scars. Microneedling also minimizes the appearance of wrinkles, fine lines, and stretch marks, leaving the skin youthful looking and rejuvenated. After the treatment, your skin may appear red for a few days.

Scar-Revision Surgery

There are various surgical procedures to remove a scar, loosen a tight scar near a joint, improve movement, and improve a scar’s appearance. The size and location of the scar will determine whether the surgeon will use general or local anesthesia. Surgery may also be performed to transplant skin from another area, a procedure known as skin grafting.

During a skin grafting procedure, old scar tissue is completely removed during a scar revision and excision. The area is rebuilt using an adjacent healthy skin flap, which is manipulated to transform the area.

The area is then re-closed with the expectation that the healing will be improved over the previous old scar. If the skin flap process cannot be performed, a skin graft is obtained from another area of the body, such as the inner thigh or buttocks.

Ensure an experienced and licensed plastic surgeon performs your scar revision surgery. They will also answer any questions about the procedure and what to expect from it.

If you do not like the appearance of your keloid or it is bothering you, have it checked and begin your treatment journey. For more information please contact Skin Deep.

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