While they are a natural part of the healing process, scars can be embarrassing or even emotionally devastating. This is especially true when the scars are especially disfiguring, very large, or on the face or other exposed areas of the body. In some cases, scars can be painful or even interfere with the way a person moves or uses a body part.
There are several different types of scars, including:
- Keloid scars: Occurring when the healing process is overly aggressive, keloid scars often extend beyond the site of the original injury and can even hamper movement; keloid scars are most common among people with dark skin
- Contracture scars: Forming on burned skin, contracture scars can tighten to impair movement; scar tissue goes deeper than with other types of scars to affect muscles and nerves
- Hypertrophic scars: Red, raised scars that look similar to keloid scars, but hypertrophic scars do not extend beyond the boundary of the original injury
- Acne scars: Acne can cause scars in a variety of shapes, from deep pits to angular or wavelike in appearance
The choice of treatment for scar removal depends largely on the type of scar, its size, and its location. Treatment choice also depends on whether it is to prevent the formation of scar tissue or to make an existing scar less noticeable. Treatment provides exceptional cosmetic and functional results in most cases. Dermatologists can recommend a treatment that provides optimal results.
Treatments for Scarring
Treatment can help prevent the formation of scars, and reduce the appearance of existing scar tissue.
Pressure therapy prevents keloid scars from forming or returning after surgical scar removal. The patient wears a pressure bandage, such as an elastic stocking or bandage that applies constant pressure to the injured area.
Treatment may take up to a year. The pressure dressing may be uncomfortable, so some patients may stop wearing it before they gain full benefit. Pressure therapy is not an option for preventing scars from a facial wound.
Silicone gel therapy reduces the size, hardness, redness, itch, swelling, and stiffness of a raised scar. Silicone gel treatment can also prevent a raised scar, particularly following surgery, or stop a scar from developing after surgery to remove a scar. The treatment involves wearing a thin, self-adhesive gel sheet over the closed wound.
Treatment may take weeks or months. Having the gel sheet in the same spot for this length of time can cause the skin to break down; some patients develop a rash on the treatment area.
Polyurethane dressing is a moist, flexible pad that patients wear to reduce scarring after surgery or to reduce the color, hardness and size of a raised scar.
Dermatologists can inject a corticosteroid solution directly into scar tissue to treat raised scars and keloids, and to ease pain and itch associated with scars. While highly effective, corticosteroid injections may cause thinning skin, dark spots, and the return of scar tissue in the treatment area. Following up corticosteroid injections with other types of scar treatment can help reduce these possible side effects.
5-FU or bleomycin injections
Injecting 5-FU or bleomycin directly into the scar can completely flatten or reduce a raised scar or keloid and easy pain and itch. Potential adverse reactions include swelling, redness, thinning skin, or dark spots at the injection site; follow-up another type of treatment can reduce these possible side effects.
Cryosurgery involves freezing the scar with liquid nitrogen. Freezing the scar in this way slowly destroys scar tissue to reduce the size of a raised scar or keloid and decrease pain, itch, discoloration, and hardness. Combining cryosurgery with other treatments, such as corticosteroid or 5-FU injections, can improve outcomes.
Scar surgery involves surgical removal of the scar to reduce the size of a keloid and improve the ability to move in cases in which a scar limits movement. While scar surgery is effective, most dermatologists recommend it as an option only when other treatment approaches fail.
Laser scar removal
Laser scar removal uses the power of light energy to break apart the scar and remove the top layer of skin where the scar formed. The treated tissue peels off, leaving behind smooth skin in which the scar is less noticeable.
The laser also produces heat and light that promotes the growth of healthy new skin cells that diminish the appearance of scar tissue. As an added benefit, the laser’s heat draws blood flow to the area to help reduce inflammation. Together, reduced inflammation and the growth of new skin cells make existing scars look less red and noticeable; the combination also promotes skin healing without excessive scarring.
Laser scar removal is a precise technology that targets only damaged tissue, leaving surrounding tissue intact. It can also be combined with other treatments for scarring.
Laser scar removal is quickly becoming the go-to prevention of scars and treatment of existing scars because it can:
- Prevent keloids and raised scars
- Decrease the appearance of existing raised scars and keloids
- Reduce scarring after surgery
- Treat certain depressed acne scars
- Lessen the color of the scar, reducing redness that makes scars more noticeable
- Increase movement in cases in which scars limit a person’s ability to move
- Reduce pain, itchiness, hardness, and swelling of scar tissue
For more information about treatments for scarring, consult with a dermatologist. Treating a scar early may optimize outcomes, and prevent any long-term physical or emotional consequences.