Scars can result from accidents, surgery, acne, skin cancer and some skin conditions. Scars may only be skin deep, but their impact goes much deeper. Scars are permanent and can negatively affect appearance and self-confidence, and ultimately quality of life, particularly when they are on highly visible areas like the face, neck, chest and back.
Scar revision therapy is designed to improve or minimize the appearance of scars, refining their texture to make them less obvious so they blend in with surrounding tissues. Treatment options depend upon the type and degree of scarring, the location of the scars, their thickness, age of the scars and the patient’s skin type.
How is a scar formed?
Scar tissue forms as a function of the natural process of wound healing. Scar tissue is made of collagen, the protein that provides support and structure to the skin, but scar tissue is inferior to the original skin. Scar tissue does not grow hair, and it lacks elasticity. Atrophic scarring (depressed scars) is the result of too little collagen. Overproduction of collagen can create hypertrophic scars creating red, raised lumps. Stretch marks are a form of scarring that results from the rapid stretching of the skin that occurs with significant weight gain and pregnancy.
Scars must mature before revision therapies can be considered. Immature scars are reddish in color and may be raised, itchy and painful. As the scar matures it will flatten out and fade in color. It can take up to two years for a scar to mature. In some cases, such as acne, the best approach is early and effective acne treatment to prevent scarring.
What are the available scar revision therapies?
A chemical peel involves the use of a chemical solution to remove the outer skin layers. Peels come in different formulations and strengths depending upon the depth of correction needed. New skin replaces the old irregular skin for a smoother appearance.
Dermabrasion or Dermaplaning
Dermabrasion is a skin resurfacing procedure that exfoliates of the outer layers of skin to improve the appearance of scars. It can be done with a wire brush or a diamond wheel. As the skin heals, the new skin will be scar free. It is used for superficial acne scars. Dermaplaning is a procedure to scrape and smooth the top skin layers causing new skin to grow to smooth the scar. It is best for rough or elevated scars.
Dermal filler injections
Dermal fillers are used to fill depressed scars and raise them to the level of the surrounding skin. The results can last months to years depending on the filer chosen.
Laser scar revision
Fractional CO2 laser skin resurfacing is the treatment of choice for acne scars (depressed scars) because the laser can penetrate and break down the scar tissue without damaging surrounding healthy skin. Thick, large, red, indented and raised scar can be treated with vascular lasers to improve the scar’s appearance by blending pigmentation and stimulating collagen production.
Fat transfer therapy is an effective method to smooth out the surface of the skin. The fat is taken from the thighs, buttocks, or lower abdomen by liposuction, processed and injected in the areas to be treated to fill imperfections. There is no risk of allergic reactions to this therapy. A few treatments may be needed to achieve correction.
Steroids injections are used for hypertrophic or keloid scars to soften them and shrink these scars to improve their appearance, size and texture.
Punch grafting is a procedure to remove the scar and replace it with a plug of healthy skin. The healthy skin is often taken from behind the ears. If the color and texture do not match surrounding tissues skin resurfacing will fix this. The scar can be completely removed, and the new wound closed carefully.
Schedule a consultation with Dr. Ritu Saini a New York board-certified dermatologist who will listen to your concerns, examine your skin and discuss the options best suited to your needs.