Scar Revision

Most of us tend to take the health of our skin for granted. Various factor like burn, injury or trauma may contribute in our skin developing a scar. Scarring is a natural part of the healing process after an injury. Sometimes these scars can be a cause of concern and embarrassment.

Its appearance and its treatment depends on multiple factors. The depth and size of the wound or cut and the location of the injury matters as well as age, genes, sex, and ethnicity play a big role in the kind of scar that forms.

• Surgical Revision: Surgical scar revision involves surgical removal of scar tissue, followed by closing the wound and suturing the area carefully to reduce the size and visibility of the scar. Once the new incision heals, the scar should be thinner and less noticeable. This method is used for large and/or wide scars that will not respond to less invasive revision techniques.
• Laser Treatments/Dermabrasion: For depressed scars, such as acne scarring, laser or dermabrasion treatments may be appropriate. These techniques resurface and/or sand down the skin to produce a smoother and more even skin tone. These methods are best for shallow scars and depressions, and may be part of a larger scar revision treatment plan.
• Steroid Injections: Steroid injections may be used as a standalone treatment, or combined with other revision methods. The treatment can reduce the size of certain scars, such as keloids (tough, thick scars that form and stick out from trauma sites), though they are not always effective on their own.
• Topical Treatments: Typically used in tandem with other treatments, topical medications can help improve scars, and may be prescribed as part of a treatment plan.

Some of the common types of scars that may need treatment are:

• Keloid scars: These scars are caused due to an overly aggressive healing process. It tends to extend beyond the original injury and sometimes may hamper movement. One can treat these scars either with surgery, steroid injections or silicone sheets to flatten the scar. Smaller keloids can be treated using cryotherapy (freezing therapy using liquid nitrogen).
• Contracture scars: These scars are caused after a burn injury. These scars tighten skin, which can impair the ability to move.
• Hypertrophic scars: These are raised, red scars that are similar to keloids but do not go beyond the boundary of the injury. Treatments include injections of steroids to reduce inflammation or silicone sheets, which flatten the scar.
• Acne scars: These are a result of severe acne. There are many types of acne scars, ranging from deep pits to scars that are angular or wavelike in appearance. Treatment options depend on the types of acne scars you have. There are over the counter or prescription creams, ointments, or gels that can be used to treat these scars.

For severe case of any kind of scar, your medical practitioner may be able to advice surgical removal or treatment for the same. Aggressive treatment options include skin grafts, excision, dermabrasion, or laser surgery. In a skin graft, the surgeon uses skin from another area of your body. This is often used with people who’ve had burns. If you’ve got scarring that impairs function, surgery can help address the functional problems. If you’ve recently had surgery that has caused scars, it is best to wait at least one year before making a decision about scar treatment. Many scars fade and become less noticeable over time.

Other types of injections, such as collagen or other ‘fillers’, may be useful for some types of pitted scarring, although these are not usually permanent solutions.