SCAR: Solutions, Correction, Aesthetic, Results
Scars come in many shapes, sizes, colors, textures, and reasons. One of the sad things about scars is that sometimes they also create emotional scars as people are upset over their appearance. Our team at Contour Dermatology is passionate in their quest to improve the appearance of scars.
We can’t use the word “erase” in our communications about cosmetic results. However, we can tell you we can come pretty close to making a scar look like it never happened. That’s our goal. And we have many treatment options to minimize their appearance.
Types of Scars
- Atrophic Scars – These sunken scars form depressions in the skin due to collagen destruction or when other underlying skin support structures like fat and muscle are lost. Examples include cystic acne, chicken pox, or surgical scars.
- Burn Scars — Most burn injuries affect only the top layer of the skin causing red and hypertrophic (raised) scars. More severe burn injuries can produce contracture scars.
- Contracture Scars — Color wise, these scars run the gamut from pink to red, brown and white. They occur as the result of burns, tightening skin and often impairing movement. This type of scar can involve not only the skin, but also the muscles and nerves.
- Hypertrophic Scars – These red and raised scars, like keloids, are the result of excessive collagen production during the healing process. Hypertrophic scars, however, confine themselves to the boundaries of the injury. Burns scars are included in this category.
- Hyperpigmented Scars– These scars range from pink to red, brown, even purple scars. This type of darker skin discoloration is known as hyperpigmentation.
- Hypopigmented Scars — White scars: Cases where skin has lost pigment are known as hypopigmentation.
- Keloid Scars – When healing is overly aggressive and too much collagen is produced, a raised scar will result. If it extends beyond the original injury, it is known as a keloid scar. These irregularly shaped, hard and rubbery textured scars range in color from pink to red and brown.
- Road Rash Scars – These scars are usually incurred in accident situations that revolve around skateboarding, mountain biking and similar pursuits where skin makes contact with asphalt or gravel and absorbs it.
- Stretch Marks — Stretched, indented scars: Commonly referred to as stretch marks are the result of rapid skin expansion – think growth spurts, pregnancy, weight gain.
Treatment Options for Scars
- Chemical Peels – TCA (trichloroacetic acid) chemical peels for acne scars and hyperpigmentation
- Cryotherapy – a freezing therapy using liquid nitrogen for smaller keloid scars.
- Dermabrasion – a procedure that removes top layers of skin, in effect “sanding down” acne scars. Treats hyperpigmentation as well.
- Dermapen – a form of microneedling, effective on hypertrophic and atrophic scars.
- Dermaroller – a form of microneedling, effective on hypertrophic and atrophic scars.
- Fillers – such as Restylane, Juvéderm, or fat transfer are used to plump up atrophic (depressed) scars, as in the case of acne, also stretch marks.
- Lasers – Fractional CO2, Fraxel®, Smoothbeam, Vbeam®, IPL, Medlite C6 lasers for hypertrophic and atrophic scars, including those related to acne, stretch marks, and hyperpigmentation
- Latisse – used in combination with fractional laser therapy, it has shown promise on hypopigmented scars.
- Retin-A – A topical derivative of vitamin A available by prescription only. Most effective against shallow acne scars and post-inflammatory hyperpigmentation. Stimulates the production of collagen. It can be helpful in relieving the pain and itching associated with keloids and hypertrophic scars.
- Steroid Injections – a variety known as Kenalog is used to flatten out hypertrophic and keloid scars.
- Silicone Sheeting – reduces keloid and hypertrophic scars, including surgery scars from tummy tucks, breast augmentation or reduction and other cosmetic, and non-cosmetic procedures such as C-sections.
- Subscision – a surgical solution that levels the skin.
- Surgical Excision – in the case of keloid scars, where an incision is made, and the scar is cut out.
- Punch Grafting – For depressed acne scars. A technique where the scar is cut out, then a skin graft, usually taken from behind the ear, is used to fill the void.
- Punch Elevation – For depressed acne scars. A technique where the scar tissue is pinched, the base of the scar raised, and the surrounding tissue sutured to seal off the site.
- Topical Creams — both RX and non-prescription. Aldara Cream has been shown to decrease the reappearance of surgically excised keloids. Mederma, a gel based on onion extract is an over-the-counter treatment. And bleaching creams can help to even out skin tone.
- Vibradermabrasion — a form of dermabrasion that uses a vibrating paddle.