Scar Removal

The skin is a smooth surface organ, like a fabric that protects vital organs from the harmful effects of the outside world. Imagine a piece of silk, where even a tiny tear can mar its beauty. The same is true for the skin. Any burn, injury, or other trauma, such as surgery, can cause a scar. A small scar in an easily hidden place may not be bothersome, but a noticeable one can be. Unfortunately, a scar will never completely disappear, but there are several methods to reduce its size and change its appearance.

How do scars form?

Scarring is a natural part of the healing process following an injury. Its appearance and treatment depend on various factors, such as the depth and size of the wound or cut, the location of the injury, age, genetics, gender, and ethnicity.

Types of scars

• Keloid scars
  • These scars result from an aggressive healing process. Keloid scars extend beyond the original injury. Some keloid scars can even restrict limb movement. Treatments include surgery to remove the scar, steroid injections, or silicone sheets to flatten the scar. Smaller keloids can be treated with cryotherapy (freezing with liquid nitrogen). Pressure treatment or silicone gel pads can prevent keloid formation after an injury. Keloid scars are most common among people with darker skin.

• Contracture scars
  • Burned skin can develop contracture scars. These scars tighten the skin, which can restrict movement. Contracture scars can go deeper and affect muscles and nerves, impairing their function.
• Hypertrophic scars 
  • These are raised, red scars similar to keloids but do not extend beyond the injury boundary. Treatments include anti-inflammatory steroid injections or silicone sheets to flatten the scar.
• Acne scars
  • Severe, inflammatory acne can leave scars. There are many types of acne scars, ranging from deep pits to angular or wavy scars. Treatment options depend on the type of acne scars.

How to treat scars? 

• Over-the-counter or prescription creams, ointments, or gels
  • These products are used to treat scars caused by cuts, injuries, or wounds, primarily to promote uncomplicated healing and thus reduce the size and appearance of the scar.
• Surgical removal or excision
  • There are several options for treating deeper scars, depending on the specific case. These include skin grafts, excision, dermabrasion, or laser treatment. In skin grafting, the surgeon uses skin from another part of the body. This is often used for people with burn injuries. If you have scarring that impairs function, surgery can help address functional problems. If you have recently had surgery that caused scars, it is best to wait at least a year before deciding on scar treatment. Many scars fade and become less noticeable over time.
• Injections
  • Raised scars, such as keloids or hypertrophic scars, can be treated with steroid injections. The doctor may use this alone or in combination with other treatments. Other types of injections, such as collagen or other “fillers,” may be useful for certain types of scars, although these are generally not permanent solutions.

Surgical scar revision

Surgical scar revision involves using a surgical method and closure technique that leaves minimal, often nearly invisible scars. This can be combined with various local treatments that promote healing and reduce the risk of scarring after the revision procedure.

The surgical approach to scar revision varies depending on the characteristics of the original scar. For example, after making an incision to remove the old scar, the surgeon may reposition the scar to make it less noticeable. Other methods may include skin grafting to replace large areas of damaged tissue or layered closure, which restores not only the surface skin but also the underlying layers.

Local treatments that accelerate healing and reduce irregularities in skin texture and color include gels, collagen strips, and external compression. Steroid-based injections can also be used to reduce collagen formation and prevent keloid formation, while skin fillers can be used for deep scars.

If the scar is less than a year old, it is still possible to minimize its appearance with locally applied therapies or injections.

What to expect after scar revision surgery?

Before scheduling the procedure, the surgeon will thoroughly discuss expectations and aftercare. However, like any surgery, scar revision typically causes local discomfort and swelling at the incision site for one to two weeks. The new scar may take up to a year to heal and fade, and it is important to carefully follow aftercare instructions to minimize scarring at the new incision site. While the scar cannot be completely removed, its appearance can often be significantly reduced, sometimes to the point of being almost unnoticeable. For contracture scars, surgical revision and proper wound care afterward can help restore both the appearance and function of the area.