Scars are the body’s way of healing injuries. When the skin is injured, the body responds by building a bridge of collagen and new skin cells to close or cover the wound. In cases of cuts, punctures, incisions or other penetrating injuries, the new skin fills in the gaps. This is a slow process. Early on in the formation process, the new skin may take on a brightly colored appearance. It is also commonly raised just above the existing skin’s surface. Over time, the skin may lessen in its color intensity and eventually flatten. When the body produces too much collagen to bridge the gap, more prominently raised scars appear. These are called hypertrophic scars. They often develop within a few weeks. Sometimes they extend over the natural boundaries of the existing skin. These irregularly-shaped, raised red scars are often referred to as keloids. There are a handful of options for treating raised scars, both keloid and non-keloid. Some are more effective than others.
Laser resurfacing is effective on small raised scars. A high-energy light burns off damaged skin, creating a smoother surface.
The top layers of a scar can be removed through cryotherapy. A freezing agent is applied to the area, causing the skin to blister and diminish its height.
Similar to laser resurfacing methods, an electrical machine is used to remove the upper layers of the skin, creating a flatter scar.
Keeping a scar moist during the healing process minimizes the formation of heavy, raised scars. This comes in two forms. Staying hydrated is an important factor when your body is developing scars after a skin injury. Covering the wound prevents the new skin from drying out and building more new cells to compensate. This method is used in conjunction with other types of scar treatment.
A non-toxic layer of silicone that stays in contact with the skin is an effective method of scar treatment. It can be used in conjunction with most other options, including surgery, cryotherapy and laser treatment. Silicone scar removal products come in gel and sheeting forms. They are used daily for three to four months, or until the scar fades away and no longer shows improvement. Silicone scar treatment is highly efficient in reducing both hypertrophic and keloid scars. Scar gels and sheets keep the skin moist and prevent excessive collagen development.
Steroids are injected directly into the scar to reduce redness, itching and burning. They are often used on hypertrophic and keloid scars with some success.
Radiation has long been used as a secondary treatment for keloid scar removal in concert with surgery. There is some evidence that postoperative radiation therapy can create tumors, but the National Institutes of Health reports that about 80 percent of radiation oncologists consider this keloid treatment acceptable when proper precautions are used on the surrounding skin.
Wearing pressure garments when a scar first develops is helpful in preventing hypertrophic scarring. They are worn a minimum of 23 hours per day for one to two years. Pressure garments are made from an elastic fabric that typically fits around a limb, such as the arm or leg. The garments can be cumbersome, but reduce the amount of blood in the scar and prevent collagen from developing into raised scars.
Revision surgery is a common option when a scar is large and raised. If the scar is on a visible location that can’t be covered up with clothing, such as the face or neck, a plastic surgeon may be able to minimize the scar and decrease its prominence. Keloid scars have a high recurrence rate with surgery, often growing back over time.
Most people don’t injure themselves on purpose. If you want to avoid scars, however, it’s wise to protect yourself when you know you may be at risk for injury. For example, wear long sleeves and long pants when you will be outdoors on rocky surfaces or coming in contact with sharp objects. Most sports have special padding and equipment for athletes. Use it. If you already have keloid scars on your body, it’s important to understand that you have a much higher risk of developing keloids anytime your skin is cut or punctured. When possible, you may wish to avoid invasive procedures. These include facelifts, body piercings, tattoos and elective surgery.