Types of Scars and Treatments

Nearly all of us have a scar somewhere on our body.  Scars are a natural result of the body’s effort to heal itself from trauma to the skin.  Scars can take many forms depending on such factors as their cause, where on the body they are located, skin type, wound care, etc.  Treatment options for scars vary depending on scar type as well as the age of the scar.  Below we will examine some of the more common scar types and treatment options.

Keloid Scars

These are thick, irregular, raised areas of fibrous scar tissue that extend beyond the edges of a wound.  They are often either red or dark and can potentially be quite painful or itchy.  They are caused by an overproduction of Collagen produced by the body in an effort to treat a wound.  Keloid Scars can form anywhere on the body and occur more regularly in dark skinned individuals.  They may develop as long as a year after trauma to the skin and can continue to grow indefinitely.  Recurrence after treatment of these scars is fairly common.  Treatments available for Keloid Scars include the following:

Surgery –  Removal of the scar via an incision.  This process often involves a skin graft whereby skin is taken from another area of the body and reattached to the area where the scar was removed.   Laser surgery is often employed to help remove, smooth or flatten Keloid Scars.

Cryosurgery – Involves use of liquid nitrogen to freeze the scar off.   Immediately after the liquid nitrogen is applied, scar cell death begins and continues for a period of days.

Steroid Injections – Involves injection of a steroid directly into the scar.  The process is normally repeated (usually monthly) until maximum results are achieved.  Steroids may help decrease the size and intensity of the scar but in some cases may also make it appear more red as a result of stimulation of red blood vessels.

Hypertrophic Scars – These scars are very similar to Keloid Scars, the difference being that they don’t grow beyond the edges of the wound.  Like Keloid Scars, they are usually thick and raised above the surrounding skin.  They too may be characterized by pain and/ or itchiness.  Common treatments for Hypertrophic Scars are the same as those mentioned above for Keloid Scars.

Acne & Chicken Pox Scars – Are often depressed or sunken below the surrounding skin due to the skin damage being within the dermis.  These scars are often referred to as pitted scars and it is difficult to improve their appearance.  Possible treatments include the following:

Dermal Fillers – Fillers such as fat, bovine collagen, human collagen, and hyaluronic acid derivatives are injected into the scar to raise the surface of the skin, hopefully leaving a smoother appearance. Because fillers tend to break down over time, scars treated via this method will likely need to be re-treated at some point.

Punch Excision – A procedure most often used on deeper acne scars that involves use of a round, sharp, cookie cutter like tool.  The tool is available in a variety of sizes so the physician can match the tool to the scar he or she is treating.  After removal of the scar, the edges of the skin are pulled together and sutured.  There is normally a new, less noticeable scar left at the site of surgery.  Some patients will elect to have the new scar treated via another method to further improve its appearance.

There really is no single best method for treating scars.  We all heal differently and each scar us unique.  An experienced Dermatologist or Plastic Surgeon will analyze each scar individually and help each patient determine the best treatment.  For those who would rather avoid surgical treatment of their scars, there are a number of topical products on the market that can be purchased without prescription.   There is growing research that these products, particularly those containing silicone can be very effective for certain types of scars.  Again, there is no single best method for all scars.  For more information on scars and scar treatment we invite you to check the other articles on our blog.