When choosing a treatment for scars, it is important to first determine the type of scar you have. Just as there are many different types of scars, there are also many different treatment options available. A treatment that is effective on one scar may not be appropriate for another. A good physician will evaluate your scar and make a determination on how to treat it based on several factors, including the type of scar, its age, severity, etc.
In this article we will discuss Punch Techniques for scar treatment. These techniques are usually reserved for the deep “pitted” type scars often associated with severe acne or chicken pox. The three main punch techniques, in no particular order, are the Punch Excision, Punch Replacement and Punch Elevation.
Punch Excision – This technique employs the use of a round, sharp, cookie cutter like biopsy tool. The tool comes in various sizes so the physician can match the tool to the size of the scar he or she is treating. Following local anesthesia, the scar is removed with the biopsy tool and the edges of the skin are pulled together and sutured. Over time the resulting new scar should fade and become less noticeable. If the new scar is still too noticeable, it can be treated via another method.
Punch Replacement – This technique involves removing the scar with a biopsy tool using the same process as described above for the Punch Excision Technique. The difference is, once the scar is removed, rather than simply pulling the edges of the skin together and suturing them, a skin graft is taken from elsewhere on the body (often from behind the ear) and used to fill the void left from the removed scar.
Punch Elevation – Just like the Punch Excision and Punch Replacement techniques described above, this technique involves removal of the scar utilizing a sharp biopsy tool. Once the scar is removed however, the scar is elevated prior to being sutured or grafted. This serves to reduce the pitted or pock appearance of the scar.
Which of the above described procedures a doctor uses will depend on the characteristics of the scar. For example, the punch replacement or punch elevation technique will most often be used for the very deep or wide scars. If the scar is less severe, the basic punch excision technique may be used. After any of these procedures, recovery time should be relatively short however it is not unsusual for there to be some bruising, swelling or redness in the treated areas. Some people choose to combine the punch techniques described above along with other procudures such as Dermabrasion, Chemical Peels or application of Topical Sheets, Gels, or Creams.