What is a scar?
Scar formation is a natural part of the healing process. Although scars usually fade over time, some scars may appear darkened, thickened or raised long after the original wound, skin condition or surgical incision has healed.
What causes different types of scarring?
The depth and size of the wound or incision and the location of the injury define the scar's characteristics, but genetics, and even ethnicity, may also affect how skin reacts to the healing process.
Scars form for many different reasons such as:
Scar types we treat include:
- Keloid scars: Thickened, raised, itchy clusters of scar tissue that grow beyond the edges of the original wound or surgical incision.
- Hypertrophic scars: Similar to keloids except that growth is confined within the boundaries of the original wound or incision.
- Acne scars: This facial scarring is caused by severe forms of acne. Large cysts, nodules and pustules are more likely to leave permanent textural and discolored scars than other types of acne because they exist deeper in the skin where they cause damage to the skin's structure.
Many treatment options exist for scars. Some of the treatments we use include:
- Corticosteroid injections: Small amounts of a corticosteroid are injected into thickened (hypertrophic or keloidal) scars to soften and flatten them.
- Vbeam laser: A gentle, non-invasive laser that reduces redness in scars while also improving their texture.
- Dermabrasion: A surgical method of "sanding down" the skin's top layers (penetrating much deeper than a Microdermabrasion) to soften the sharp edges of surface irregularities, resulting in a smoother surface.
- Fraxel® Restore Laser: This non-invasive fractional laser improves surface irregularities and evens out skin color.
- Deka Dot Laser: A resurfacing CO2 laser that works by removing the top layers of the skin in a pixelated manner, leaving behind a smoother surface after healing.
- Punch Grafts: A tiny cookie cutter-like instrument called a punch is used to surgically remove deep ice-pick scars, or isolated large pores. The removal site is sometimes filled with a graft of normal skin taken from behind the earlobe, or it can be sutured closed until healed. Grafts will often need to be smoothed down after they are healed to blend in with the surrounding skin.
- Scissor/scalpel un-roofing: If two or more adjacent acne cysts heal together and form a tunnel (epithelized sinus), we will surgically “un-roof” the scar holding the two cysts together by removing the skin that covers the sinus.
- Subcision®: This technique is used to release bound-down depressed scars. A needle is inserted beneath the skin and is moved back and forth to release bound-down fibrous scar tissue, allowing a depressed scar to become elevated. This procedure also stimulates new connective tissue to form to support the skin through the natural healing process.
- Injectable dermal fillers: Various fillers can be used to lift depressed or pitted scars.
What can I expect?
You will first have a consultation to evaluate the scarring, which will be followed by a discussion of the best course of treatment for improving its appearance. Oftentimes, a combination of different treatments may be utilized to improve different aspects of the scarring (color, texture, etc.) The treatments will be dependent on the scar’s characteristics as well as your skin type. Scar revision is performed with minimal discomfort, as we use a combination of topical and injectable anesthesia methods to completely numb the areas being treated.
Some procedures require multiple treatments, each one providing gradual improvement. Scar revision is not an exact science and individual healing and response to treatment varies from person to person.
Have a question about your treatment?
We have a dedicated triage nurse (RN) who answers patient questions during office hours. If you have a problem or question about a procedure or a prescribed medication, please call our office and ask to speak to our nurse. If she is unable to answer your question, she will consult with your practitioner and return your call.