Treatment is key to minimizing their appearance
by Dr. H. Christopher Coley
Do you have a scar from a procedure or injury that you wish you could erase? Fortunately, with today’s technology there’s something you can do to prevent and minimize its appearance.
A scar is formed as a natural healing response to an injury. This healing process and scar remodeling can last for months. Depending upon the depth of injury, scars can be mild or severe. They vary in their characteristics, including shape, size and color.
Common types of unsightly scars include hypertrophic scars, stretch marks and keloids. Hypertrophic scars are those that are slightly wide, raised or thick in appearance. Typically, they’re confined to the original injured area and are formed by excess collagen formation. Stretch marks are caused by the stretching of the skin during pregnancy, bodybuilding or excess weight gain. Keloids are a type of hypertrophic scar that continue to grow outside the boundary of the original injury and can become large and unsightly.
Different areas of the body scar differently, with better scars occurring in areas where the skin is thin such as the face and neck. Areas where the skin is thicker, such as the back and trunk, generally scar worse. Genetics also can play a factor in scarring.
Surgical scars can be minimized in several ways. The key factors to help prevent surgical scars include delicate handling of tissue during repair, avoiding excess tension on the repair, and using proper technique and supplies. Removal of stitches and staples at the proper time also is important. Good wound care after the injury is just as important. It helps prevent infection, avoiding excess drying or moisture, limiting motion, and protecting the incision from the sun.
Some scars are inevitable due to circumstances surrounding the injury or condition. In some cases, incisions can be placed to help camouflage the scar in a natural skin fold. Other surgical techniques also can be used to minimize scarring.
To further minimize scarring, there is evidence that gentle compression through taping or a specialized bandage can aid in preventing hypertrophic scarring. Because hypertrophic scars essentially are excess inflammation and collagen, an injection with a steroid — a potent anti-inflammatory — or a topical steroid can prevent or correct a hypertrophic scar.
Other common scar remedies include topical antioxidants such as vitamins C and E. There are numerous other additives and home remedies that can help with scar formation as well. One of the best and well-known is silicone, which has been shown to prevent hypertrophic scars and improve the appearance of older scars. Two popular formulations available are Scarguard and Hybrisil, both of which are available by prescription.
Other ways to treat hypertrophic and unsightly scars include surgical excision or scar revision, laser resurfacing, and dermabrasion. Current research also suggests that there might be a role for radiation and treatment of severe hypertrophic scars and keloids with some potent medications and even chemotherapeutics.
If you have an unsightly scar, then obtain a consultation with a cosmetic surgeon to discuss your options.
Dr. H. Christopher Coley, board-certified and fellowship-trained in both cosmetic and hand surgery, is owner and chief surgeon of the Coley Cosmetic & Hand Surgery Center in Greensboro. To learn more, call (336) 617-8645 or visit www.coleycosmetic.com.