Treatment Options Available
It is important to realize that no scar can ever be removed completely. All scars are permanent, though they may improve naturally over a period of time. Sometimes it is possible to improve the appearance of a scar by surgical removal or other scar therapies. Listed below are the main recognized scar therapies that are used by the medical profession to improve the appearance of scars. More information is available from your doctor or dermatologist.
1) Surgery: Any surgical removal will always leave a new scar that will take up to two years to mature. Surgery will never remove a scar but can be used to alter its position, alignment or shape. In the case of hypertrophic and keloid scars, there is a very high risk of recurrence of excessive scarring following surgery.
2) Laser Surgery & Resurfacing: Like surgery, the role of laser surgery in the management of scars has been traditionally limited. The color of a red scar may be improved by management with a vascular laser. It has also been suggested that removing the surface layers of the skin with a carbon dioxide laser may help to flatten scars. The CO2 laser is a relatively unrefined, harsh instrument in terms of scar revision and in some cases may aggravate the original scar.
3) Steroid Injections: A series of steroid injections can be repeated at 4 to 6 week intervals under medical supervision. They may help to soften and flatten a hypertrophic or keloid scar. The steroid is injected into the scar itself. Very little is absorbed into the blood stream, so side effects are minimal.
4) Pressure Garments: Pressure garments are only used under supervision by a medical professional. They are most often used for burn scars that cover a large area and are only effective on recent scars. Pressure garments are tight fitting and are usually custom-made from an elastic material. They work best when worn 24 hours a day for 6 to 12 months. How they work is not understood, though it may be that continuous pressure on the surface blood vessels plays a part. Over a period of months, the scars soften, flatten and become paler.
5) Radiotherapy: Low-dose, superficial radiotherapy may reduce the recurrence rate of hypertrophic and keloid scars after surgery. It is effective in about 70% of cases, but is reserved for the most serious cases because of the possibility of long-term side effects from radiation.
6) Cryotherapy: Cryotherapy is a technique that uses special equipment to freeze the scar tissue using liquid Nitrogen or carbon dioxide. Research suggests that this technique is only effective in around 30% of cases and it is mainly used to improve scars on the shoulders or back. It may be associated with a large risk of hypopigmentation in some cases.
7) Dermabrasion: Dermabrasion can be used to reduce irregularities in the skin surface associated with scarring. This involves the removal of the surface of the skin with special instrument, much like a drillbit. The procedure usually requires a general anesthetic. It may be helpful where the scar is raised above the level of the surrounding skin, but is less useful when the scar is sunken or pitted. There may be a recovery period of a few days to a couple of weeks.
Crystal or Diamond Microdermabrasion: Similar to dermabrasion, but gentler, milder and performed without anesthetics. Appreciable results are seen after multiple sessions (minimum of 10 to 20; probably an even greater number of treatments for more serious scars).
9) Liposuction: Liposuction involves the removal of normal fat from beneath the skin. This has a limited role in leveling out the contour around a sunken scar.
10) Collagen Injections: Collagen can be injected beneath a sunken scar in order to build up the level of the skin. However, the effect is temporary. Injections need to be repeated at regular intervals---every 3 β 4 months. Injections are expensive: approximately $ 350 per syringe. Furthermore, because of the risk of allergic reactions, all patients require a test patch.
11) Punch Grafts: A tiny instrument is used to punch a hole in the skin and remove the scar. The area is then filled in with a matching piece of unscarred skin, usually taken from the back of the earlobe. The "plugs" are taped into place for five to seven days as they heal. Even though the punch grafts form scars of their own, they provide a smooth skin surface which is far less visible than depressed scars.
12) Chemical Peels: Chemical peels remove the top layer of the skin with a chemical in order to smooth depressed scars and give the skin a more even color. This technique is helpful for superficial scars. Light peels require no healing time while deeper peels can require up to two weeks to heal. The amount of scarring and color change determines the type of peel selected. There is a risk of both hypo- and hyper-pigmentation with chemical peels.
13) Silicone Gel Sheets: Widely used in the therapies of red and raised scars by moisturizing and covering the scar area. This helps by flattening, softening and fading red and raised scars. Silicone gel sheeting was developed in the 1980's and has been used by over 1 million people throughout the world. Tests indicate that the average improvement time should be between 2 - 4 months.
14) Vitamin E Cream: Although Vitamin E cream is sometimes recommended for the self-management of scars, there is no strong medical evidence to suggest that it has an effect.
15) Cosmetic Camouflage and/or Permanent make-up: can be a very effective way of disguising a scar, birth mark, 'port wine' stain, vitiligo (a condition which destroys pigment in the skin causing white patches).
So which do you prefer?
