Cosmetic Therapies: Scar Management

Cosmetic Therapies Index : Scar Management


What is Scar Management?
Scars are an unavoidable part of every part of every cosmetic or medically necessary surgical procedure. To make a scar as invisible as possible requires extra effort from both the patient and the surgeon. Following wound care in post surgical activity instructions is essential, as is limiting strenuous activities during the postoperative period. Most wounds on the trunk or extremities require 10 days to 2 weeks before sutures can be removed, while facial wounds are typically ready for suture removal in 7 days. No matter the site, a wound will regain its full strength and look its best in approximately six months. Common side effects of surgery can include temporary lighter or darker skin, prolonged pink or red skin, or scarring. Scarring can be as settle as a faint line or as visible as a keloid. Hypertrophic scars are raised or red sore bumps that do not extend beyond original sight of the procedure. These are often mistakenly called keloids, but do not carry any of the complications that accompany keloids. Keloids are raised, enlarged scars that grow far beyond the original surgical site. These scars are more common after surgical procedures on the chest, neck, or back. Although they are frequently seen in black skin, any skin type can develop a keloid. Curiously, earlobe keloids in any color skin are not a marker for keloids in other areas of the body. Everybody wants to have an invisible scar after surgery. No matter the procedure, the most common question is “Will I have a scar afterwards?”

Therapies For Scar Revision
Re-Excision and Closure Some scars, will not raise, are still concerning. These are scars that have spread a bit or are slightly raised, but in an area that is suitable for re-excision. The skin is numbed with local anesthetic and just the scar tissue is excised. The area is closed together tightly with two layers of stitches, to achieve a more cosmetic pleasing effect. Cortisone Injections This well-established technique uses cortisone’s ability to dissolve collagen to reduce the size of a scar. It will also decrease itching, burning, or soreness in the scar. A numbing cream can be applied before the procedure to reduce discomfort. Multiple sessions may be needed to achieve acceptable results. Shave Excision with Interferon or Aldara Application Raised hypertrophic scars and keloids can be improved by shaving them even with the skin. Interferon is a naturally according immune factor in the body that limits the formation of scars. It is injected into the numbed sight right after the top of the scar is removed. There can be a 75% reduction in the recurrence of keloids. Chills, fever, or a flu-like condition can rarely occur. We recommend simple pre-treatment with Tylenol extra strength tablets (2) one hour before the procedure. Aldara cream stimulates the formation of immune factors that decrease the formation of scars. It is applied to the site every night for two weeks starting the night after removal of the scar. Irritation and inflammation can occur; If this happens, reduce the application to every other night for one week and then increase to every night. If the condition does not improve, please contact the office. Pulsed Dye Laser There is usually something that can be done for all scars. While some scars may require more than one type of treatment, all will require more than one session to achieve the best result. Deep scars including acne and traumatic scars will require several different therapies and multiple treatments. Some of these scars can be removed surgically by cutting them away with a small cookie cutter punch. The resulting small hole will be closed with a single stitch. A resurfacing treatment with either a CO2 or Erbium YAG laser or manual dermabrasion can then be used to flatten and blend the scar into the surrounding skin. Broad flat depressions can be filled from beneath using a number of fillers. These include collagen and silicone.Collagen is temporary and can last from two to five months. It is effective as a quick fix and has minimal discomfort. Collagen requires a skin test. Silicone, FDA approved for ophthalmologic use, has been used in an off-label manner for over 25 years. It is permanent and requires multiple sessions to achieve results. It is injected in microdroplets, and stimulates the body to make its own collagen. Non-invasive therapies can include microdermabrasion, but require multiple treatment session to maximize the results. No matter what type of scar you have, there is something that can be done ot improve its appearance.

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