Consultant ENT, Head and Neck and Thyroid Surgeon
The skin is a seamless organ protecting our body from infection. Throughout our lives, we have experiences that injure our skin, leaving behind a scar. Scars depend on many factors. These include: the depth and size of the wound, your age, genetic factors, and even your sex and ethnicity. There are four main types of scars and various treatments can help reduce their size and appearance. Before you begin, however, remember this basic truth: scars will never completely disappear.
What are the four main types of scars?
Hypertrophic scars: These are raised, red scars that are similar to keloids (see below), but do not extend beyond the original injury site. Possible treatments include steroid injections and laser surgery.
Keloids: These scars protrude from the skin and extend beyond the original injury site and are due to overproduction of certain cells. Over time, keloids may affect mobility. Possible treatments include surgical scar removal, laser surgery or steroid injections. Smaller keloids can be removed with cryotherapy (freezing therapy using liquid nitrogen). You can also prevent keloid formation by using pressure treatment, silicone gel. Keloids are more common in darker skin types, specifically people of African or Asian descent.
Contracture scars: These scars cause tightening of skin that can impair the ability to move. These can happen after a burn. Additionally, this type of scar may go deeper to affect muscles and nerves.
Acne scars: Any type of acne can leave behind scars. There are many types of acne scars, ranging from deep pits to scars that are angular or wavelike in appearance. Treatment depends on the type of scars.
What are possible treatments?
Over-the-counter or prescription creams, ointments, or gels: These products may reduce scars that are caused from surgical incisions, other injuries or wounds. Treatment options include corticosteroids or antihistamine creams if your scars cause itching and are sensitive. Likewise, if you are have scarring as a result of acne, you should ask your dermatologist for specific recommendations for treatment of the acne and type of scarring. Your doctor may also recommend intra-lesional steroid injections, pressure dressings, or silicone gel sheeting to prevent acne scars and to help treat existing scars.
Surgical scar removal: There are many options under this category, depending on your particular case, including skin grafts, excision or laser surgery. When looking into surgery, discuss with your doctor whether you will have local anaesthesia with an oral sedative or general anaesthesia. If you’ve recently undergone plastic, cosmetic, or other surgery that has caused your scars, it is best that you wait at least one year before making a decision about scar removal treatment. Many scars fade and become less noticeable over time.
Injections: In the case of protruding scars such as keloids or hypertrophic scars, your doctor may elect to use steroid injections to flatten the scars. Such injections can be used as a stand-alone treatment or in conjunction with other treatments.
Laser surgery: Vascular (blood vessel) specific lasers may be used to lighten flat or raised scars that are pink to purple in colour. Vascular laser treatment may also facilitate the flattening of raised scars.