The skin consists of the epidermis and the dermis. The dermis is the deeper of the two layers and any injury here be it traumatic or surgical will result in scarring. New scars are usually red and can be raised. Over a period of 12 months, the scar matures, flattens and loses its redness. Occasionally ‘bad’ scars such as keloid scars or hypertrophic scars can form which are lumpy, itchy and painful. Scars can also be located in prominent areas such as the face which may cause patients to feel self conscious of their appearance. There are various treatments available to manage scars ranging from steroid injections, laser scar treatments and scar revisions. The type of treatment appropriate to you depends on the maturity and type of scar that you have.
There are two types of ‘bad’ scars that can form :
A keloid scar is a lumpy, red and itchy scar which can extend beyond the initial injury. It more commonly occurs in asian and afro-carribean skin although it can also occur in caucasian skin. They also occur more commonly in certain areas such as the central chest, the shoulders and the ears. Keloid scars are notoriously difficult to treat due to their propensity to recur.
A hypertrophic scar occurs more commonly than a keloid scar. They are usually red, lumpy and itchy too but do not extend beyond the initial injury. The majority of hypertrophic scars resolve conservatively over time however in some cases, they require treatment.
Before & Afters
Treatment Options :
Conservative management consists of scar massage and moisturising the scar. This helps the scar to mature. Scars generally take 12-18 months to fully mature. The effectiveness of this treatment however is limited for hypertrophic or keloid scars.
Silicone tape or silicone gel can be effective when used on hypertrophic scars however they need to be used consistently over a minimum period of at least six months for any appreciable improvement
Steroids can be injected into both keloid and hypertrophic scars to improve them. The injections usually need to be performed every 6-8weeks directly into the scar and a course of treatments typically consists of three to five injections
Scars that are depressed can benefit from fat injections to raise the scar up and disguise the depression. Fat cells that are injected also have important growth factors that can help improve the overall skin quality around a scar thereby making them less obvious