The best scar management approach I know is to prevent scars using precise, advanced surgical techniques that cause minimal tissue injury from the outset of any cosmetic plastic surgery. At my Chicago practice, however, that is not always possible. I see many patients who, for one reason or another, have scars that have already advanced to the degree where they are painful, itchy, and unattractive.
In 2 previous blog posts, I discussed the types of scars and what causes them to develop and my approach to scar prevention based on years of research and innovation. In this post, I’ll talk about the range of treatments available for patients who already have a scar that they want to reduce.
As I mentioned in my first post of this series, the 4 common types of scars include:
- Immature hypertrophic scars
- Hypertrophic scars
- Minor keloids
- Major, high-risk keloids
Treatment is appropriate when a true hypertrophic or keloid scar, rather than an immature scar, is diagnosed.
For individuals with scars, getting them removed is not an issue of vanity. Studies have linked scarring to anxiety, depression, low self-esteem, and the loss of self-confidence.
Fortunately, research into scar reduction treatment is yielding non-invasive products that are effective in many cases.
Scar treatment using ointments, gels, or creams is often preferable to silicone sheeting, which isn’t as convenient and is particularly troublesome for children.
Steroids and antihistamine creams are useful for scars that cause severe itching. Raised scars, such as keloids or mature hypertrophic scars, may also be treated with steroid injections alone, or combined with other treatments.
A Stronger Approach
If a conservative approach to treatment — including the use of silicone gel, pressure garments, and steroid injections — isn’t successful after a year, surgical excision of a scar can be considered. The specific technique used depends on the type and size of scar. For example, fairly small scars may be treated with cryosurgery, which freezes the top skin layers and causes the skin to blister.
More extensive surgical scar revision surgery involves removing the entire scar and rejoining the skin. The goal is to create a minimal scar using specialized techniques. Not all scarring can be effectively treated through surgery.
Raised, major keloids pose significant challenges in part because the rate of recurrence is so high. I use similar techniques in these cases, working to minimize the chance of recurrence by providing thorough aftercare.
Anyone concerned about a scar should first contact a board-certified plastic surgeon to get a specialist’s advice about the best treatment path.
As I wrap up this 3-part series on scarring, I hope that you’ve learned more about what causes scars and that for anyone considering cosmetic surgery, the best treatment is prevention. That means choosing an experienced plastic surgeon who uses advanced techniques designed to minimize scars.