Scars form as a natural part of the healing process when the dermis, the thick layer of skin below the surface, is damaged. The body forms new collagen fibres to mend the damage, resulting in a scar. The appearance of a scar often depends on multiple factors including the nature of the injury, the direction of the wound, the blood supply to the area, the thickness and colour of your skin, and more.
In this blog, Chester Consultant Plastic Surgeon Anca Breahna offers her expert insights into the complex world of scar treatments, leveraging her extensive experience in plastic and reconstructive surgery.
Scars are not all alike, and understanding the types you have is the first step in finding the appropriate treatment. Hypertrophic scars are red and raised, remaining within the boundary of the original wound. Keloid scars are similar but extend beyond the initial injury area, sometimes growing over time. Atrophic scars create a dent or pit on the skin, commonly found with acne or chickenpox. Lastly, contracture scars result from burns and can affect muscles and nerves, potentially limiting movement.
When managing scars, there are several general treatments you can consider. These range from over-the-counter solutions that you can easily purchase at most pharmacies to more specific prescription medications that a doctor might recommend depending on the severity and type of your scar. Here’s a deeper look at each of these options:
For many people dealing with scars, over-the-counter treatments are the first line of defence. These products are readily available and can be used to treat a variety of scars, including those that are newly formed and relatively minor in appearance.
If your scars are more severe or do not respond well to over-the-counter treatments, your doctor may prescribe stronger medications. These prescription options are formulated to address more problematic scars and can provide noticeable improvements:
For those dealing with more severe scarring, professional treatments might be necessary. These treatments, which include surgical options, laser therapies, and injections, are carried out by Anca. Each type of treatment comes with its own set of potential benefits and is chosen based on the specific characteristics of the scar and your skin type.
Surgical treatment of scars may involve various procedures aimed at improving the appearance of scars. Here are some of the common surgical methods:
For many individuals dealing with scars, non-surgical options can be effective for improving the appearance of scars without the need for invasive procedures. These treatments usually involve less downtime and can be less intimidating than surgical options. Here’s a look at various non-surgical scar treatment methods that are commonly used:
This treatment involves applying a chemical solution to the scarred area, which causes the outer layers of skin to peel off, helping to reduce deeper scars as new skin forms:
Microdermabrasion is a minimally invasive procedure that involves sanding down the outer layers of skin with a special instrument. It’s particularly good for superficial scars and can help to make the skin smoother and more even in texture:
Non-ablative laser treatments can also be used for scar management without removing any skin:
Microneedling involves using small needles to create tiny punctures in the skin, which can help to induce collagen production and lead to smoother skin:
Cryotherapy involves freezing the scar tissue to help reduce its size, particularly in the case of raised scars like keloids:
For hypertrophic scars and keloids, steroid injections are an effective non-surgical option to help reduce scar tissue buildup, ease discomfort, and flatten the scar.
These non-surgical methods provide a broad range of options for patients looking to reduce the visibility of scars with minimal downtime and less risk than surgery. Consulting with Anca is important to determine the best approach based on the type of scar and your skin characteristics.
Proper wound care is essential to prevent scars or reduce their severity. Always clean a new wound with water or a gentle cleanser to remove any debris and bacteria. Applying a thin layer of petroleum jelly can keep the area moist, which helps prevent a scab from forming. Scabs can delay healing and increase the likelihood of a scar remaining. Cover the wound with a sterile bandage to protect it from irritation and infection.
Protecting your skin from the sun is vital to reduce the visibility of scars. UV exposure can darken scars and make them more noticeable. Use a broad-spectrum sunscreen with an SPF of 30 or higher to cover scars when you’re outdoors. Additionally, regular moisturising can help keep the scar and surrounding skin soft, reducing the development of a rough, raised scar.
Children’s skin is more sensitive than adults’, requiring special attention when treating scars. Use gentle methods and always consult a paediatric dermatologist before starting any treatments. Silicone gels and sheets can be safe options that are less invasive and painful than other treatments.
If your child’s scar is large, growing, or causing them discomfort or restricted movement, it is important to consult a healthcare provider. Early intervention can prevent scars from becoming a bigger problem as they grow and their skin stretches.
The risks depend on the specific treatment but generally include infection, changes in skin colour, allergic reactions, and potential worsening of the scar appearance. Surgical treatments might carry additional risks such as bleeding, pain, and extended recovery times. Non-invasive methods like laser treatments and chemical peels might cause temporary discomfort, redness, and swelling. It’s important to discuss all potential risks with Anca before starting any new treatment.
Silicone sheets and gels are widely regarded as an effective treatment for reducing the thickness and colour of hypertrophic scars and keloids. They work by creating a moist healing environment around the scar which helps to decrease collagen production and improve the scar’s appearance. Consistent use as directed, usually over several months, is necessary to see significant improvement.
Yes, massage therapy can be beneficial for certain types of scars, especially those that are thick and raised, such as hypertrophic scars. Massaging the scar helps to break down the thick scar tissue and promote better circulation, which can soften the scar and make it less prominent. It’s best to wait until the wound has fully healed before starting massage therapy and to consult with a professional to learn the proper techniques.
Protecting scars from the sun is vital as UV exposure can permanently darken scars, making them more noticeable compared to the surrounding skin. It’s recommended to cover scars with a strong SPF sunscreen or protective clothing whenever exposed to sunlight, especially during the first year of healing when the scar is still maturing.
While many natural remedies are touted for scar treatment, aloe vera and onion extract have shown some promise in scientific studies. Aloe vera is known for its anti-inflammatory and soothing properties which can help reduce scar redness and swelling. Onion extract, commonly found in over-the-counter scar treatment products, may also help improve scar texture and appearance by controlling collagen production. However, results can vary, and these treatments might be more effective when combined with other therapies.