Scars Reduction

Scars were respected when incurred in the wars as bravery medals. But for civilians, freak accidents, burns, operations, infections leave their footprint on the body like scars. They not only spoil the beauty but serve as a constant reminder of one’s suffering. Scars may be thick or thin, immature in early stage when they look reddish in colour or mature when they are old and whitish. Some scars cause tightening effects on nearby tissues resulting in bunching of the skin on one side. These are called bridle scars. The scars can be associated with darkening or hyperpigmentation, and they also feel inelastic and tough.

Some scars become very thick and itchy and extend beyond the original wound. These are more troublesome and are termed keloid. Keloids are common on the chest bone, earlobes, and shoulders. The chest keloids typically start with a small boil. The ear keloids are usually triggered by piercing, especially in the parts where the ornament passes through the ear's cartilage. Scars after acid and oil burns often become keloidal, especially if the burn wounds take more than 2-3 weeks to heal.

Some people are prone to have keloids anywhere after an injury. This tendency can even be seen in family members. Such people need to be careful when they opt for any surgery or invasive treatments like lasers or derma rollers/derma pen. In such patients, a single scar of operation can be keloidal yet can be managed. But multiple scars become difficult to manage.

Today many modalities are available to reduce the scars. The most important bottom line is that scars cannot be removed, but they can be reduced. Scars can be rendered imperceptible to a viewer at a speaking distance by hiding them in natural creases or changing their direction by an operation to make them fall in invisible areas. One can remove a large scar and adjust the surrounding skin with Z or W plasty or apply new skin there. But all these procedures require stitching, and a small amount of scar does form with the stitching. Of course, the stitching is done with fine material, yet the scar forms in the tiny gap as a bridge.

Operation scars like cesarean scars or appendix or abdominal operation scars can also be treated similarly. For the burns scars and other scars covering some surface area, fractional CO2 laser or microneedle radiofrequency or dermaroller treatments are useful in reducing the scar's toughness and roughness. With this treatment, the scarred skin becomes more supple, less pigmented, smoother, and softer, merging it with the surrounding normal skin.

For depressed scars, either an operation to rejoin the separated tissues under the skin or fill them with fat may be required. If the depression is minimum, fractional CO2 laser or microneedle radiofrequency or dermaroller may work. The acne scars are typically depressed scars, and these are treated on the same lines.

Some large scars may require skin grafting. The skin is obtained from a colour matching area. The donor area will have scars, but they will be inconspicuous and less. Sometimes very major operations like tissue expansion surgery or a flap surgery may be needed.

Keloid scars are treated with injections and lasers. Pressure garments made of elastic cloth are useful in the early stage to prevent the formation of a thick or keloid scar.

One must remember that a scar treatment is considered successful when one cannot see an abnormality on a conversational distance. It is a myth that scars can be removed completely by plastic surgery. They are just made less visible and less conspicuous. The scars are not a disease. They are the glue that binds with the tissue. So it is sufficient to make them less visible and noticeable. Every person seeking scar treatment must bear this in mind.