Scar reduction treatment

Scars are a part and parcel of life. Starting from the scars which one encounters fairly early in life while playing in childhood to stretch marks of growth and pregnancy and finally scars resulting from any skin damage, injury or illness. However, scars are not always pleasant and sometimes decreases one’s self-confidence and self-esteem for life. Sometimes scarsare present on certain body areas where they look aesthetically unpleasant.  The most common scar reduction treatments are sought for post acne scars. So we will be discussing about post acne scars in detail. However, one needs to understand that as all scars have almost similar pathology all the techniques mentioned below can be used for scars resulting from any type of skin damage.

Types of Scars

Scars are basically of two types:

  1. Atrophic/ depressed scars
  2. Hypertrophic/raised scars
Scar Reduction Treatments

Atrophic scars are further of three types:

  1. Icepick scars: Ice pick scars are deep, very narrow scars that extend into the dermis. The skin looks as if it has been pierced by an ice pick or sharp instrument. Ice pick scars seem to make a small, thin, deep hole into the skin. Some may look like a large, open pore.

How They Develop: Ice pick scars develop after an infection from a cyst or other deep inflamed blemish works its way to the surface. Skin tissue is destroyed, leaving a long, column-like scar.

  • Boxcar Scars:Boxcar scars are round or oval depressions with steep vertical sides. Wider than ice pick scars, boxcar scars give the skin an uneven, pitted appearance.

How They Develop: When an inflammatory breakout destroys collagen, the tissue is lost. The skin over this area is left without support, creating a depressed area. Boxcar scars can be superficial to severe, depending on the amount of tissue lost.

  • Rolling Scars: This type of scarring causes rolling or wave-like depressions across the otherwise normal-looking skin. Rolling scars differ from boxcar scars in that they aren’t sharply defined. The skin itself looks uneven and craggy.

How They Develop: Rolling scars arise when fibrous bands of tissue develop between the skin and the subcutaneous tissue below. These bands pull the epidermis binding it to deeper structures of the skin. It is this pulling of the epidermis from within that creates the rolling appearance of the skin.

Hypertrophic and Keloid Scars

Hypertrophic scars are raised, firm scars that grow above the surface of the skin. Hypertrophic scars caused by acne are most often found on the torso, especially in men, but they can happen anywhere on the body. Hypertrophic scars are more common after a deep wound or trauma.

Keloids are a more severe type of raised scar. They differ from hypertrophic scars in that keloids grow larger than the original wound. They can send out raised, lateral shoots that expand much farther than the wound itself, and can continue to grown long after the original wound has healed. Some people are more prone to developing keloids.

How They Develop: Unlike ice pick and boxcar scars, hypertrophic scars are not caused by a loss of tissue. Rather, they develop because of an overproduction of collagen. In the case of keloids, it’s like the skin doesn’t

Post-inflammatory hyperpigmentation

Discoloration left on the skin after a pimple has healed isn’t a true acne scar, but rather post inflammatory hyperpigmentation. It’s incredibly common for people with acne. Post-inflammatory hyperpigmentation is a flat area (neither raised nor pitted) that ranges in color from pink to red, purple, brown, or black, depending on your skin type.

How It Develops: Post-inflammatory hyperpigmentation develops when a wound, rash, pimple, or other trauma causes skin inflammation. As the skin heals, it produces too much melanin (the substance that gives skin its color) leaving a darker area.

The approach towards scar management at Skinhealers

At Skinhealers, we first examine the patient carefully to evaluate the different types of scars. Usually the patients have all the three types of atrophic cscars together along with some oost inflammatory hyoerpigmentation. Thus a multidimesnsional approach is used targeting the various types of scars as follows:

  1. Ice pick scars – for these scars, a procedure known as TCA CROSS. This procedure employs the use of an agent trichloroacetic acid which is very carefully applied to the scars using a very thin needle. The treated scars heals with crsut formation which when falls off leaves behind much shallower scar. Over 3-6 sittings, profound improvement can be appreciated in icepick scars. This treatment has been considered the best option for Ice pick scars despite much technical advancement.
  2. Boxcar and Rolling scars: For these types of scars one or more of the following options are used depending upon patient to patient

Prior to doing any treatment SUBCISION is done to brak the fibrous tissue beneath the scars

  1. Microneedling + Platelet Rich Plasma (PRP therapy): This technique makes use of the skin;s natural property to heal any injury with formation of new collagen in this technique controlled injury is goven to the skin with very fine microneedles employing a dermapen. In response to injury the skin creates more collagen and fills the scar. PRP further enhances the amount of collagen prodiced by skin and gives even better results

Procedure:  A numbing cream is applied to the skin for 30-45 minutes before the procedure. After this, hyaluronic acid is applied to the skin which is then infused into the skin using a dermapen. The microneedles in the dermapen take the hyaluronic acid inside the skin along with which it also causes micro-injuries to the dermis which heals with collagen production over 6 weeks. After micro needling PRP is injected into the skin after which sunscreen is applied and the patient leaves.

Sittings: depending upon the severity of scars 3-6 sittings at 6 weekly intervals are advised. The results are visible from the very first sitting

  1. Microneedling Radiofrequency: This technique involves not only controlled mechanical injury but also thermal injury to the dermic which then makes collagen to fill the scars using a micronedling

Procedure and sittings are same as microneedling itself

  1. Lasers – Two types of lasers are used depending upon the patient’s scar severity and acceotance of downtime
scar Reduction Treatments
  1. Ablative lasers: We use the best in class Lumenis CO2 laser as the ablative laser which can reach up to a depth of 2.5 mm and treat the deepest of scars. These lasers are more obtrusive and work by vaporizing the external layer of the skin as well as the dermis. They definitely result in a downtime of 7-14 days because of crusting and redness but if a patient has really bad acne scars this treatment is worth the downtime
  2. Nonablative lasers- We have the best in class Lumenis resurFX (Er: glass laser) which works by warming up the focused tissue without really crushing it. This animates the body’s collagen generation to fill in the scars. For patients with superficial rolling scars who are not willing for any downtime, this is a good option

Procedure: After applying a numbing cream on the skin for 30-45 minutes, the patient is subjected to laser treatment which usually lasts for 15-30 minutes. Post the laser therapy PRP is injected into the skin, sunscreen is applied and the patient leaves.

Sittings: depending upon the severity of scars 3-6 sittings at 6 weekly intervals are advised. The results are visible from the very first sitting

  1. Peels: Peels are generally the easiest and the painless method in case of scar reduction treatments.

Most peels are fruit acid based and work by peeling of the layers of the skin which because of getting healed quickly, mend the adjacent skin as well. The fundamental guideline is that the peeled areas invigorate creation of collagen which in this way tops off the scar pits. The skin for this situation anyway tends to peel off for some time. The quantity of peels required additionally relies upon the power of scars and the affectability of your skin

For hypertrophic scars: The best treatment for you will depend on your personal situation, but can include injections, silicone gels, cryotherapy (freezing the scars with liquid nitrogen), to help shrink and flatten the scar.

Pre Care Instructions for Scar Removal Treatments

  • Avoid Laser treatment on the areas to be treated from 15 days prior to the procedure or as suggested by the doctor
  • Always apply Moisturiser and Sunscreen before going out, the specification for the same should be as prescribed by the doctor
  • Avoid use of warm water on the skin
  • Avoid swimming from 2 days before the procedure is to be done
  • Avoid parlour activities from 5 days prior to the medical procedure such as threading, Bleaching, waxing.
  • Avoid the use of night creams at least 2 days prior the procedure or as instructed by the physician
  • Avoid exercising 1 day before the procedure

Post Care Instructions for Scar Reduction Treatments

  • Avoid excessive sweating, swimming, sauna etc 2-5 days post the treatment
  • Avoid parlour activities for 2 weeks post the procedure
  • To see best results please stick to the time duration between 2 sessions as suggested by the doctor.
  • Avoid wearing tight fitting garments for 2-3 days after the laser scar reduction treatments is done.
  • If you face any kind of discomfort or uneasiness, itching or erythema on treated areas please consult the clinic as soon as possible and our team will be happy to help you out.
  • Keep your skin hydrated, apply adequate amount of moisturiser to ensure that your skin doesn’t dry up.
Scar reduction treatment
Scar reduction treatment

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