Keloid scarring
Patients with constitutional keloid scars can receive a direct injection of the steroid Cortisone which will alter the scar tissue to reduce redness, itching and burning.
After several consecutive months of treatment, the skin area may become lighter and smoother over time.
If this treatment does not produce the desired results, surgical removal is recommended. This operation usually takes place under local anaesthesia. The operation involves cutting out the scar tissue and closing the wound with stitches. In order to prevent the scar from proliferating once again, iridium radiation is performed after the operation. After several days, the stitches may be removed.
Hypertrophic scars
Because these scars are similar in appearance – swollen, red and raised – to keloid scars, the two are often confused with one another.
However, hypertrophic scars usually arise from incision wounds or operation scarring. They usually fade and recede on their own. Sometimes this may take up to a year, and in some cases, steroid or silicone patches or injections may be needed. The patient should first attempt to flatten a hypertrophic scar by wearing a silicone patch for two to three months.
If the scar has not improved noticeably after one year, it may be corrected through surgery. Plastic surgery removes excesssive scar tissue, placing the scar in another direction so that may heal better. Depending on the dimensions of the scar, the procedure may be performed under local or general anaesthesia. In order to prevent the scar from thickening again, Cortisone patches or injections may be prescribed.
Contractures
Burns and other injuries can result in the loss of skin.
If these wounds are allowed to fade slowly, shriveled scars will develop. This causes a tissue deficit which results in a scar contracture. This shortening/shriveling may affect the surrounding muscles, tendons and joints, impeding their normal range of motion. In this case, the scar can be surgically removed and replaced with a skin transplant or skin flap.
Another possibility is a procedure known as Z-plasty, which adapts the scar to the natural process. The scar become less visible and the stretching is reduced. This operation takes place under local anaesthesia. The scar is removed and incisions are made on both sides, creating two small triangular skin flaps. By exchanging the two flaps, the surgeon gains length at the expense of width, ultimately eliminating the contracture. The new wound is closed with fine stitches that can be removed within just a few days. The new scar has a Z-shaped appearance.
Facial scarring
There are several different ways to made a facial or body scar less visible.
It is often sufficient to surgically remove the scar and to stich up the new wound with fine sutures which can be removed after a few days. If the scar runs against the natural progression of wrinkles, the new scar can be made to run in this direction, thus becoming less conspicuous. Peeling, laser treatment and dermabrasion can contribute to the successful improvement of facial scars. These procedures remove the upper layers of skin. They do not cause the scars to disappear entirely. However, they do having a smoothing effect on the skin.
Are there other options for scar correction
Expanders
Large areas of scarred skin can be removed by stretching the surrounding healthy skin using what are called expanders.
Under the skin, the expander functions like a balloon that is blown up with a sterile liquid using a fan in an ongoing outpatient procedure. Once the healthy skin has been sufficiently expanded, the expander is removed and the area where the scar once was can be covered with the excess healthy skin. Linear stitches are made which later are barely visible. In rare cases, skin expanders can case inflammation and early removal may be necessary.
Dye laser
A dye laser can reduce the redness of scars after several treatment sessions.
What is important to note after the procedure
The patient will experience high sensitivity and pain at area of the skin operated on. In some cases, small, harmless blisters may appear and occasional itching may occur. Avoid athletic activity and excessive movement while the stitches are in place. Pulling may cause the new scar to widen. Therefore, scars should ideally be protected from pulling by bandages or patches. Not a risk-free operation
Scar correction is normally completely safe. Although the greatest care is taken during and after medical procedures, however, complications may arise in some cases.
Complications may include: Reactions to the anaesthetic used
- Bleeding
- Internal bleeding into the skin, muscles and fatty tissue
- Swelling and discoloration caused by bruising
- Inflammation of the wounds
- Temporary numbness
- Infections
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