Scars are marks that are left on the skin after a trauma or damage to the surface of the skin has occurred. Most people have at least one scar on their body as they are a part of the natural healing process.
Scars can develop inside and outside of the body. Inside the body they can occur after cuts have been made on organs during surgery, and externally can develop after conditions of the skin such as acne or chicken pox.
The formation of scars occurs when the body’s tissues are broken or damaged; the body in response starts to produce more of a protein called collagen. This is a natural part of the healing process. Collagen builds in the area that the tissues have been broken or damaged; this helps to support and repair the wound.
The main types of scarring are atrophic scars, hypertrophic scars and keloid scars.
Atrophic scarring can occur anywhere on the body. They look similar to small dents in the skin; they are usually an irregular shape and are quite uneven around the edges. Chicken pox and acne are common causes of atrophic scarring. They are formed when underlying structures supporting the skin such as muscle or fat are damaged and there is a lack of collagen production which results in an indented structure.
Hypertrophic scars are usually a darker colour than the surrounding skin and are slightly raised. However, the difference between these and keloid scars is that hypertrophic scars remain within the confines of the wound. They usually improve over one to two years but can cause some distress due to the fact that they can be quite itchy and can sometimes restrict movement.
Keloid scars form when excess collagen is produced at the site of the wound, it builds up and overgrows over the wound. They grow larger and are more uneven than the original wound that was healing. Keloid scars are usually raised above the surrounding skin and are hairless, shiny, pink or purple in colour and they do not improve over time.
Sculptra with subcision
Sculptra with subcision is an extremely effective way to treat atrophic scars, such as acne scars. Sculptra is a stimulating injectable treatment used to encourage the production of the body own collagen. Subcision involves inserting a needle into the scar area and breaking up the scar tissue by moving the needle back and forth. Sculptra is injected during the subcision to restore the lost volume of the scar. After the course of Sculptra, one or two sessions of C02 laser resurfacing is recommended to deliver the best possible results.
Steroid injections are an effective treatment for keloid scars and they have minimal pain. Almost 50-100% of keloid scars respond to steroid injections, it supresses inflammation and increases the constriction of blood vessels. The injections are administered every two to six weeks until a significant improvement is seen.
The aim of this procedure is to re-pigment the scar to diminish the visibility of it by aiming to blend it with the surrounding skin. Very small amounts of coloured pigment are injected into the skin with the aim of re-colouring the scar. This treatment usually requires multiple sessions and maintenance sessions are required every 12-18 months.
C02 Laser Resurfacing
C02 Laser resurfacing treatment is most commonly used for atrophic scarring. The laser delivers very small spots per square centimetre onto the skin. This creates a heat reaction in the middle layer of the skin which induces the production of collagen and has structural changes in this layer of the skin and in the scar. One to three treatments are usually needed at six week intervals. Topical anaesthetics are applied to the area before treatment to limit any discomfort. C02 laser treatment combined with Sculptra treatment delivers the best results for atrophic scars.
Surgery can provide some improvement to scars. Scar revision surgery involves removing the scar tissue itself. Removing scars such as hypertrophic or keloid scars will leave another scar that may take up to two years to heal fully. There may also be a chance of increased hypertrophic or keloid scarring.
Dr Ayham Al-Ayoubi: A thorough consultation should always take place before any one treatment is decided on. At London Medical and Aesthetic Clinic we offer a range of different options to treat all types of scars.