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Scars Treatment

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Scars treatment

A scar results from the biologic process of wound repair in the skin and other tissues. They form when the dermis is damaged and the body forms new collagen fibers to mend the damage

ACNE SCARS GLOBAL CLASSIFICATION

  • Grade I – Macule – erythematous / hyper pigmented/ hypopigmented flat mark
  • Grade II – Mild rolling, small, soft papular scar
  • Grade III – Significant rolling, shallow boxcar, and mild- moderate papular / hypertrophic scar

 

  • Grade IV – Punched out, atrophic deep boxcar, ice pick, bridges, tunnels, dystrophic, hypertrophic, keloidal scar

Scars can be atrophic or hypertrophic.

ATROPHIC SCARS CAN BE CLASSIFIED AS:

  • Craters – These are deep scars whose width is equal to or greater than their depth.
  • Pits – These are scars whose width is less than depth.
  • Ice pick scars – These are rocket-shaped /V-shaped scars where the base of the rocket is on the skin surface and the tip lies at a depth
  • Box scars – These are deep U-shaped scars
  • Rolled scars – These are W-shaped scars.

HYPERTROPHIC SCARS

These are raised scars associated with excessive fibrous tissue formation.

What Are The Types of Scars?

There are several different types of scars including:

  • Keloid scars: These scars are the result of an overly aggressive healing process. They extend beyond the original injury. Over time, a keloid scar may hamper movement. Treatments include surgery to remove the scar, steroid injections, or silicone sheets to flatten the scar. Smaller keloids can be treated using cryotherapy (freezing therapy using liquid nitrogen). You can also prevent keloid formation by using pressure treatment or gel pads with silicone when you are injured. Keloid scars are most common among people with dark skin.
  • Contracture scars: If your skin has been burned, you may have a contracture scar. These scars tighten skin, which can impair your ability to move. Contracture scars may also go deeper, affecting muscles and nerves.
  • Hypertrophic scars: These are raised, red scars that are similar to keloids but do not go beyond the boundary of the injury. Treatments include injections of steroids to reduce inflammation or silicone sheets, which flatten the scar.
  • Acne scars: If you’ve had severe acne, you probably have the scars to prove it. There are many types of acne scars, ranging from deep pits to scars that are angular or wavelike in appearance. Treatment options depend on the types of acne scars you have.

What Are Possible Treatments for Scars?

Scar treatments may include:

  • Over-the-counter or prescription creams, ointments, or gels. These products can be used to treat scars that are caused by cuts or other injuries or wounds. If you are under the care of a plastic surgeon and your scarring is from cosmetic or plastic surgery, ask your surgeon if over-the-counter treatment is an option. If not, there are prescriptions that may help. Often, treatments can include steroids or certain oral antihistamines for scars that cause itching and are very sensitive. Likewise, if you have scarring from severe acne, ask your dermatologist for advice. Your doctor can also recommend or use pressure treatment or silicone gel sheeting to help treat scars or as preventive care.
  • Surgical removal or treatment. There are many options to treat deeper scars depending on your particular case. These include skin grafts, excision, dermabrasion, or laser surgery. In a skin graft, the surgeon uses skin from another area of your body. This is often used with people who’ve had burns. If you’ve got scarring that impairs function, surgery can help address the functional problems. If you’ve recently had surgery that has caused scars, it is best to wait at least one year before making a decision about scar treatment. Many scars fade and become less noticeable over time.
  • Injections. You may get steroid injections to treat scars that stick out, such as keloids or hypertrophic scars. Your doctor may use this on its own or with other treatments. Other types of injections, such as collagen or other “fillers,” may be useful for some types of pitted scarring, although these are not usually permanent solutions.

TREATMENT OF ACNE SCARS

Dermaroller – This is a special instrument, with micro needles, which is used to fill up superficial as well as deep acne scars. The procedure will even out the skin texture through collagen stimulation.

Dermastamp – This is an instrument, which has five small micro needles in it to treat localized depressed scars.

Laser – Fractional Resurfacing is a new technique where microscopic thermal wounds within the selected target area are created producing tiny dots, or grid-like treated areas on the skin), leaving the other zones within it perfectly intact. This causes fractional damage through the heat created in the skin. This allows the skin to heal much faster with minimal discomfort and less downtime as the healthy untreated tissue surrounding the treated zones helps to fill in the damaged area with new cells. Recovery occurs in 5-7 days.

There are different types of fractionated lasers:

  • Pixel (2940nm)– This is a fractionated ablative resurfacing Erbium Yag laser. This laser is very effective in treating superficial and deep scars.
  • Fraxel(1550nm)/Starlux Palomar Laser (1540nm)– These are nonablative resurfacing lasers with Erbium glass which are effective in treating both superficial and deep scars

Light Systems – IPL acts by heating the dermis and stimulating new collagen formation. It is useful for treating red post-acne scars.

Chemical Peels – 70% Glycolic Acid peels can be done to treat hyper pigmented, red and shallow scars. TCA peeling can be done for hyper pigmented and deep-pitted scars. Spot TCA peeling is a very good technique for isolated ice pick scars.

Microdermabrasion – A fine stream of aluminum oxide crystals is used to exfoliate the skin’s upper layers. The intensity of exfoliation can be varied to suit an individual’s skin type from light exfoliation to deeper resurfacing. This procedure stimulates collagen production and renews skin elasticity; thereby, enhancing the skin tone and resilience. This treatment is useful for treating superficial acne scars.

Fillers – these can be used to raise sunken scars to the level of surrounding skin. Hyaluronic acid is a very safe injectable material that is used to restore structure and volume to the skin. It is a good and safe option. The effects are usually temporary lasting 6- 12 months.

Autologus fat transfer – Autologous fat transfer, is a procedure in which an individual’s own body fat is removed from the abdominal area, emulsified and put in the areas of volume loss e.g. sunken or emaciated areas of the face.

Radiosurgery – In this procedure, radio waves are used in ablative mode, to ablate the unwanted layers of the skin and flatten out the edges of scars and promote collagen remodeling thereby filling up deep irregular scars.

Steroid injections – Intralesional Steroid Injections like Triamcinolone Acetonide 10mg-40mg may be used for raised keloidal and hypertrophic scars. These injections help to soften thick stubborn fibrous tissue.

Subcision – This involves subcutaneous sectioning of dermal adhesions with a sharp needle thereby lifting the scars. This technique is useful for very deep-pitted scars. ice pick scars, boxcar scars and rolled scars.

 

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