Scars are marks of injury and once formed will always be there. It is important to understand there are good looking scars and there are bad looking scars. Scar revision Surgery, lasers, topical creams play a very important role in improving the looks and quality of the scars.
Scars mature over time and some scars like acid burns may take several years to improve. It is vital to be patient and not to hurry into procedures. A wait of six to twelve months can dramatically improve scars.
Intense Pulsed Light (IPL), fractional CO2 laser, Erbium laser treatments can produce dramatic improvement in scars. Generally three to four treatments will be required at three week interval. It is an outpatient, quick and easy procedure, commonly performed under topical or local anaesthesia.
Sun protection is important, dressings are usually not required. The healing is very quick and sometimes there will be no external wound. Burns contractures can be released without skin grafting.
Ultra Pulse CO2 and M22 Erbium Resurfax are very potent tools in treating scars and their sequela.
These are unsightly scars which have the capacity to spread into surrounding normal tissues. Most people are born with tendencies to develop keloids. In these, any small or big wound can become a keloid. The common areas are chest, shoulders, joints, ears or sites of injury or piercing. Keloid treatment is cumbersome and chances of recurrence are high.
Silicon & Gels/Cream: Silicon gel sheets and silicon based gels along with topical steroid creams helps in softening the keloid. They also help with colour changes are betterment of keloid. These can be used to suppress the recurrence as well. Adhesive tapes are the most useful.
Injections: Triamcinolone acetonide and 5FU are the commonly used injections into keloid sites to reduce its thickness and limit its spread. They have to be used very carefully as they may have their side effect profiles in the long run.
Multiple such injections might be needed depending on the extent of your keloid. These can be painful and thus can be used under topical Emla or Local Anaesthesia with Lignocaine.
Please speak to your skin care provider if you are a candidate to take these.
Lasers: Fractional CO2 and Pulse dye laser have shown some help. Small localised keloids can be very carefully removed with intralesional CO2 laser excision. It is a meticulous job and the risk of developing keloid in lasered areas cannot be neglected.