“Scars can cause people to isolate themselves and can really impact quality of life...I see patients come in after treatment with a totally different energy and confidence.”
Some scars are barely noticeable, but others may lead to self-consciousness, cause pain or interfere with movement. Whether scars stem from injury, surgery, burns, acne or another cause, treatments are available to lessen their impact.
“There are different types of scars, and the treatment varies based on the cause and appearance of the scar,” says Andrew J. Vardanian, MD, a UCLA plastic surgeon who specializes in scar management. “Before initiating treatment, we discuss what aesthetic or functional improvements the patient wants to see with treatment.”
Two common types of scars are depressed scars and keloids. Depressed scars, also called icepick scars, sit below the surface of the skin and have a sunken or pitted appearance. They can result from acne or chicken pox, and they may become more pronounced with age. UCLA physicians recently have begun treating depressed scars with microneedling, says Emily Newsom, MD, a UCLA dermatologic surgeon in Santa Clarita. This technique uses a roller covered in tiny needles to make many small pinpricks on the skin. The microscopic injuries break up the abnormal collagen of the scar tissue and stimulate the body to form new collagen. “Microneedling also is good for stretch marks or general resurfacing of the skin,” Dr. Newsom says. “It can decrease fine lines and discoloration and rejuvenate the skin.”
Cosmetic fillers — gel-like substances injected beneath the skin — also may be used to treat depressed scars. Fat grafting, a surgical option, harvests fat from another part of the body to inject into the scar area.
Keloid scars occur when the tissue spreads beyond the wound that caused the scar. Often painful and itchy, keloids tend to form on the chest and trunk and are more common among individuals with dark skin. Methods of treating keloids include corticosteroid injections, pressure garments, surgery and lasers, which help deliver medication to deeper levels of the scar. “When it comes to keloids, it’s best to explore all the options and consider multiple modalities to reduce risk of recurrence,” Dr. Vardanian says.
Other scar-reduction treatments can include:
• Dermabrasion, which uses a wheel or rotating wire brush to smooth the surface of the skin.
• Subcision, which involves sliding a needle under the skin to release scar tissue, accompanied by saline injections to stimulate production of new collagen.
• Laser treatment, which uses highly focused beams of light to remove layers of skin and minimize the appearance of thick, irregular and reddish scars.
• Laser-assisted drug delivery, which uses lasers to form tiny channels in the skin that allow medication to more easily and deeply penetrate the skin.
Surgical approaches include tissue rearrangement, which moves healthy tissue or skin to the scar area; tissue expansion, which stretches normal skin and uses it to resurface the scar; and skin grafting, which transplants a thin layer of healthy skin to the affected area. “Scars can cause people to isolate themselves and can really impact quality of life,” Dr. Newsom says. “I see patients come in after treatment with a totally different energy and confidence.”
