As a dermatologist, I am often asked how to prevent and treat scars by patients and friends. As a sister, I have seen firsthand how skin disease can leave significant scarring which can affect one’s confidence and self-esteem. It is important to understand that no one needs to be ashamed of a scar. A scar is the body’s way of protecting itself and healing. It shows how strong our bodies are and how resilient our skin can be to injury. With that being said, board certified dermatologists are your experts equipped with the knowledge of scar formation and can help you to both prevent scars from forming and improve them after they have formed. When assessing a scar, it is important to understand the duration of the scar, what factors contributed to its formation and an individual’s skin type before determining the best treatment approach. A thorough consultation and discussion of options and expectations is key to good outcomes and happy patients.
Topical treatments- Silicone based scar therapies are a great first line treatment for newer scars. These treatments can be applied to more recent scars typically in gels, creams, or bandages to help to soften and fade inflamed scars. Vitamin A derived retinoid creams can work to minimize scars by accelerating cell turnover. Lighting creams such as hydroquinone work to decrease melanin or excess pigment found in many scars. Lastly, in office chemical peels and microdermabrasion done in combination with a well thought out at home regimen can provide fantastic results for patients. With any treatment game plan, it is of paramount importance to protect any scar from the sun with a reliable broad-spectrum sunscreen and sun protective clothing when possible.
Injections- Cortisone or steroids can be injected into raised or hypertrophic / keloid scars to soften, flatten and fade their pink appearance. It is critically important that these injections are done by a well- trained physician to minimize risk of complications. Hyaluronic acid, a natural component of the skin’s collagen, can be injected into scars which are indented or depressed such as acne scars. The results of these hyaluronic acid injections typically last 6-12 months but can trigger natural collagen production over time. Micro-needling, a procedure which stimulates collagen formation with a series of tiny needle pricks into the skin, triggers the collagen to repair itself which helps to tighten and smooth the uneven texture of some scars including acne scars, surgical scars and older stretch marks. Microneedling can be done with or without PRP (platelet rich plasma). The abundant growth factors in plasma can accelerate results and decrease healing time.
Lasers- There are a number of laser and light emitting devices which can be used to improve scars. These include IPL (Intense Pulsed Light) or BBL (Broad Band Light), Pulse Dye, YAG and fractionated laser resurfacing. Laser treatments can help to fade redness, flatten raised scars and improve texture and tone of the skin. It is of critical importance that thorough medical consultation is done prior to any laser treatment and that pre and post care is provided for patients undergoing these treatments. Dermatologists are at the forefront of understanding scar
biology and advances in laser devices in the treatment of scars. We are also trained to manage the rare complications should they arise and are experts in optimizing outcomes using the combination of in office procedures and at home skin care protocols.
Monique Kademian, MD, FAAD Skin Dermatology and Aesthetics