How to Remove Scars?

i have lots of skin scars. what's best for getting rid of scars?

Doctor Answers (22)

Scar removal treatment depends on what scar looks like

+6

If the scar is large, you may have to excise it first and then close it. If it is long you may need to close it in an irregular way to break up the line so that the brain doesn't notice it.

Your brain is more likely to notice a line that is over 7mm in length. Anything longer than that will need to be made irregular for the brain to not notice it as easily. Once the scar is thinner you can then use lasers to resurface the area to make it look better.

CO2 lasers are the best for this and there are a lot of names for these lasers depending on the company. Lumenis, with its Active FX is the best CO2 laser out there in my opinion, and it also has Deep FX, which is fractional and can tighten the skin.

Some very large scars need more complicated treatment approaches to make them look better. Dermabrasion can also help the appearance of the scar.

All of these techniques depend on the person doing it, so you want to go to someone with a lot of experience with these techniques and someone with a diverse approach to treating scars.


Bellevue Facial Plastic Surgeon
3.5 out of 5 stars 29 reviews

Scar Treatments and Stretch Mark Removal

+4

There are many kinds of scars. They can result from acne, infection, injury or surgery. While technically not scars, stretch marks, which may follow a rapid growth spurt during adolescence, pregnancy or prolonged overweight, possess some of the microscopic characteristics of scars and for that reason have been included here. Whatever their cause, all scars are by definition permanent. Happily, however, there are now a variety of successful approaches for improving the appearance of scars and making them less visible. The precise technique or combination of methods chosen must be tailored to the specific kind of scar and its location on the body. Acne pock scars, like those from chicken pox, are tightly bound down.

Although they may be cut out and the resulting wound stitched together with delicate stitches, I have found that combining subcision and microneedling to be quite effective. Subcision involves the insertion of a needle below the skin surface to break up the tight fibrous bands that pull the scar downward.

Medical microneedling employs a roller containing numerous spoke-like needles to create microchannels in the skin, which besides physically breaking up the underlying abnormal collagen stimulates new collagen synthesis further improves the appearance of the scar. Many treatments, including a variety of lasers, have been proposed for dealing with stretch marks. None have proven universally satisfactory and to date the results have been far from gratitying in many cases.

I have found a combined using of a series of medical microneedling sessions followed by the injection of Radiesse at a later date to be quite helpful. The microneedling improves both the crinkly surface of the stretch mark and softens up the dermis below, making it more responsive to plumping right up when injected with the Radiesse. I have also used this approach successfully for improving traumatic and surgical scars.

Acne pit scars may be removed by simply punching them out, next closing the site with superfine sutures (so that stitch marks will be minimal) and finally, gently dermasanding the resulting wound with sterilized sandpaper about ten weeks later to leave the area barely perceptible when healed, a process known as scarabrasion. Pit scars may also be successfully improved by instilling a potent solution of trichloracetic acid 100% deep within the long, narrow walls of the pit.

During healing, the irritated tissue seals together making the pit more shallow and less noticeable. Hypertrophic scars and keloid scars are entirely different forms of scarring and require their own therapies. Hypertrophic scars, or "proud flesh" stick up above the surface of a healed wound site like a reddish or reddish purple mountain. They can sometimes be itchy or tender. I find they respond well to injections of an antiiflammatory agent, such a triamcinlone acetonide (TAC)uspension.

When healed, they are flat and slightly off-white in color. Keloids are a bit more problematic. They, too, extend up like mountains over the wound. But they characteristically spill out to cover normal surrounding tissue. Keloid scars typically need higher TAC concentrations and a series of treatments in order to induce significant shrinkage. In addition, other treatments, such as topical imiquimod and silicone gel bandages may be needed to achieve more significant and lasting improvement.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
5.0 out of 5 stars 11 reviews

Skin scars

+3

Scar revision is a broad topic, and unfortunately your question does not classify what type of scar you have in terms of location, depth, width, age, etc.  A thorough evaluation is necessary.  Among some of the options I can discuss with you are scar excision, rearrangement, shifting to a new location, sanding, lasering, and filling.  Realize however that scars cannot be completely removed, only minimized.  Many times the scar can be made quite negligible in appearance.

Thomas T. Le, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

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Scar treatments

+3

There is no way to "get rid" of scars. Scars are permanent.  Scar revision can be considered for  wide, depressed, or irregular scars with the goals of a narrower, smooth scar that is oriented within natural skin tension lines so it is less conspicuous. Topical treatments and laser treatments work best for discolored scars, to improve blending with surrounding skin. Many over the counter scar treatments do not have proven effectiveness. In the situation of new scars or incisions, keeping the skin soft and supple with moisturizer, sunscreen, and simply being patient is usually the best course of action. Scars mature and fade to normal skin color at around 1 year, and sometimes longer in certain individuals. Everyone heals differently. Abnormal scars such as hypertrophic scars (raised, nodular, red and inflammed scars) and keloid scars (scars that outgrow the zone of injury)  respond best to steroids (topical or injections) and silicone sheeting with pressure over the scar. 

Hayley Brown, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 20 reviews

Scars can be improved but not removed

+2

Hi!

You have got to be realistic. When the skin is cut, there is going to be a permanent scar, which hopefully becomes inconspicuous with time.

In our plastic surgery practice in New York City, we have a whole protocol to PREVENT bad scarring. And there is exciting research for the future.

We have patients use a gel (Scarfade) after surgery.

But when there are existing noticeable scars, we work with a dermatologist, because laser treatments can be very helpful (different lasers for red or for brown scars).

I suggest you see a board certified dermatologist.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Scar removal treatment depends

+2

Hello,

The "removal of a scar" is a loaded concept. When you remove a scar you replace it with another scar. The idea is determining to what extent the removal technique will allow the result to be better than the current scar. The answer depends upon the scar and the conditions under which wounding occurred as well as the patient's capacity to heal.

See a plastic surgeon who brings expertise in scar revision and improvement and go from there. Some scars can be revised in the office under local anesthesia with good results.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 23 reviews

Treatment for surgical scars

+2

Surgical scars fall into two categories: acute and chronic. During the acute phase of scarring after surgery, the most effective treatments include keeping the scar clean and free of infection, massage, and topical application of wound healing creams. These creams will decrease inflammation and minimize pigmentation.

Chronic surgical scars may require scar revision with surgery, topical application of creams, use of silicone strips, massage, or injection of TAC. These should be discussed with a board certified plastic surgeon.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 46 reviews

5 ways to remove scars

+2
  1. Avoid sun exposure as the harmful rays can cause your scar to hyperpigment, or darken
  2. Perform scar massage as directed by your physician. This usually involves rubbing the scar with a moisturizer with vitamin E oil in it to loosen up the scar tissue and make it feel softer
  3. Avoid directly applying vitamin E oil as it can act as an irritant and cause dermatitis
  4. Silicone gel or silicone strips purchased online or over the counter at most major pharmacies can help soften and flatten the scar
  5. Band-Aid, Kelocote, Scarguard, and Curad all make variants of this product

Jennifer L. Walden, MD
Austin Plastic Surgeon
4.0 out of 5 stars 16 reviews

If you have a history of bad scars, you must tell your...

+2

If you have a history of bad scars, you must tell your surgeon. Ideally, your surgeon will use techniques to minimise scarring and place them in inconspicuous sites that won’t be too visible. After surgery, keeps scars away from sunshine until they have faded and moisturise scars regularly.

Charles Nduka, MD
London Plastic Surgeon
5.0 out of 5 stars 1 review

Again, there are many excellent products available; but...

+2

Again, there are many excellent products available; but in general, I reserve the use of these products if there are any problems developing or any concerns regarding the normal healing process. Most scars will settle down and fade with time.

A couple of basic principles are moisturizing and massaging the scars to keep them soft and avoidance of direct sun exposure to any scars. Sunblock should be applied to scars even if they have covered with clothing, as the SPF factor of most clothing is extremely low. For example, the SPF factor of a white cotton T-shirt is less than 10.

Rodger Wade Pielet, MD (in memoriam)
Chicago Plastic Surgeon
5.0 out of 5 stars 2 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.