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Options to Reduce Old, White Cigarette Burns and knife Scars?

asked 3 years ago by Samantha44
Latest answer by William Ting, MD
Question viewed 8,456 times
Tags: burn, burn scar, cigarette, white scar

Hi! I have numerous cigarette burns and some knife wounds that are very old (approximately 15 years). They have faded as much as possible, but are now much whiter than the rest of my skin (which is very fair), so they are still quite visible. None are keloid and most are not raised to any significant degree, although a few are.

I have not had any consultations yet, but spoke to a plastic surgeon friend who does not specialize in this area. He said Fraxel might help somewhat, but didn't think the results would be spectacular. I used some sort of silicone strip (scar-ease?) about 5 years ago for several months, but the scars were already white and pretty flat, and I didn't see any real improvement. Other than that, I haven't tried much besides just giving them years to heal. I can't find a lot of research on this.

What type of procedure do you think is most likely to lead to satisfactory results? How do I find a U.S. doctor who specializes in this sort of skin repair? I know experience is the most important thing when selecting a physician, but I can't seem to find anyone (at least looking online) who specializes in this sort of thing. I'm okay with some sort of scarring, so long as it's not obvious what it was from. That is, I don't care so much about my skin being aesthetically pleasing, so long as it's not embarrassing in this particular way.

10 answers to Options to Reduce Old, White Cigarette Burns and knife Scars?

+2

Correction of old wide scars

After a full thickness wound is sustained, a scar continues to change and mature for 8-12 months during which time it MAY be able to be modified by external factors. Once it becomes white (like Stretch Marks do) the small blood vessels inside it were replaced by stable white scar tissue and nothing much can be done. WYSIWYG. While SOME lasers may reduce vascularity in scars (making them whiter sooner) and others can "sand" the top or blur the edges - NO LASER will make a scar... more
+2

Few options for old white scars

Unfortunately, what you are describing is as good as mother nature can do given the injuries you had. No lasers or other treatments will help at all and excising the scars and revising will turn them into visible lines that will take years to become white again. If there are just a few that really bother you, however, that might be the best option. So see a plastic surgeon for possible "scar revision" but realize that scar revision doesn't mean "scar erasure."... more
+2

White scar treatment

Unfortunately, old white scars are very difficult to treat. So far, a series of Fraxel Restore treatments will sometimes help blur the edges. The results from excimer laser treatments were not good. Keeping the normal skin as light as possible with sunscreens and bleaching agents helps. Sometimes a topical retinoid (Retin-A type) cream will help blend the edges. This is a very difficult problem.
+1

Treatment options for 'old white scars'

Needless to say, prevention would be the best approach, e.g. sun protection and avoidance of trauma and other inciting triggers. Combination of topical retinoid and fractional co2 laser resurfacing can be helpful to facilitate blending in of color and texture. Seek out an experienced board-certified dermatologist for a multi-prong approach.
+1

Options to reduce old white scars

"Old white scars" imply that the pigment has been lost in the skin where the scar or trauma insulted the skin. The reality is that the color of these scars is virtually impossible to change. You can have a plastic surgeon excise them but I would caution you that the risk of making the scar worse may happen with this approach.
+1

Treatment for old white scars

The white scars from the burns are from 2 things. The scar tissue being very dense does not allow the fine capillaries to give the skin it's pink color. The melanocytes (pigment producing cells) could have been damaged in a deep burn and this also adds to the pale or white color of the scar. Fraxel laser can help in some cases (acne scars) but have a limited benefit in white scars. Scar excision works by cutting the scar out and bringing together the surrounding healthy skin.... more
+1

Getting rid of old white scars on the body using scar revision techniques

Stable white scars can be dramatically improved using a technique known as serial excision in which the chronic scar is removed using an incision that is hidden within the scar itself.  This would be of much use in your condition. 
+1

Get rid of old scars

After so many years of healing, light procedures will probably not do much. I would recommend looking into scar revision or maybe silicone sheeting. Consult with a surgeon or doctor and she what other options they suggest.
+1

Combination approach for old, white scars

Hello, Old scars are harder to improve than those earlier in the healing cycle. For wider white scars, scar revision will probably help. You can always try silicone sheeting and massage for any scar. Light treatment are probably a waste of money though.
+1

Options for old white scars

The reason you do not find a lot of experts for hypopigmented (white) scars is that there are not a lot of viable treatments. We do not believe that Fraxel treatments will help at all and think that the only possible viable solution for you would be some form of surgical revision. While a surgical revision may be time intensive and still leave linear scars, it may get rid of the white skin that is bothering you. Best to contact a plastic surgeon in your area for a consultation. Good luck.... more

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