What Treatments Are Suitable for Smooth White Scars Like Hypopigmentation?
Doctor Answers 4
Scar treatments generally best for dark scars
Hypopigmented (light, white) scars are difficult to treat. In general, we have lightening creams and lasers that can lighten dark scars, but we don't have any good treatment to add color back to a scar that's lighter than the surrounding skin. If you have hyperpigmented skin around the scar, you might be able to treat that skin to make it blend with your scar better. Treatment also depends greatly on the type of scar (surgical, traumatic), location of the scar (face, legs, etc), and the size of the scar.
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Management of scars and options
In general, there are alot of options available when it comes to scar revision; sunscreen, camouflage make-up, topical medications/creams/bleaches/peeling agents, silicone gel or sheeting, microdermabrasion, chemical peels, collagen injections, subcutaneous fillers (fillers, grafts, implants), tattoo, dermabrasion, laser resurfacing/ablation/treatment, scar revision surgery, etc. These can be administered by the patient, nurse, and/or doctor.
It is generally advised to await for scar maturation prior to proceeding with scar repair. This may take up to two years from the time of the injury.
Treatment of darker complexions: olive (mediterranean descent), hispanic, asian, black, etc. has a higher risk of post-operative hyperpigmentation (darkening or blotchiness) and erythema/hyperemia (redness) when compared to a fair complexion (typically northern european). I oftentimes will try a test area to asses an individual's responses to healing. In some darker skin individuals, I have found that I get a better response with dermabrasion. Again, I recommend performing a test patch to assess the individual’s response to treatment. Multiple treatments may be required and will have to be spaced at least 4 months apart. It is extremely important that you avoid sun exposure with any technique post-operatively. Dark complected individuals are ideal candidates for the skin roller techniques.
In some cases, I recommend the CO2 Laser or IPL treatments. Other lasers are available. The procedure takes about 1 hour and is performed on an outpatient basis. Additional treatments may be required.
There are risks to crossing the street or flying in an airplane and, of course, there are risks to any surgical procedure. These risks can occur regardless of surgeon or technique. These include but are not limited to: infection, discomfort, wound breakdown, hypertrophic scar formation, unfavorable healing, irregular pigmentation (darkening or lightening), prolonged redness, need for secondary surgical revisions, and inabiltity to guarantee a specific cosmetic result.
This is a difficult matter to assess without the benefit of an exam or photos. In general, treatments for scars include dermabrasion, topical creams, laser therapy, and excision. Topical creams like Retin A can exfoliate the skin and stimulate new collagen formation. This will probably not dramatically improve a hypopigmented scar, but is unlikely to make it worse. Dermabrasion will resurface an area, but will not entirely eliminate scars. Laser therapy will depigment a scar and decrease redness, but is unlikely to help a hypopigmented smooth scar. My first choice would be Retin A. Then more invasive treatment could ensue if necessary.