The Issue of Unsightly Scars
Scars occur at sites where a full thickness injury has taken place. This includes surgical incisions, lacerations, deep burns and other types of wounds. Some scars are thin, light in color and barely noticeable. Others, such as keloid and hypertrophic scars, can be wide, raised and a real source of concern for some patients. These unsightly scars, examples of overhealing, are more common in certain skin types and involving certain areas of the body. Frequently they are associated with symptoms such as itching, pain, and burning. It is important to remember that most scars improve over time and typically take at least one year to attain their final appearance.
As a plastic surgeon, I believe it is much more efficient to prevent poor scars than it is to treat them. Prevention includes sound surgical technique and adequate prevention of infection. Tension on the closure can be decreased by taping incisions and by using dissolving sutures which remain in the wound for a minimum of six weeks. Patients are frequently encouraged to massage their scars to make them softer and flatter. Even with the best efforts to prevent them, problem scars can still occur.
Numerous techniques have been used to prevent and treat unsightly scars. The most commonly used methods are surgery, silicone dressings, pressure, and corticosteroids. Other methods include radiation, cryosurgery, lasers, vitamin E, and other topical medications. Often treatments are combined to decrease the likelihood of recurrence.