Scar Types & Solutions

by

Scars: Fibrous Tissue - Collagen (same protein as the tissue it replaces)

TYPES
  • Hypertrophic
    • Your body over produces collagen creating a "raised" scar (red raised lump)
    • Usually appears within 4-8 weeks after wound closure or infection
  • Keloid
    • Grows beyond site of injury
    • Mores serious form of Hypertrophic scarring - can potentially grow into benign tumorous abnormal mass of tissue (inert masses of collagen - not cancerous)
    • Most common in dark skinned people
    • Most common on the shoulders and chest regions
    • Common with acne, accident, body piercings or surgery
  • Atrophic
    • A recessed or sunken scar
    • Loss in the underlying support to the skin (fat and muscle)
    • Common with acne, Chickenpox, MRSA, surgery or accidents
  • Stretch Marks
    • Rapid stretching of skin, tears of dermis
    • Common with pregnancy, quick and significant weight gain, growth spurts, or tension during a healing process (near joints)
    • May generally improve in appearance on its own after a few years
    • Potentially attributed to an overproduction of your body's steroid hormones

Preventative Measures
  • Avoid direct sunlight due to hyper-pigmentation (6 months to a year)
    • Sunblock with Zinc Oxide
    • Very important for Facial Rejuvenation procedures
  • Lotion/Moisturizer (ex. scent free body lotion) - CoCo Butter for stretch marks
  • Massage - start a week after sutures have come out and all lesions have closed/healed
    • Massage down the length of the scar in all directions - this assists with relieving tension and lumps
  • Drink Water - H2O is a primary molecule essential for cell replication
  • Suture Technique - Dr. Gorman has performed personal studies and has concluded that occasionally non-dissolving sutures help prevent inflammation and excessive scar formation by your body. Also, Dr. Gorman uses his own technique for each procedure ranging from "mattress suturing" to lower epidermis and dermis layer suture techniques of the skin that can assist in lowering tension of wound closures.
  • Sensitive Skin - avoid any medications or tapes that may irritate skin further and do not use any items that you are allergic to. Make sure your doctor is aware of all your allergies

Treatments
  • Collagen Induction Therapy
    • "microneedling" or "skin needling"
  • Chemical Peels
    • A controlled breakdown of the epidermis (outer layer of the skin)
    • Those susceptible to Keloid formation, active infections or are dark skinned should proceed with caution
    • The strength and type of chemical peel will depend on the depth of the scar (generally used to treat acne scarring) will determine the type of chemical peel
    • Call our Skin Care Clinic for more details (512) 732-3000 or visit their Chemical Peels page
  • Filler Injections
    • Fillers of collagen, fillers that promote collagen production, and Artefill
    • Dr. Gorman specializes in Sculptra Aesthetic (facial fillers)
    • Other filler options that we carry:
      • Juvederm
      • Restylane
      • Perlane
      • Belotero
      • Radiesse
    • Risks vary based on filler
    • For additional filler brands/options give us a call (512) 454-6733
  • Dermabrasion
    • Occasionally involves local anesthetic and/or sedation
    • The removal of the outer superficial skin layer using specialized equipment
    • Call for additional details (512) 454-6733
  • Laser Treatment
    • Generally used to treat Hypertrophic or Keloid scars as well as fine wrinkles
    • In order to achieve pliability, texture and redness for Keloid or Hypertrophic scarring several treatments are required
    • Similar to Dermabrasion, lasers are used on the skin to a specific depth
    • Also assists with Atrophic and Acne scars
    • Ablative (more invasive and risky) and Nonablative (minor) Therapy options
  • Radiotherapy
    • Low dose, superficial radiotherapy
    • Usually used as a preventative measure for Keloid and Hypertrophic scarring
    • Only used in severe cases due to risks and long term effects
  • Semiocclusive Ointments and Pressure Dressing
    • Used as a preventative measure as well as reducing appearance of current scars
    • Silicone Scar Treatments are sometimes recommended
    • Pressure Dressing assists with burn and Hypertrophic scars
    • Constant pressure to surface blood vessels, and softening and flattening of scars
    • Elastic/Gauze materials used - Dr. Gorman uses pressure treatments due to its other helpful side effects, like its assistance with blood flow, motion restrictions, and minimal lesion disturbance.
  • Steroids
    • Generally softens and flattens Keloid and Hypertrophic scars
    • Injected directly into the scar with minimal side effects since little is absorbed into the blood stream
    • Thins scar tissue
    • Treatments can be administered in 4-to-6-week intervals
    • Topical steroids are generally ineffective
  • Surgery
    • Scar revision involves surgical removal of scar and re-suturing
    • Layered closure with gentle technique
    • Cutting the scar tissue out
    • Primary Intention Treatment (generally excluding drains, and involves a combination of epidermis and dermis suturing reducing total penetration of epidermis) - multi layered closure
    • Combination treatments with surgery have proven to assist severe to moderate Keloid and Hypertrophic scars
  • Vitamins
    • Topical Vitamin E and Onion extract can worsen scar appearance
    • Vitamin C helps fade dark scar pigmentations
    • Sterile and natural oils moisturizing the skin epidermis (outer layer of skin), id generally helpful
  • Moisturizers
    • Keeps the skin moist and elastic
  • Sunscreens
    • Prevents hyper-pigmentation of scars
    • Assists in keeping the skin moist and elastic
    • Prevents UV damage of skin

Article by
Austin Plastic Surgeon