The Surgical Treatment of the Self-Harm (Self-Inflicted) Arm Scars


Harming his or her own body by razor blades, glass or other sharp instruments is a behavior in which cultural, social and psychological factors play a role on the basis. The behavior of cutting himself with a razor blade is not in itself a psychiatric disorder. Usually, it is regarded as a symptom associating some psychological problems. This behavior pattern may improve over time when the underlying psychological problem is treated or self-improved. It is observed especially in adolescent and young adult males and females. This type of behavior can be seen in individuals of all types of socio-economic and socio-cultural levels of the society, from street urchins to university students. This problem is not unique to just one culture or country, it is observed allover the world.
For instance, it has been reported that the incidence of self-harm cases in the USA is 4% and is increasing further.
The multiple scars due to self harm with a sharp object are observed especially in the arms and chest wall and they are lifelong permanent and difficult to hide. These scars have a unique view and are easily recognized by the people.
Even if these people are now psychologically stabilized and have left this behavior type, they may feel a a lifetime shame, guilt, and regret due to the scars left in their bodies. Moreover, they are stigmatized (stamped) and socially excluded by the society. An individual who has done such a thing before, and is now fully improved and leading a normal life, has difficulty in explaining these scars which suggest negative features in his career and social life. These scars are encountered as a nightmare in the periods of making friends, marriage, entering a new job, and entering a new social environment. A person who is married and has become a mother or father is worried about how to explain the scars on his arms to his children.
The most important difference between socially unaccepted self-harm scars and the other socially accepted scars such as an operation scar or burn scar is that they are side by side and more than one (multiple).
There is no way to get rid of these self-inflicted multiple scars using classic treatment options such as dermabrasion, scar revision or laser. Sometimes tattoo is applied on the scars as a camouflage, but the result is often even more tragic.


An operation method developed by Dr. Cengiz Acikel and his colleagues in this regard has been published in the Journal of the American Plastic and Reconstructive Surgery, in 2005, under the title “Camouflage of self-inflicted razor blade incision scars with carbon dioxide laser resurfacing and thin skin grafting” and entered the international medical literature. The principle of this treatment method is to remove the 50-150 micron top skin layer of the area of the scars, including the normal skin between the scars, with the help of laser or dermabrasion tool, and to cover the created raw surface with very thin skin ( 0.2 mm-thick) patches (grafts), taken from anterior or lateral thigh . As the applied skin patch covers over and camouflages the colour difference between the underlying scars and the normal skin, the scars can no longer be seen individually, and that area is seen in only one color – but in a little different color than the surrounding normal skin. While the difference of color tone between the operative field and the normal skin is more remarkable in the first months, it gradually decreases after the 6th month, and after a year it becomes mostly seen only if carefully viewed. The most important advantage of this method is the elimination of the typical image of self-inflicted scars that are unique and easily understood and/or the transformation of them into socially acceptable, less remarkable, and more innocent scars such as burn scars.
The surgery is performed under local or general anesthesia, according to the size of the area to be treated. The patient can go home the day after surgery. The surgery field remains dressed for 10-14 days. Afterwards, the surgery field should be protected from mechanical trauma and from the sun for at least 6 months. And, the skin-removed area self-recovers in one week, and becomes unremarkable in about 1 year. The skin graft donor area heals spontaneously in two weeks and a slight acceptable scar remains after 1 year. 
Article by
Turkey Plastic Surgeon