Is there anything than can be done to correct white scars that are lighter than my skin color?
What Can Be Done for White Scars?
Doctor Answers 10
White scars can be revised or camouflaged with permamanent make-up
All "scars" are white, as there is an absence of the melanin pigment producing cells in scar tissue. If the scar can be made smaller/less wide by a scar revision, this will improve appearance. To "cover" the white color, camouflage tattooing works quite well. This done by permanent makeup tattooists that have special training in this technique. The color of your skin is "matched" to a tattoo pigment that is tattooed into the scar tissue to replace the "lost color" due to the lack of melanin.
Treatment for white scars and hypopigmentation
Some white scars can respond to UVB laser treatment which can help stimulate dormant melanocytes to produce more pigment hence making the white scar look less white.
Effective Treatment for White Scars and Other Causes of Hypopigmentation
Ivory white scars, as well other types of loss of pigmentation problemw often result from prior injury or treatments, such as trauma, scalpel surgery,lasers and chemical peels. They may be due to certain infections and inflammatory processes that damage the pigment producing layer of our skin. Loss of pigment, or hypopigmentation, from any cause tends to be notoriously difficult to treat with any current modality.
I have had some success with repigmentation, regardless of the prior cause of the pigment loss, using a combination of medical microneedling followed immediately by the application of tyrosine solution. Tyrosine is the naturally occurring enzyme that stimulates melanin production in our skin. (It is the enzyme whose function we try to suppress with agents like hydroquinone when treating overpigmentation or HYPERpigmentation).
Successful treatment of hypopigmentation in this fashion usually requires a series of generally three to four (sometimes more) treatments spaced at four to six week intervals.
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White Scars: Treatment of Hypopigmentation
White scars are characterized as scars that are hypopigmented whereby the pigment is lost. These scars are very difficult to treat as the process will have to stimulate the production of melanin in the area. This should be distinguished from vitiligo, which is an immunologic destruction of melanin by the body.
Depending on the location of the scars, the width, and the quality of the underlying tissue, the scars can be improved with specific lasers to stimulate pigmentary deposition, sun exposure, and excision.
The particulars of treatment can be managed by an experienced physician but should include a combination of surgery and laser/chemical peel treatment. Typically, these scars are much harder to treat than hyperpigmented dark scars.
Treatment for white scars
We have a couple different suggestions for white scars. Although this type of scar is very difficult to treat these are worth checking into.
- If you scar is small and isolated, then you may want to consider a surgical revision to the scar. In this procedure a plastic surgeon would remove the light scar tissue and pull the skin together in the area. You may be left with a small light line, but perhaps in many cases, much less noticeable than what you are describing.
- The Excimer laser. This type of laser is effective for bringing back pigment to the skin. It is more commonly used for Vitiligo, but is an option for repigmentation depending on the scar itself.
Eximer laser or IPL purple
If these are actually white areas of hypopigmentation and not true scars, this would be the most effective modality.m This wavelength (320) is the wavelength which is most effective for psoriaisis and also seems to stimulate the melanoctyes to make pigment. This treatment is totally painless and rapid.
There is also some preliminary research that peperine, an ingredient in black pepper may also stimulate pigment production.
If these are true scars secondary to tissue injury, my suggestion would be a Fraxel device.
White scars and Laser treatments
I have had some success with the Fraxel Re:store to treat hypopigmented scars. It requires multiple sessions and can slowly improve the pigmentation problem. The goal is to stimulate melanocytes to produce melanin. Again, this is usuallly for flat white scars and sometimes striae (stretch marks, as from pregnancy, weight loss, etc.).
White scars can be tattooed
If the scar is fine (and doesn't require re-excision and closure) and the only objection is the white of the line, they can be tattooed with a pigment to match the color as closely as is possible. If the line is wide, uneven, or depressed, it will require re-excision and a better closure.
Maybe scar revision for white scars
If the scars are wide and noticeable, scar revision can remove these "wider" portions and make them less noticeable. As you can see by the variability in the answers here, scar treatment really depends upon exactly how the scars look, their shape and where they are. You need to have them properly evaluated to know your best course of action.
John Di Saia MD