Scar

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Scar
Synonyms	Cicatrix
Pronounce	N/A
Specialty	N/A
Symptoms	Fibrous tissue formation, discoloration, thickening of the skin
Complications	Keloid, hypertrophic scar, contracture
Onset	After injury, surgery, or inflammation
Duration	Permanent, may fade over time
Types	N/A
Causes	Wound healing process
Risks	Infection, repeated trauma, genetic predisposition
Diagnosis	Physical examination
Differential diagnosis	Keloid, hypertrophic scar, dermatofibroma
Prevention	Proper wound care, silicone gel sheets, pressure therapy
Treatment	Laser therapy, steroid injections, surgical revision
Medication	N/A
Prognosis	Generally good, but varies with scar type
Frequency	Common
Deaths	N/A

A scar tissue is a result of injury, which can be due to accidents, surgery, acne. Scar tissue is usually discolored or differently colored and textured compared to the surrounding skin. There are many ways to manage a scar in Aesthetic medicine and Plastic surgery.

There are several ways to improve the appearance of scars:

• The scar may be removed completely and the new wound closed very carefully.
• Dermabrasion involves removing the upper layers of the skin with a special wire brush called a burr or fraise. New skin grows over this area. Dermabrasion can be used to soften the surface of the skin or reduce irregularities.
• A cosmetic laser may be used to soften the surface of the scar, and stimulate new collagen growth within the scar.
• Very large injuries (such as burns) can cause loss of a large area of skin and may form hypertrophic scars. These types of scars can restrict movement of muscles, joints and tendons (contracture). Surgery removes extra scar tissue. It may involve a series of small cuts (incisions) on both sides of the scar site, which create V-shaped skin flaps (Z-plasty). The result is a thin, less noticeable scar, because a Z-plasty may re-orient the scar so that it more closely follows the natural skin folds and releases tightness in the scar.
• Skin grafting involves taking a thin layer of skin from another part of the body and placing it over the injured area. Skin flap surgery involves moving an entire, full thickness of skin, fat, nerves, blood vessels, and muscle from a healthy part of the body to the injured site. These techniques are used when a large amount of skin has been lost in the original injury, when a thin scar will not heal, and when the main concern is improved function rather than improved appearance.
• Tissue expansion is used for breast reconstruction. It is also used for skin that has been damaged due to birth defects and injuries. A silicone balloon is inserted beneath the skin and gradually filled with salt water. This stretches the skin, which grows over time.

Laser scar revision

Laser scar revision is an effective method for treating a wide range of scars that improves skin texture and pigment as well as functional aspects. For acne and some surgical scars (see also Acne Scars Treatment), fractional skin resurfacing can effectively treat textural and pigment concerns. Intense Pulse Light or IPL can also be used to decrease pigmentation and vascular effects. Scars caused by burns and other traumatic injuries are more complicated in nature and can negatively affect the quality of life due to disfigurement, pain, bleeding, pruritis (itching) and restricted range of motion. Fractional laser resurfacing has been proven to effectively treat such scars and provide consistent and significant functional improvement as well as measurable cosmetic benefits.

Acne scar treatment

Persistent and untreated inflammatory acne lesions may cause various degrees of permanent scarring. Laser resurfacing is one of the most effective ways of reducing and clearing acne scars. Available laser treatments include ablative and non-ablative skin resurfacing. The choice of treatment depends on the type of scar (box, rolling, or icepick) and on the patient’s preferences and expectations in terms of number of treatments and downtime.

• Ablative resurfacing: ideal for patients seeking an amazing improvement in a single session.
• Non-ablative resurfacing: ideal for patients who prefer a milder treatment approach that requires several treatments but has less downtime.

Laser resurfacing

Laser resurfacing is a laser surgery technique that disassociates molecular bonds. It is used for the treatment of wrinkles, solar lentigenes, sun damage, scarring (acne scars and surgical scars), stretch marks, actinic keratosis, and telangiectasias. It can be combined with liposuction to help tighten and smooth over the new contours after removal of excess fat. Resurfacing can be ablative, which vaporizes tissue and creates wounds, or non-ablative which keeps the skin intact. When compared to a chemical peel, dermabrasion or other forms of treatment, a laser allows the surgeon to customize the surgery not only for each patient but also to each area of the face. Laser resurfacing is usually done with a 2940 nm Er:YAG laser or a 10,600 nm CO₂ laser. Complete resurfacing was first done with a CO₂ laser. Both Erbium and CO₂ are used to treat deep rhytides, sun damage and age spots. Through the heating of the deep dermis, fibroblasts are stimulated to form new collagen and elastin helping to bring increased turgor and thickness to the skin. A variety of modes have been developed including Nd:Yag lasers and a plasma device.

Fractional laser

Fractional Laser photothermolysis (FP) is a form of laser based skin resurfacing commonly used now, with several devices on the market. A fractional laser delivers tiny pinpoints of laser light to a part of the skin. Hundreds or thousands of laser pinpoints may be used per square inch, leaving healthy skin between the ablated areas, to allow more rapid healing and lower risks. FP may provide similar results to CO₂ laser resurfacing without risk of scarring or significant downtime. Complications observed in a study of 961 treatments included acne and herpes outbreaks and were temporary.

W8MD's Scar Revision Laser

Using the advanced, non-ablative skin resurfacing called ResurFX technology, W8MD weight loss, sleep and medspa offers scar treatment for both acne and other scars.

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