Scar removal or scar revision is one of the most common requests of patients in our clinic. Dr. Leo employs different techniques to minimize the appearance of scars, depending on type and severity.
New scars less than 6 months old are generally considered as immature scars. These scars usually appear slightly red and may be raised. At this stage, scar creams are prescribed as a first-line treatment to reduce the appearance of scars. The aim is to wait for the scar to mature first, and based on its final outcomes, the next course of action is decided.
Mature scars refer to scars after 6 months from the initial injury. Mature scars, which are red or hyperpigmented, are treated using a combination of creams and QsNd:YAG laser therapy. The laser helps disintegrate melanin deposits, resulting in lightening of the scars.
For mature scars that are widened, surgical scar revision is recommended. This widened or stretched scars are often pale in colour and may even be depressed in shape. The procedure involves excising the scar entirely and stitching the resulting incision via loupe magnification and using the smallest possible suture for the best cosmetic outcome. The procedure is performed under local anesthesia. Stitches are removed as soon as possible to prevent “tram-track” marks.
Hypertrophic Scars and Keloids
Hypertrophic scars and keloids are the most common problems that we treat. Hypertrophic scars and keloids look similar to each other in the sense that both are red and raised. However, hypertrophic scars develop soon after an injury, while keloids may develop a few years after the said injury. In terms of treatment, both conditions are treated first using topical silicone creams and monthly steroid injections. Severe cases are usually surgically removed or revised. Radiotherapy may be employed to control the progression of the scars.
Contracture scars are those that form in the joints, restricting function and movement. These scars need to be surgically removed. Post excision, the soft tissue defect may be reconstructed using a combination of skin grafts or flap surgery, and skin resurfacing treatments.