Scars: Types, Treatment and Results

Scars – are a normal healing process for damaged tissue. It fills in defects in the skin, mucous membranes, organs, and tissues. Skin scarring depends on age, type of injury (acne, piercing, burn, or surgical intervention), skin type, location on the body, and the depth and size of the wound. The scar formation process can take 12 to 18 months.

What are the different types of scars?

Normotrophic scars – are the most common type of scar, where the scar goes through all the stages of wound healing correctly. These scars flatten and become less noticeable as they heal;
Keloid scars – are thick, irregularly shaped scars that grow at the site of the wound and spread beyond the wound. They are often red or darker in color than the surrounding skin. Keloid scars are made up of collagen, which the body produces when a wound heals. These scars can occur anywhere on the body. However, they are more common on the chest, back, shoulders, and earlobes;
Hypertrophic scars – are similar to keloid scars. However, they only grow within the boundaries of the wound and do not spread beyond it. These scars may also appear red, thick, and raised;
Atrophic scars – are round, indented, and usually small in size. These scars can form when collagen synthesis is suppressed and inflammation is less than normal. The bottom of the scar can be of various types: concave, flat, or V-shaped.

Scar removal methods

Local treatment

Local treatment includes special dressings and gels that inhibit the growth of scar tissue, soften and smooth the scar tissue. This treatment is usually more effective when the wound is healing or for mild, newly formed scars. Most people need to use topical treatments for several months.

Injectable substances

Injectable substances are effective in treating hypertrophic and keloid scars. They can reduce the size of the scar and reduce pain, itching, and irritation. Most people need several injections.

Types of injections:

Corticosteroid injections: work by reducing collagen formation in the skin, which can reduce the size and appearance of scars;
Cryotherapy: liquid nitrogen or argon gas freezes the excess scar tissue. Cryotherapy is usually only used to treat small scars;
Hyaluronic acid filler injections: can help reduce the appearance of scars beneath the skin's surface. They are effective in treating hypotrophic scars (acne scars).

Skin resurfacing

Skin resurfacing procedures are performed by removing the top layers of skin. The procedure helps reveal smoother, undamaged skin, which can improve the color and texture of scars.

Types of skin resurfacing:

Chemical peel: removes the top layer of dead skin cells. Peels are best for small, mild scars on the face.
Light or laser therapy: These procedures use light or heat to rejuvenate the skin or body and remove minor skin imperfections. Laser skin resurfacing can also reduce the irritation caused by scars and help scars regain their normal skin color.
Skin lightening: Skin lightening agents can reduce the color of scars and even out skin tone.

Surgical scar removal

Sometimes surgery is necessary for large, severe scars, especially if the scars cause pain or interfere with movement. During the operation, the doctor removes the scar and the wound is sutured layer by layer with special sutures.

Detailed information about scar removal

What happens before the operation?

Your doctor will give you specific instructions on how to best prepare for the planned treatment. It is recommended to avoid taking aspirin, anti-inflammatory drugs, or anticoagulants a few days before the surgery, as they may increase the risk of bleeding and bruising. It is also important to inform your doctor if you are allergic to any medications, especially local anesthetics.

What happens during the operation?

The doctor will mark the planned incision site with a special skin marker. The operation can be performed under local or general anesthesia. The doctor will then make the incision using a scalpel or electrode. Depending on the type and size of the scar, the doctor may perform scar removal together with local tissue plastic surgery. After scar removal, the wound is sutured layer by layer with special sutures. During the operation, you may feel slight discomfort and pressure in the incision area.

What happens after the operation?

After the operation, the doctor may monitor you for up to 15 minutes to ensure that you do not experience any side effects, including dizziness, nausea, or an allergic reaction. If you had local anesthesia during the surgery, it won't make you tired or sleepy, so you can drive yourself home. If you had general or regional anesthesia during the surgery, it's recommended that you stay at the clinic for further observation and treatment.

After the operation, it is recommended:

Resting;
Wound dressing;
Do not wet the wound until the stitches are removed and for one day after the stitches are removed;
Remove the stitches after 10-14 days, if stitches are used;
Medication for pain relief.

The doctor will also schedule a follow-up appointment approximately two weeks after the operation to remove the stitches and evaluate the results of the treatment.

FAQs about scar removal

What are the side effects or complications of the operation?

Redness, swelling, and pain at the site of the procedure;
Bleeding;
Postoperative seroma;
Prolonged wound healing;
Infection;
Nerve damage;
Hypopigmentation or hyperpigmentation of the skin.

What is the healing period after the procedure?

The healing period depends on your overall health and the type of treatment. The results of local treatment may take several months to appear. Most people need several injections or scar revision procedures to achieve the desired result. Surgical scar removal is likely to take up to 2 weeks to heal. During this time, you will be able to carry out your daily activities, but you may experience slight discomfort. To promote faster healing and avoid infection, you should follow your doctor's instructions.

It is important to remember that scar removal will most likely not completely remove the scars. Discuss your treatment goals with your doctor to ensure that you have realistic expectations about the results.