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Unsightly scars and stretch marks, or striae, have presented problems for men and women for centuries. Many people generally consider scars and stretch marks unsightly, disfiguring and unacceptable.
What Causes Scars And Stretch Marks?
Scars form as part of the skin's healing process whenever multiple layers of skin are injured. The injury may be the result of an accident, surgery, a burn or even severe acne.
While the exact cause of stretch marks is unknown, it is thought that striae are the result of your skin's collagen and elastin breaking down under stress. Pregnancy, bodybuilding and weight loss are the leading causes of stretch marks. Stretch marks occur most frequently in areas of mechanical stress such as the breasts, abdomen, thighs, groin or buttocks. In the beginning, stretch marks are red. They turn white as part of the healing process.
In the past, cryosurgery (freezing), excision, steroid injections and the use of topical creams and ointments were the standard of care for the treatment of scars and stretch marks. The results of these treatments range from fair to minimal, with recurrences commonly seen after many of these treatment options.
Scar Removal Laser Treatments (conditions such as acne, surgery, keloids, injury / accidents)
Scar removal, scar revision and scar reduction options by laser and non surgical treatments vary in cost and risk. Laser acne scar removal is highly effective; however, the costs and risks are higher than compared with non-surgical scar removal creams and lotions.
There is a big difference between the lasers now, compared to the CO2, Erbium of the past. The lasers of the past are considered more aggressive and becasue of this, recovery was longer. Unlike the older lasers that burn the surface of the skin and denude the layers, new “Fractionated” laser systems place hundreds of holes in the skin surface that is intermixed with normal skin surface. Recovery is must faster and there is virtually no down time.
We have complied doctors and non-surgical treatment options for the reduction of acne scars, facial scars, burn scars, keloid scars, plastic surgery scars, hypertrophic, scar tissue removal and more.
- Acne scar removal
- Laser scar removal
Acne scar removal
Mild Acne scars disappear over a period of time. But at times, severe scars resulting from acne cysts and nodules can leave a permanent impression on the skin. To treat severe scars, Acne surgery can be resorted to.
A lot of factors need to be considered before resorting to get an acne scar removal surgery done. It has to be done by a well experienced surgeon who has handled such surgeries before. It would also help if you were referred by someone who has experienced good success in treating scars with the help of the surgeon.
Depending on the type and severity of scarring, appropriate scar treatment surgery method could be employed. Some of the widely used treatment surgery methods are discussed below:
- Punch Excision :
Punch Excision involves surgically removing the portion of the scarred portion of the skin. The skin can then be sutured and left to heal by itself. It is used to treat Ice pick scars that do not cover a huge surface area of the skin. The face would be bandaged after the surgery and hospitalization would be a necessity. This Surgery is usually carried out on a local anaesthetic.
- Skin Grafting with Punch Excision :
At times when the scarred skin covers a large surface area of the skin, punch excision needs to be coupled with skin grafting. Punch excision could be performed as discussed above to scrape out the scarred portion of the skin. Since, the scarred skin surface area is large, a skin graft needs to be performed by taking a portion of skin from the body, usually from the back of the ear and replacing the scraped out pit on the skin caused by the excision of the scar.
- Fat Transfer for Scar Pits :
This method is used to treat huge pits left by acne scars. Fat taken from the body is injected under the pit. This can cover the depressions left by the acne scar. However, fat needs to be injected from time to time as the skin has the tendency to absorb the fat into its layers.
Precaution needs to be taken before resorting to acne scar removal surgeries as it opens out the possibility of infections as a result of open wounds. It needs to be done with the hands of an experienced surgeon.
Laser scar removal
Who are the best candidates for laser scar and stretch mark removal?
The patients that respond the best to laser treatment for scars and stretch marks are those with a fair complexion and light pigmentation as well as those with shallow scars or stretch marks.
Note: Patients with a history of Vitiligo, pigmentation disorders, dark tans or dark pigmentation may require an initial skin test for evaluation prior to treatment.
New Laser Technology
Many types of lasers are available, each of which has unique benefits for scar removal.
The CO2 and Er:YAG lasers are best suited for acne scarring. The CO2 is an ablative laser that basically sandblasts the skin away; resulting in some substantial downtime. The Er:Yag is also ablative, but less so than the CO2; meaning that it is less damaging. Many different companies manufacture CO2 and Er:YAG lasers.
Fractionated CO2 and Er:YAG lasers including the Fraxel and fractionated radiofrequency treatments also are very helpful for acne scarring, but they require multiple treatments. Fractionated lasers work by treating a fraction of the skin's surface. These lasers create tiny wounds in the deeper layer of the skin. Each wound is surrounded by untreated skin, helping to repair the treated area via a controlled wound-healing process. Both CO2 and Erbium YAG lasers as well as radiofrequency treatments can be fractionated.
The 585-595-nm pulsed dye laser technology which includes Cynosure and Candela lasers, is often used to treat hypertrophic and keloid scars. These lasers may be used with or without steroid or five percent 5-fluorouracil (5-FU) injections, both which can help flatten scars.
These lasers are considered non-ablative because they do not burn off the skin surface. Instead, they target the tissue under the skin surface and stimulate new collagen growth. There is little downtime with these lasers.
Until recently, African-Americans were not considered ideal candidates for laser scar removal, but times are changing. Certain lasers (such as fractionated infrared lasers) and radiofrequency devices such as Thermage may be helpful in treating acne scars among African-Americans. There is still little that lasers can do to treat keloid scars affecting this population.
The laser's energy stimulates the skin under the scar and causes the fibroblasts in the skin to begin to divide again. It also stimulates the production of collagen. This thickens the skin under the scar until it closely resembles the surrounding normal skin.
Before After
Before After
Do laser treatments work?
Our current laser technology has been shown to improve red or raised scars. Recent studies have demonstrated that laser treatments stimulate the production of collagen and improve the appearance of stretch marks.
Additional studies show that the appearance of stretch marks continues to improve over a period of time ranging from 3 to 6 months after the laser treatment was given. Even those treatments that showed little if any initial improvement showed as much as a 50% improvement at their 6-month
What else can be used to treat scars?
Scarfade and Laserfade are silicone gels that when applied to the skin form a micro-thin layer of silicone on the scar. Both of these products can be worn under cosmetics and are easily tolerated by children. The silicone is thought to moisturize the skin, reduce capillary irritation and allow the skin to return to its normal texture and color.
Complications and Risks of Laser Scar Removal
The most common side effect of laser scar removal is hyperpigmentation or hypopigmentation, both of which can be exacerbated by sun exposure. Infection or allergic reactions are also possible, and can be prevented or treated with medicated ointments, creams and oral antibiotics.
Do laser scar and stretch mark treatments hurt?
Most patients do not require anesthetic. Some patients have indicated that they feel a slight tingling when the laser pulses, or that the laser pulse feels like the snap of a rubber band against the skin.
What should i expect after my treatment?
Results vary from patient to patient and may not be immediate. Results from laser scar and stretch mark treatment are generally progressive and may require multiple treatments. If you respond to the first treatment, your second treatment will usually be as good as the first, and the third treatment will be almost as good. About 70% of patients receiving laser treatments for their stretch marks notice a marked improvement. Newer and shallower stretch marks and scars respond better than older and deeper scars and stretch marks. To enhance the results of your laser treatments your surgeon may recommend the use of tretinoin cream or a glycolic acid cream prior to and after your laser treatments.
What is a hypertrophic scar?
A hypertrophic scar is often confused with a keloid scar. Both tend to be thick, raised and red. However hypertrophic scars remain within the boundaries of the original scar and typically will improve with time. Treatment options include waiting, steroid injections, silicone sheeting, laser treatments or scar revision surgery. Depending on the size and location of the scar, surgery may be performed in the office with local anesthesia or in the operating room under sedation anesthesia.Hypertrophic Scar
What is a keloid scar?
Keloids are thick, hard, raised scars that tend to itch and in some cases hurt. The skin color can be red or darkened causing the appearance of the scar to be worse. Keloids can develop soon after surgery or in many cases months after the initial incident. Keloids can occur anywhere on the body but are more common on earlobes, shoulders and chest. They occur more commonly in darker skinned people, but can occur in any skin type. Keloids will grow outside the boundaries of the original scar, almost like a tumor.
Keloids are often treated with pressure, silicone sheeting and steroid injections. More radical treatments include surgery and in some cases radiation therapy. Keloids are stubborn and can recur, in some cases even larger than before. If you have a keloid and undergo treatment, this may require close observation for long periods of time so that if the keloid does recur it is treated properly early so that scarring is minimal.
