Scar tissue forms as your body heals from a dermal injury. Although you may experience minor cuts and injuries, not all will become scars. For a scar to form, the wound must go deep enough to harm the inner layers of the skin (the dermis). When we injure the deeper dermal layers, our cells make collagen and fibrous tissues to repair the wound. Scar formation occurs as a result of the fast-growing cells that close up the site of the injury. Unfortunately, the new tissues holding the skin together will be thicker and less flexible, resulting in a jagged or raised appearance.

There are many different types of scars, including:

KELOID SCARS

This type of scar is the result of an overly aggressive healing process. They often extend past the original injury site. As time goes on, they may impede movement. More invasive measures are usually used to remove or decrease the appearance of these scars. Treatment may include surgical removal of tissues, steroid injections, laser treatments, or silicone sheets to flatten the scar. Some smaller keloids can be treated by a freezing technique using liquid nitrogen (also known as cryotherapy). A keloid scar may be prevented with pressure treatment or gel pads at the time of the injury. Keloid scars are more common in people with a darker skin type.

CONTRACTURE SCARS

Contracture scars, or burn scars, are more severe and often impair a person’s ability to move. They drastically tighten the skin and often go deeper than the dermal layers, affecting muscles and nerves. Therapy and other medical treatments are often required to help the body heal during its recovery process. In some cases, treating severe burns quickly can help effectively prevent severe scarring.

HYPERTROPHIC SCARS

A hypertrophic scar is similar to a keloid scar, often raised and red. However, hypertrophic scars do not extend the boundaries of the injury. Treatments for hypertrophic scars are often the same as those for keloids.

STRETCH MARKS

Stretch marks often develop as the skin expands or shrinks quickly, causing minor damage to the connective tissues underneath. Usually, this occurs during pregnancy, puberty, due to weight gain, or even during some weight loss programs. Stretch marks typically appear on the breasts, stomach, thighs, and upper arms.

ACNE SCARS

Severe acne can often leave behind significant scarring. There are many types of acne scars – ranging from deep pits to angular or wave-like scars, and even some slightly raised scars. Treatments may vary depending on the type of scar.

There are many options available for scar treatment. Some of the more common scar treatments to encourage healthy skin, decrease the appearance of old scars, and help achieve a more natural look include:

Surgical Removal or Nonsurgical Treatment:
Although there are many nonsurgical options available, there are times when deeper scars need more intensive, invasive treatment. Skin grafts are the more common surgical method for treating scars. A skin graft takes skin from another area of the body and replaces the damaged skin. This is more common for those with severe burn scars or a scar that impairs function. Surgical scars are often removed similarly. We recommend waiting at least one year before making any decisions involving invasive measures for scar treatment, as a lot of scars fade and become less noticeable over time.

Laser Treatment:
Laser treatment can prevent a raised scar from forming after surgery, reduce scar pain and itch, and increase your range of motion if a scar limits movement; it can even improve the appearance of stretch marks. These treatments can also make a scar less noticeable, but they cannot get rid of a scar. When you have laser scar treatment, you replace one scar with another less noticeable scar.

A series of laser treatments is recommended to give a patient long-lasting results and the most improvement. To give patients the best results, Dr. Dima Ali often uses more than one treatment for scars, such as injecting fillers.

Injections:
Steroid injections help treat raised scars. They are often used alone but can also be paired with other options. Other injections may include collagen fillers or Botox® to help treat pitted or deep scarring. However, these options are not permanent.

VISIA® Skin Analysis

VISIA® is a unique imaging technology that scans your skin and captures critical visual information using multi-spectral imaging and analysis, which helps discover practical ways to improve scars and skincare concerns. It also saves money by allowing you to focus on the areas of most need. With VISIA®, you can better understand your skin rejuvenation goals. VISIA® allows Dr. Dima to recommend customized treatments and products based on detection and overall evaluation to improve your skin’s glow, look, and feel.

LASER RESURFACING

Laser resurfacing uses a laser to send brief pulses of energy absorbed by water and other substances in the skin. The heat from this energy vaporizes thin skin sections, layer by layer, removing unwanted scarring, wrinkles, and more. New, fresher skin will then grow in its place, revealing a more youthful appearance. This procedure promotes natural collagen production for a healthy healing process and smoother skin.

Laser resurfacing is an effective treatment for superficial scars caused by acne, surgery, or trauma.

CHEMICAL PEELS

Chemical peels improve the texture and appearance of the skin by sloughing off the outer layers. This solution works by reacting with the upper layer of the skin to efficiently dissolve the bonds that bind surface cells to the skin, ultimately revealing smoother, healthier skin underneath. Depending on the type of peel, superficial peels exfoliate the skin and can help clear acne, while moderate and deep peels can help reduce scarring.

BELLAFILL®

Bellafill® is a revolutionary new treatment for moderate-to-severe acne scars. It’s an FDA-approved 5-year filler that works with your body, helping it produce more collagen and fill in the lost areas from those pesky marks on your checks! The PMMA cells help replace the lost collagen from the treated scars. The effects are immediate, so you never wait long before seeing beautiful results.

SCULPTRA® AESTHETIC

Sculptra® is a versatile injectable biocompatible filler composed of poly-l-lactic acid. It can create volume and stimulate collagen production, making it an ideal choice for treating certain acne scars. Sculptra® also can gently stretch the skin’s surface, which minimizes any appearance of atrophic scars left behind following surgery or other trauma, such as animal bites or burns that may have caused permanent scarring on your body. Most patients require two sessions for this treatment, with additional treatments being highly recommended in more severe cases, requiring up to three sessions if necessary.

ONABOTULINUMTOXINA (BOTOX®)

Sometimes, the skin around the acne scar puckers. Injecting Botox® relaxes the surrounding skin, which may improve the appearance of an acne scar. Results are temporary, so repeated treatments are needed to maintain desired results.

MICRONEEDLING

Microneedling is a skincare technique that uses tiny needles to puncture the surface of your skin. The process produces more collagen, which helps you get smoother-looking and feeling skin by filling in fine lines, wrinkles, and scars from past injuries. Microneedling can also be used for:

• Burn scars
• Acne scars
• Surgical scars
• Melasma
• Sun damage
• Stretch marks
• Sagging skin
• Large pores
• Hair loss

Microneedling is most effective with depressed scarring rather than raised scarring. Because microneedling helps the skin produce collagen, it lifts the depressions in the skin. Raised scars are often a sign of excess collagen in that area.

Microneedling is also considered one of the safest options for men and women with darker skin tones (compared to other minimally invasive treatments such as laser therapy). Microneedling is also generally safer for people with thinner or more sensitive skin.

No. Unfortunately, scars cannot be removed permanently. Once a scar becomes permanent, a variety of treatment options can be used to remove the outer layer of damaged skin, decreasing the appearance of scars. These options are more for scar revision, smoothing the skin, improving skin tone, and helping reduce noticeability.

When you first notice an injury to your skin, there are a few steps you can take to prevent the potential scarring. Scars may often appear due to poor aftercare or elemental exposure. When you are injured first:

1. Always clean the cuts, scrapes, or other skin injuries as soon as possible: Gently wash the area with a mild soap and warm water to remove debris and keep out germs.
2. Use petroleum jelly to help the healing process and prevent the development of thick scar tissue: Petroleum jelly keeps the wound moist and prevents scabbing. Scabbed wounds often take longer to heal and can leave behind a larger scar. As long as the wound stays clean, there’s no need for antibacterial ointments.
3. After cleaning the wound and applying ointment, protect the injury with an adhesive bandage: If you have an adhesive allergy, try using gauze sheets with paper tape.
4. Clean and change the bandage daily to prevent infection. If stitches are needed, follow your doctor’s advice for wound care and discuss treatment options once the stitches have been removed.
5. Use sunscreen! Protecting your skin from sun damage is important for your health, but also in preventing scar discoloration (which can make them more obvious). Always use a broad-spectrum sunscreen with a higher SPF and reapply frequently!