Skin Care Scar Treatment

While no scar can be removed completely, plastic surgeons can often greatly improve the appearance of a scar. Many treatment options are available. Because some scars become less noticeable with time, it is sometimes best to up to a year after an injury or surgery before you decide to have your scar treated. Your physician at The Centre, P.C. can examine your scar and guide you.

While insurance doesn't normally cover scar revision, if surgery improves your ability to function, the procedure may be partially covered.

Types of Scars

Keloid Scars. Keloids are thick, puckered, itchy clusters of scar tissue. They grow beyond the edges of a wound or incision and are often red or darker in color than the surrounding skin. Keloids are formed when the body continues to produce collagen (a tough, fibrous protein) after a wound has healed.

Rather than surgery, keloids may be treated with steroid injections, which reduce redness, itching and burning, and sometimes shrink the scar. Because keloids have a stubborn tendency to recur, your surgeon may combine the steroid injections with direct application of steroids during surgery or radiation.

Although they can appear anywhere on the body, keloids are most often found on the breastbone, earlobes and shoulders.

Hypertrophic Scars. Like keloids, hypertrophic scars are thick, red and raised. They differ, however, in that hypertrophic scars remain within the boundaries of the wound or incision. Steroid injections may help. If not, surgery can be performed. The surgeon may continue to treat you to ensure that the scar does not reform.

Contractures. When a large area of skin is damaged due to burns or other injuries, the edges may pull in, causing a contracture. Contractures can restrict normal movement by affecting the adjacent muscles and tendons. To treat the contracture, your surgeon may cut out the scar and replace it with a skin graft or flap. Z-plasty (described below) may be successfully used, as well as tissue expansion.

Facial Scars. There are several options for facial scars. One method is to simply cut the scar out and close it with tiny sutures, leaving a thinner, less noticeable scar. Another is the Z-Plasty technique (described below) for scars that lines across the natural creases of the face. Dermabrasion is a technique in which the top layers of the skin are scraped, leaving a smoother surface but not a complete erasure.

Treatment Options

Z-Plasty. The Z-Plasty technique repositions a scar so that it more closely conforms to the natural lines and creases of the skin, making it less noticeable. It can also relieve the tension caused by contracture.

In a Z-Plasty, the old scar is removed and new incisions are made on each side. These incisions create small triangular flaps of skin, which are rearranged to cover the wound at a different angle. A "Z" pattern results. Z-Plasty is an outpatient procedure and performed under general anesthesia.

Skin Grafts and Flap Surgery. Skin grafts and flap surgery are major inpatient procedures, performed under general anesthesia. Healing may take several weeks or months; a support garment or bandage also may be required for up to a year.

With a graft, a section of skin from one part of the body (the donor site) is removed and used to cover the injured area. Most grafts are successful, but sometimes they do not take. Flap surgery is complex and involves taking not only skin, but underlying fat and blood vessels (and sometimes muscle) to use at the injured site. In general, flap surgery results in a better appearance than skin grafts.

For any of the above types of surgery, The Centre, P.C. recommends the use of the VitaMedica Surgery Program, a comprehensive pre- and post-surgery nutritional supplement system designed specifically for patients undergoing extensive surgical procedures.

Laser Treatment. The pulsed-dye laser has been showing some signs of success in optimizing the appearance of surgical scars. Treatment usually begins immediately after suture removal and is repeated monthly. The laser treatment is not suggested for persons with darker skin, since it may cause adverse changes in skin pigmentation.

Silicone Gel Sheeting. Silicone gel and silicone gel sheeting are treatments that have proven effective for improving the appearance of both fresh and long-standing scars. Silicone gel is a thick liquid applied to the affected area. Silicone gel sheeting is a treated, fabric-like sheet that covers the scar.

Studies have shown that the gel and gel sheeting, applied for 12 to 24 hours per day for at least two months, resulted in significant improvement in appearance, as well as lessening the recurrence of hypertrophic scars.

Another treatment shown to be effective in improving the appearance of scars, especially stretch marks and acne scars, is collagen channeling.

If you are considering treatment for a scar, call or e-mail our cosmetic surgeons at The Centre, P.C. to schedule your skin care consultation. The Centre, P.C. serves patients in Elkhart and South Bend, Indiana, Michiana and the Southern Michigan area, and Chicago.

RiverPointe Medical Building
500 Arcade Ave., Suite 300
Elkhart, IN 46514

Chesterton
810 Michael Drive, Suite K
Chesterton, IN 46304
Toll Free: 800.909.2992
Phone: 219.395.9200
Fax: 219.926.3534