Scar Revision
This procedure is usually performed under local anaesthesia when
it is felt that an existing scar can be improved because of
particular circumstances or complications of healing in the first
instance, or because the procedure is likely to be carried out in a
better manner. Post-operative pain is usually minimal. Sutures
(stitches) are usually removed in four to six days from the face
and seven to ten days from other parts of the body. However,
dissolving sutures are frequently used on the trunk and limbs to
avoid post-operative stitch marks. Stitch marks are much less
likely to appear on the face as stitches are removed early. All new
scars will initially be red. Fading occurs within six to twenty
four months depending on the scars location and the patient’s skin
type.
Acne Scars
Scars caused by active acne are difficult to treat. On the face
it is sometimes possible to cut out the deep scars or to lift them
to normal skin level. Dermabrasion and chemical peels have been
used to reduce the overall depth of scars and to tighten the skin.
More recently laser resurfacing has been used for the same purpose
and has become very popular. It should be stressed that these
treatments do not remove the scars and at best, give a moderate
improvement. None of these surgical procedures are suitable away
from the face. Other procedures that can occasionally be helpful
are facelifts to tighten the skin and simple excision of badly
affected areas.
Burn Scars
Deeper burns tend to heal with scars. Children are particularly
badly affected and suffer thick red hypertrophic scars as a result
of scalds. The main route of treatment is with pressure garments,
but silicone applications can also be helpful. Surgery is used to
replace very severe scars with skin grafts and to reduce tension in
the scars by putting in extra skin extentions.
Keloids
These are a difficult to resolve scars. The easiest to treat are
earlobe keloids which sometimes appear after piercing and often
simple excision is adequate. Elsewhere a course of steroid
injections are the main treatment, rarely, excisions to try and
reduce recurrence of keloids can be helpful.