Treatments for Scarring
Scars are fibrous tissue that replace normal skin after injury. The goal of scar treatment is to encourage the skin’s collagen to regenerate and improve the appearance of scarring. All types of scars in the skin, including hypertrophic and keloid scars, surgical scars, and atrophic scars such as acne scarring, can be treated. At Advanced Dermatology, we offer various scar treatments, including cosmeceutical products, collagen induction therapy and laser treatments to address your particular scar type.
Two common types of scarring are hypertrophic and keloid scarring. Hypertrophic scars occur when the body overproduces collagen. This results in thickened or raised tissue. Keloid scars are hypertrophic scars that grow larger and outside the original wound area. They can be caused by surgery, piercings, acne, tattoos, or injury to the skin. Keloids are most commonly seen on the chest, shoulders, upper back, arms, and earlobes and can be itchy and painful. Hypertrophic and keloid scar treatments include intralesional steroid injections and Vbeam® (pulsed dye laser) to flatten the scar and reduce redness. Unfortunately, some keloid scars do not respond to any type of treatment.
Scars will also occur after surgery. Surgical scars may be thin white lines, thick wide lines, or even red, thickened, raised, and itchy lines. The treatment of surgical scars can improve the appearance by decreasing the scars’ redness and thickness and can also improve the symptoms. Treatments for surgical scars include topical agents such as silicone Strataderm® Scar Therapy Gel, intralesional steroid injections, and laser treatments.
Atrophic scarring is another type of scar that appears as a sunken recess or divot in the skin, often occurring after acne or chickenpox. There are 3 types of acne scars. Rolling scars look like broad, low hills. Boxcar scars have thick, hard centers that pull down. Icepick scars are very narrow and deep.
Atrophic scarring can be treated with a topical cream, injectable fillers, collagen induction therapy, and laser treatments. Topical retinoids increase cell turnover and improve the texture of the skin while topical growth factors help plump divots. Injectable fillers, such as Bellafill®, Sculptra®, and hyaluronic acid (Restylane®, JUVÉDERM™, Voluma™XC) can immediately show improvement by filling in acne scars. Microneedling, or collagen induction therapy, uses tiny, sharp needles to create microscopic wounds in the skin to induce collagen renewal and scar repair.
We favor 3 forms of fractionated laser resurfacing for scarring at Advanced Dermatology: eMatrix™, a radiofrequency device, Fraxel® Restore, and CO2RE Fractional Resurfacing. Fractionated resurfacing ablates a fraction of the skin rather than all of the skin. Fractional treatment results in quicker healing and fewer complications and is very effective for scar repair.
Due to the variety of the scar types, a combined approach is often needed for optimal results. When
treating acne scars, it is important to control acne first as many treatments for scarring can cause acute acne to flare. We also do not recommend investing energy, time, and money to improve acne scars if you are likely to make new ones. We invite you to schedule a consultation visit to meet with a cosmetic coordinator and a physician or a physician assistant to answer your questions and determine the best treatment plan for you and your type of scarring.