The scar formation is a natural part of the healing process to occur at almost any skin lesion. The more the skin is damaged, the more is the time it takes to heal and, consequently, the greater the likelihood that a patient will remain with an obvious scar. In most cases, the healing progresses normally and hesitates a scar that does not cause further problems. In an ideal situation a mature scar is thin, pale, flat, and does not cause symptoms. This maturation process takes about 18 months. However, some people develop abnormal scars that can be disfiguring and unsightly. These scars can also be a symptom of itching, pain, causing sleep disorders, anxiety, depression, and disruption of normal daily activities.
Some scars are carved out, for example after acne or chickenpox. These are the so-called atrophic scars where there is a loss of collagen and volume. These scars are generally small, round depressions that lie below the surface of the surrounding skin. They are formed when the healing process is disrupted.
These scars are more common in the young, following burns and in people with darker skin. These scars are usually red, thick color and can be itchy and pain, but their growth is confined within the boundaries of the original wound. The hypertrophic scars usually start to develop within weeks after the injury and may improve naturally, although this process can take up to a year or more.
Keloids may occur at any age, but tend to develop more readily in younger individuals and in darker-skinned people. These are irregular clusters of scar tissue often rounded and that extend beyond the original wound. They often appear red or darker in color than the surrounding skin. Keloids can develop for many months after injury, and may also worsen during pregnancy.
The problem is definitely bigger if we are talking about extensive scarring from burns. In fact, besides the aesthetic aspect we could also have a tissue retraction making it more difficult the movement of the affected body part. In these cases we may consider all the previously exposed techniques also will also evaluate reconstructive surgical techniques of the body such as plastic to zeta and skin expansion that will allow to make smaller and move the scar in a hidden location.
The options for the treatment of scars can be non-surgical or instead by scar revision.
The non-surgical options include the use of silicone ointments for topical use or laminae, or the injection of scars with anti-scarring agents such as triamcinolone. Larger areas may be treatable with the use of laser or intense pulsed light (IPL). Laser and IPL therapies work aiming intense light on the skin. The light is focused on the area around the scar or stain. The laser light or IPL then penetrates through the surface layer of the skin. The treatment stimulates the growth of new skin, and when the treated area heals, the scar or stain is usually much less noticeable than before. After treatment you will need to use sunscreen on the area for at least six months after treatment. The full results of your laser or IPL treatment usually not seen until 10-12 months later. Lasers can cause uneven color of brown and black skin so that treatment may not be suitable for people with these types of skin.
The scar revision aimed at replacing the pathological scar with a fresh scar. The new scar is carefully positioned and sutured with techniques that aim to reduce the risk of recurrence. In some cases, the direction of the scar can be changed so as to fall into the natural creases of the skin. Some drugs can be injected into the scar at the time of surgery to minimize the probability of formation of keloids. Keloids annoying may take several injections every 3-4 weeks to keep scar formation in check.