Scar Revision- Benefits, Types and Treatment

What is a scar?

A scar usually occurs as a natural part of the healing after an injury or a wound. Some will fade in time, and some scars will not disappear fully.

The other reasons for scar formation are due to surgery, infections or tissue inflammation. A scar can appear anywhere in the body where the injury has occurred. It will appear as a lumpy, flat or sunken skin.

In some cases, the scar can be itchy or painful, and the final texture of the scar will depend on the factors like skin type, location of the scar on the body, direction of the wound, age of the person, type of injury and nutritional status.

What is a scar revision?

Scar revision is a surgery that attempts to minimise the appearance of the scar. It helps improve the skin’s overall appearance and restores the functions of the affected part.

It also helps to reduce the itching sensation of the scar. However, a scar cannot be removed completely. The appearance of the scar can be reduced.

Types of scars and their treatments

The types of scars are categorised depending on their appearance.

Keloid scars and scar tissue removal

Keloid scars are thick, irregular and round clusters of scar tissues that grow at the site of the wounded skin and beyond the edges of the borders of the wound.

These scars usually appear red or darker in colour compared to the surrounding normal skin. These types of scars form from connective tissues and skin cells that begins to multiply to repair the damaged skin.

Keloid scars can appear on any part of the body but are commonly found on the neck, face, ears, chest and shoulders. Additionally, they occur in dark-skinned people.

The treatment may vary depending on the scar type, and recurrence after the treatment is common. Some of the common treatments include.

Steroid injections

Steroid injections are directly injected into the keloid scar tissues. These injections help with itching and burning sensations. In some cases, these injections may reduce the actual size of the scar.

Cryotherapy

Cryotherapy freezes the scar with the help of medication. It is combined with steroid injections and is found to be effective.

Surgery

When the keloid scar becomes unresponsive to the non-surgical methods, then surgery will be recommended. An incision will be made that directly removes the scar formation and will be stitched to close the wound. In some cases, skin grafts are used to close the wound.

Laser surgery is also an option for scar treatment. Depending on the underlying cause, the scars can be treated.  Laser surgery is used to remove abnormal colour caused due to the scar, to smooth a scar or flatten the scar.

In most cases, laser treatment is combined with treatments like steroid injections. However, multiple treatments will be required, regardless of the initial treatment.

Pressure therapy

The pressure therapy applies pressure, and the scar will be removed. A pressure device will be applied and should be worn for about 4-6 months for the scar to disappear.

Radiation therapy

Radiation therapy is combined with surgery to reduce the scar’s recurrence risk.

Hypertrophic scars

Hypertrophic scars usually develop directly at the wound site and have a thick cluster of scar tissues. They are similar to keloid scars, but their growth is constricted within the boundaries of the original skin.

They appear as clusters of skin and are red in colour. They usually occur within days after injury in the injured skin.

In most cases, the hypertrophic scars improve over time. However, it takes about one year for the process or more.

Steroid injections are commonly recommended for treating hypertrophic scars. However, there is no cure for this type of scar, and surgery is also combined.

Contractures

Contractures and scars occur when a large area of the skin is lost or damaged. It causes a tight area of the skin because the scar pulls the edges of the skin together. If the scar occurs where the wound crosses and restricts the movement of the joints, elbows, and fingers.

Who can get scar revision?

Anyone can get a scar revision. However, there are certain criteria to get scar revision.

• When a person is healthy.
• When a person is a non-smoker.
• When a person is bothered by scar tissue in the body.
• If other skin diseases have to be treated.

How to prepare for a scar revision?

Before the scar revision treatment, medical tests are required.

• A lab test is required or a medical evaluation of the body.
• If a person is on medication, they should be adjusted.
• If there is a smoking habit, stop in advance before the surgery.
• Stop the anti-inflammatory drugs or herbal drugs that can increase bleeding.

How do topical treatments reduce the appearance of scars?

Initially, the healthcare professional will give topical applicants to reduce the appearance of the scar. Topical creams and ointments are effective for newly formed scars. Common types of topical treatments include.

Polyurethane dressing

Polyurethane dressings are self-adhesive pad or bandage that helps reduce the size and hardness of the scar. It also reduces discolouration and helps return to the normal colour of the skin.

Pressure therapy

Pressure therapy is used alongside polyurethane dressing. It exerts pressure and reduces the scar size. Pressure therapy helps reduce the appearance of the raised scars.

Silicone gels

Flexible sheets with silicone gels are applied over the scars or the wound. It helps relieve redness, irritation and itching. It is also effective for raised scars.

How do injectables reduce the appearance of scars?

Injectables are effective for keloids and raised scars. They help reduce the size of the scar and minimise itching, irritation and pain.

Types of injectables used are

5-FU or bleomycin injections

These types of injectables are used to treat the growth of cancer cells. The healthcare professional will use them on scars to prevent the scar cells from producing new tissues.

Corticosteroid injections

Corticosteroid injections are steroid injections that reduces the formation of collagen in the skin, which in turn minimises the appearance, size and texture of the scar.

Risks of scar revision

The risk of scar revisions will depend on the type of treatment. After receiving a scar revision, follow-up care is required for best results.

Topical applicants tend to have certain risks like mild discomfort or skin rash. Injections can cause redness, blisters, swelling and increased sensitivity to sunlight. They can make the scar tissue darker than it was.

Surgery carries the most risk, like bleeding and infection. The scar is likely to return, or the surgery can cause a new scar.

Benefits of scar revision

Benefits of scar revision treatment include

• Texture
• Colour
• Size
• Stiffness
• Thickness

What to expect after a scar revision?

The recovery will take time, depending on the treatment. Topical treatment will take months to produce results. In most cases, multiple injections will be required to achieve results.

Results after surgery can take weeks or months. However, the scar will not be removed entirely.

Conclusion

Scar revision treatment can help reduce the size of the scar. However, it will not completely remove the scar. Before opting for scar revision treatment, talk to your healthcare professional about your goals and expectations. The professional will also evaluate the severity of the, the size and its location. After a full evaluation, the treatment will be planned accordingly.

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