Most of us have – or know someone who has – a scar. They can be created by a variety of factors, including an acute injury (e.g. a dog bite), a medical condition (e.g. acne), by burns, or by surgery. Depending on the severity of the scar, it may be more (or less) visible. What is also important is the location of the scar. A large scar on your face is considered to be much more noticeable than a scar on your back, for example.
This blog post walks us through the type of scars which can occur, as well as 6 ways to remove them or at least reduce their severity. This process is known as ‘scar revision’.
4 Types of Scar
Did you know that there are 4 main types of scar? The American Society of Plastic Surgeons categorizes them as follows:
- Discoloration or surface irregularities (subtle scars, the least severe type)
- Hypertropic scars (more severe, usually scar tissue formed at the wound site)
- Keloids (larger than hypertropic scars and may appear anywhere on the body)
- Contractures (as the name suggests, they contract the skin, restricting movement)
How to remove a scar?
As per the infographic below, there are 6 main ways to remove a scar:
1. Chemical peels
If your scar is not too deep – that is to say only affecting the upper layers of the skin – then this may be a suitable procedure. It works by causing the epidermis to peel off, so in effect exfoliating the skin. Then new skin will grow back, ideally leaving the scar less noticeable than it previously was.
Similar to chemical peels, this procedure is most appropriate for scars which are not too deep. The process, similar to exfoliation, uses a dermabrasion machine to remove the top layers of the skin (where the scarring is), subsequently leaving the undamaged lower layers of the skin, resulting in a ‘polished’ or untainted appearance.
3. Fill injections / soft tissue
This procedure is considered most appropriate for indented scars. In other words, scars which do not stick out, but instead are indented into the skin. Collagen or other suitable fillers are used to literally ‘fill the indentation’, subsequently raising it to the level of the rest of the skin, thus making it less noticeable.
4. Surgical scar revision
This is the process of surgically removing the scar and then rejoining the layers of skin and is known as ‘excision’. It cannot totally remove the scar, but can decrease the length or width of a scar. Closure of the resulting surface would is known as a “simple” closure. Layered closure is used where the excision extends to tissue below the skin surface or in areas with a high degree of movement. This first step, or layer, requires a sub-dermal closure (below the skin surface) with absorbable or non-removable sutures. Layers of closure continue to build, concluding with closure of the remaining surface wound.
PRP offers an opportunity to promote not just the speed of healing of scars, but also the degree of their healing. As a result, this can reduce the severity of scars, meaning a better (less visible) outcome. Read more about PRP for scars.
6. Laser Revision
Lasers, various energies and types can be used to lessen scar tissue; the type of laser depends on the age and quality of the scar as well as the skin pigmentation. Regardless, best case scenario, scar’s can be improved but rarely fully removed.
About Thomas Zaydon, M.D.
Dr. Zaydon is certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons. He is also a fellow of the American College of Surgeons. Dr. Zaydon serves as an expert witness on liability cases around the country. He has reviewed many cases and has served as an expert witness for both the plaintiff and defense. He is sought as an expert witness in these cases because of his experience and fairness. Read more about Dr. Zaydon’s role as a plastic surgery expert witness, Plastic Surgery Expert Medical Advisor, or about Plastic Surgery Peer Reviews and Plastic Surgery Independent Medical Evaluations.