Scar Revision

What is scar revision?

Scar revision will attempt to minimize a scar so that it is less conspicuous and blends in with the surrounding skin tone and texture. The revision can help improve the cosmetic appearance of the scar, help restore function to a part of the body that may be restricted by the scar, or improve an itchy scar. It is important to remember that scars cannot be completely removed.

What is a scar?

A scar is the body’s natural way of healing a. A scar is usually composed of fibrous tissue. Scars may be formed for many different reasons, including as a result of infections, surgery, injuries, or inflammation of the tissue.

Scars may appear anywhere on the body, and the composition of a scar may vary-appearing flat, lumpy, sunken, or colored. The scar may be painful or itchy.

The final look of a scar depends on many factors, including the skin type and location on the body, the direction of the wound, the type of injury, the age of the person with the scar, and his or her nutritional status.

Different types of scars include:

  • Discoloration or surface irregularities might include acne scars or scars resulting from a minor injury or prior surgical incisions.
  • Hypertrophic scars are thick clusters of scar tissue that develop at a wound sight. These scars are normally raised and might be red, and could become wider over time. They can be either hyperpigmented or hypopigmented.
  • Keloids are larger than hypertrophic scars. These can be painful or itchy. They can occur anywhere on the body but normally develop in areas with underlying fatty tissues.
  • Contractures are scars that restrict movement due to skin and underlying tissue that pulls together during healing.

Types of scar revision

Treatment varies by type of scar.

Keloid Treatment

Treatment for keloid scars can vary depending on the scar.

  • Steroid injections can help decrease the itchiness, redness, and burning sensation that can be caused by these scars. The injections can also help the size of the scar.
  • Cryotherapy is when the scar is “frozen” off with medication, this is normally done in conjunction with steroid injections.
  • Pressure therapy is when a pressure appliance is worn over the scar area. It can be worn day or night for up to four to six months.

Keloids can also be treated with surgery if the scar is not responsive to nonsurgical options.

Hypertrophic Scars

Hypertrophic scars are very similar to keloid scars. However, their growth is restricted to the area of scar tissue or the area of the skin defect. These scars may improve on their own, but this process can take up to a year or more.

Normally, steroid injections can be given. The injections are normally given with the combination of surgery. The injections can be continued for up to two years after the surgery to help the area heal and decrease the chances of the scar returning.

Contractures

The scar formation pulls the skin together, causing a tight area. This can also occur as scars heal. Contractures decrease in the size of the skin which can then affect the muscles, joints, and tendons, leading to a decrease in movement.

These types of scars are normally treated surgically by one of the following methods:

  • Skin grafts or skin flaps can be done after the scar tissue has been removed. Skin grafts are performed by taking a piece of healthy skin from another area of the body and attaching it to the needed area. Skin flaps are where a part of the skin is taken from another area, but with the skin flaps, the skin that is retrieved has its own blood supply. The flaps may be used in areas that do not have good blood supply.
  • Tissue expansion is a process that increases the amount of existing tissue available for the reconstruction of the affected area.

It is best to discuss with your dermatologist to evaluate your scar and discuss possible treatment options to best fit your needs.

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