Our skin is a seamless organ protecting our body from infection. But throughout our lives, we all have experiences that injure our skin, leaving behind a scar. How you scar depends on many factors: the depth and size of your wound, your age, heredity, even your sex and ethnicity. Below, we discuss the four main types of scars and the treatments that can help reduce their size and appearance. Before you begin, however, remember this basic truth: scars never completely go away.
The four main types of scars:
- Keloid scars: These scars protrude from the skin and extend beyond the original injury site. Over time, a keloid scar may affect mobility. Possible treatments include surgical scar removal or injections with steroids. Smaller keloids can be removed using cryotherapy (freezing therapy using liquid nitrogen). You can also prevent keloid formation by using pressure treatment or gel pads with silicone.
- Contracture scars: If your skin has been burned, you may have a contracture scar. These scars cause tightening of skin that can impair your ability to move. Additionally, this type of scar may go deeper to affect muscles and nerves.
- Hypertrophic scars: Raised and red scars that are similar to keloids, but do not extend beyond the boundaries of the injury site. Possible treatments can include injections.
- Acne scars: If you’ve had severe acne, you probably have the scars to prove it. There are many types of acne scars, ranging from deep pits to scars that are angular or wavelike in appearance. Possible treatments will depend on the types of scars you have.
Over-the-counter or prescription creams, ointments, or gels: These products may reduce scars that are caused from surgical incisions or other injuries or wounds. If you are under the care of a dermatology or plastic surgeon, ask your physician for his or her recommendation. Treatments may include corticosteroids or antihistamine creams if your scars cause itching and are extremely sensitive. Likewise, if you are have scarring as a result of acne, you should ask your dermatologist for his or her recommendation for treatment of the acne and scarring. Your doctor may also recommend intralesional steroid shots, pressure dressings, or silicone gel sheeting to prevent acne scars or help treat existing scars.
Surgical scar removal: There are many options under this category, depending on your particular case, including skin grafts, excision or laser surgery. When looking into surgery, discuss with your doctor whether you will have local anesthesia with an oral sedative or general anesthesia. If you’ve recently undergone plastic, cosmetic, or other surgery that has caused your scars, it is best that you wait at least one year before making a decision about scar removal treatment. Many scars fade and become less noticeable over time.
Injections: In the case of protruding scars such as keloids or hypertrophic scars, your doctor may elect to use steroid or cortisone injections to shrink the scars. Such injections can be used as a stand-alone treatment or in conjunction with other treatments.
Laser surgery: Vascular (blood vessel) specific lasers may be used to lighten flat or raised scars that are pink to purple in color. Vascular laser treatment may also facilitate the flattening of raised, red scars.