What is scar revision?
Scar revision involves procedures and treatments to healed scars in order to improve the cosmetic appearance of the scar or to restore function to an area of the body that has been affected by the scar.
What is a scar?
Scars are the result of a process of recovery of the skin after being injured (such as cuts and scratches). Injuries can be caused by external factors, such as trauma or surgery, or caused by inflammatory processes or diseases such as acne. In ideal scenarios, the healing process results in the seamless regeneration of new skin that is flat and similar to the rest of the skin tone. But in many cases, scars are textured and differently coloured, and may be itchy, feel tight, or be considered unsightly, thus requiring revision.
The final appearance of a scar can vary dependent on factors such as type of injury, location, skin type, age of the patient, and type of scar care and nutritive practices they engage with.
There are many different types of scars, including:
- Keloids: thick, rounded, irregular groups of scar tissue that originate at the site of injury but expand beyond the borders of the wound. They are dark red or blackish in colour. They form from overactive skin cells and fibroblasts that multiply to repair tissue damage. They most commonly develop from the shoulders and upwards. Keloid scars can form within a year after the original injury has healed.
- Hypertrophic scars: similar to keloids but contained within the boundaries of the original injury. They are most likely to improve naturally with time.
- Contractures: only occur after a large portion of skin has been damaged or lost, resulting in a scar formation that pulls the edges of the skin together, which can obstruct movement.
Methods of scar revision
There are several approaches to scar revision, ranging from methods of therapy, injections, and surgery. The best approach will depend on the type of scar.
- Steroid injections: used to decrease itching, redness, and discomfort, particularly for keloid scars. Can also help reduce the size of the scar.
- Cryotherapy: extreme cold is applied to the scar to ‘freeze’ it off. Often employed alongside steroid therapy.
- Pressure therapy: garments or bandages are worn tightly over the area of the scar to prevent the scar tissue from thickening or developing texture. They can be worn day and night consistently for up to six months.
- Radiation therapy: radiation beams are transmitted through the skin to disrupt abnormal cell production. Can be used with surgery to decrease the risk of a recurring keloid.
- Surgery: the scar tissue is removed via incisions and the wound is sealed with sutures or medical glue. Sometimes, a skin graft may be performed if the wound is too big to seal normally. Surgery is only considered an option when other treatments have been ineffectual.
- Laser surgery: used to smooth or flatten scar tissue and correct colour.
Who performs scar revision procedures?
Scar revision, depending on the technique utilised, can be performed by plastic, reconstructive, and general surgeons, aestheticians and dermatologists.
