A special sign: how to get rid of scars

Scars on the skin embarrass many people, cause stress, reduce self-esteem and quality of life. They can also interfere with the functioning of the body. For example, located on the limbs, they impede their function. How to get rid of scars, said Ekaterina Davtyan, Ph.D., dermatologist, cosmetologist, trichologist, physiotherapist.

Causes of scar formation

Damage to the surface layer of the skin (epidermis) rarely results in a scar. As a rule, scratches heal quickly and without a trace. If the injury was deeper, different options are possible.

According to the expert, scar formation occurs as a result of the replacement of normal skin with rough connective tissue. The cause may be a physical, chemical or mechanical injury, in particular, surgery, as well as an inflammatory process (acne, smallpox, lichen planus, pyoderma).

The predisposition to the formation of scars in people is not the same. On one person, everything heals without a trace, on another, any scratch leaves a mark for life.

“The formation of scars depends on many factors: their localization, the cause of the injury, the amount of damage, genetic characteristics, age, concomitant diseases, and therapeutic measures taken,” says Dr. Davtyan.

• Normotrophic scar formed during the normal recovery process. Such a scar is almost invisible, since it is flat, thin, does not go beyond healthy skin, and almost does not differ in color from it, it has normal elasticity and sensitivity. Such scars do not require treatment, they heal on their own. After a few years, finding them on the body is no longer easy.

• Atrophic scars lie below the surrounding skin. They occur due to a reduced response of the connective tissue (collagen and elastin) under the scar. Such scars remain after acne, chicken pox, with a sharp weight gain (stretch marks or stretch marks).

In addition, the factors leading to this type of scarring include: taking medications, hormonal disorders, chronic diseases.

• Hypertrophic scars, on the contrary, are located above the surrounding tissues. They are bright in color (red, crimson, cyanotic), with raised edges, but they never go beyond the injury. They turn white over time.

Such scars appear as a result of an excessive response of connective tissue (high collagen synthesis) in response to injury due to inflammation, infection, reduced local immunological reactions, stretching of the scar.

• Keloid scars cause the greatest problem of all types of scars in terms of aesthetic, psychological and medical criteria. They cause itching, burning and pain. Occur as a result of an excessive aggressive healing process. Their main difference is that their edges always go beyond the initial injury. Moreover, they tend to grow rapidly and uncontrollably. Unfortunately, even after treatment, the recurrence rate reaches 60 percent.

Many people are in no hurry to go to the doctor after an injury. They wait until everything heals by itself, and the scar disappears. But in this case, time often plays against them.

“It is best to start treating the scar within the first year of its appearance,” says doctor Davtyan. “But if it is a hypertrophic scar or a keloid, then the time frame can be reduced to a few weeks after the initial injury. At the appointment with a cosmetologist, dermatologist, physiotherapist, surgeon, the optimal scar treatment protocol is selected (it can be therapeutic, surgical, external). The doctor makes the decision individually, depending on the type, area of ​​the lesion, duration of damage, depth and localization.

Often the treatment of scars is a long and combined process. For example, the treatment of hypertrophic and atrophic scars may begin with conservative therapy and end with surgery. Medical treatment (including topical) can reduce the likelihood of excessive scar tissue formation, reduce the height of the scar, reduce tissue tension, and remove post-inflammatory hyperpigmentation and redness.

Surgical excision is performed under anesthesia (local or general) to reduce the width and height of the scar. Excess tissue is removed, mobility of the scar area is restored. This procedure is used mainly for hypertrophic scars.

Cosmetic procedures will help to make atrophic and hypertrophic scars less noticeable and flatter. They are carried out by cosmetologists, dermatologists. Lasers (Co2 and erbium), phototherapy (ipl, bbl), needle RF-lifting are used for this purpose.

“The laser is used to vaporize the scarring and reduce the area of ​​the scar,” says the expert. – This device not only accurately vaporizes damaged cells, but also remodels the deep layers of the scar, smoothes the skin relief, lifting the bottom of the scar, tightening the skin due to the formation of young collagen and elastin fibers. Healthy tissues are not affected, the rehabilitation period depends on the treatment regimens and protocols, and ranges from 3 to 14 days.”

Needle RF works like this: radio frequency pulses at the end or along the entire length of the needles penetrate the skin to a depth of 0.5 to 3.5 millimeters, triggering the synthesis of elastin and collagen fibers. As a result, the scar tissue tightens, the retraction of the atrophic scar decreases, the surface of the tissues is leveled, the skin becomes more elastic. Recovery takes from 2 to 14 days, depending on the depth of damage.

Phototherapy (ipl, bbl) uses broadband pulsed light that is converted into heat in the skin. As a result of treatment, red scars turn white due to coagulation of pathological vessels in the tissue, hyperpigmentation is eliminated (dark spots on pathological and healthy tissues brighten), the skin thickens, the severity of atrophic scars (stretch marks, post-acne) decreases.

There are injection methods for the treatment of scars. For these purposes, use:

• collagen stimulants, collagen, hyaluronic acid filler. These drugs work with atrophic scars, raise their bottom and align the sunken tissues. New collagen is formed, tissue elasticity increases.
• Corticosteroids. They slow down the growth of scar tissue, reduce the formed hypertrophic or keloid scar, reduce inflammation, reduce itching and redness. This is the gold standard of keloid treatment, the first and sometimes the final stage of its treatment.
• Enzyme treatment suppresses inflammatory processes, reduces the severity of hypertrophic, keloid scars, increases tissue elasticity, evens out the relief.
• Botulinum therapy has shown excellent results for the treatment of hypertrophic and keloid scars, reducing severe itching, tightness and pain in the scar area. Inflammatory reactions, redness, thickening and growth of pathological tissue are reduced.

“The type of laser, the number of procedures, the interval between sessions and the combination with injection procedures are selected by the specialist at an in-person consultation individually,” the expert warns.

Additional sources:

1. Modern approaches to pharmacological correction of pathological scars
2. Methods for optimizing the treatment and prevention of scars
3. Prevention and treatment of pathological scars in surgical practice