A scar is the result of the biological process of wound repair in the skin and other tissues. It is a natural process during which normal skin is replaced by fibrous tissue. Every wound, surgical or traumatic, (with the exception of very minor lesions) results in some degree of scarring.
There are many different types of scars
Atrophic scars: the skin appears to be stretched, thin and usually white. Stretch marks are a typical example, but atrophic scars can also appear as the consequence of acne, recurrent cysts and infections on the body.
Pitted and sunken scars: mainly caused by acne and chickenpox, but also as the result of accidents and surgery. These are the result of the loss of underlying structures supporting the skin.
Hypertrophic scars: often mistaken for keloids, but unlike what happens in the latter, the excess scar tissue remains within the margins of the original lesion. They are red and protruding, and often itchy and moderately painful.
Keloids: pathological scars: ones that grows too much and that usually grow beyond the margins of the original wound. They are raised, red or purple, shiny, hairless lesions often painful or itchy. Most people with keloids have only one or two. However, some people have many, especially if they have come up after acne or chickenpox scars
A keloid can occur after surgery, after major skin trauma but also after very minor skin damage, such as acne spots. It is also possible to develop a keloid even if there has been no obvious damage to the skin at all.
Keloids usually occur on the upper chest and shoulders – particularly over the breastbone (sternum) – and on the earlobes. In dark skinned individuals they very often occur in the beard area and on the scalp.
Asians and dark skinned people develop keloids much more easily than those with a paler skin. A tendency to develop keloids certainly runs in some families.
Is it possible to remove scars?
Unlike what many people think, scars are permanent marks that cannot be eliminated by any surgical technique: they can only be improved upon.
What influences the quality of a scar?
The impact and severity of a scar can be influenced by a number of factors which include whether it is as a result of surgery or an accident, whether you are fair or dark-skinned (if dark, the scar will likely be worse) where on the body it is and how it is treated.
What kind of treatment can be used to improve scars?
First of all the correct care of a wound is essential: topical antibiotics to cure or prevent infections, continuous pressure (if possible), occlusion with silicone gel sheets or daily application of silicone gel for several months. Following this there are a number of cosmetic and surgical procedures that can be used including excision of the scars, intralesional steroid injections, chemical peels and laser treatment.
Atrophic scars: the most difficult type of scar to treat. Chemical peels and laser treatment may some times improve their appearance. Very good results have been obtained with the new fractional lasers which improve both the texture of the skin and the color. If the atrophic scars are very wide it is advisable to perform an excision of the scar.
Pitted and sunken scars: pitted scars due to acne can be improved with chemical peels and laser resurfacing with fractional lasers or surgical lasers. If very deep, they can be treated, like sunken scars, with injections of collagen or hyaluronic liquids.
Keloids and hypertrophic scars scars have typically been improved both through medical and/or surgical treatments. Surgical removal would often result in the return of of new and sometimes even larger keloid scars at the site of the incision and the use of steroid injections is really only effective when applied to small keloid scars.
Thanks to an exciting new medical development, we are now treating patients with keloid scars with Cryoshape and seeing remarkable results.
The Cryoshape probe treats keloid and hypertrophic scars by way of direct thermal effect on the deep scar material whilst also causing a softening and normalising of the collagen within and surrounding the scar.
It freezes and destroys deep scar tissue that causes the keloid to develop. The Cyroshape probe treats the scar material and freezes the tissue along the entire scar. Even large keloid scars can be treated in a single session with both volume and the discomfort cause by the scar being significantly reduced.
The treatment is carried out under local anaesthetic and is quick to perform with minimal discomfort for the patient. The patient can leave the clinic immediately after the treatment and will be able to return to work and resume normal activities the following day.
In a study of patients who were treated with Cryoshape, in 97% of cases, no scar recurrence was observed. This is in contrast to other treatments which require several sessions over an extended period of time with sometimes moderately successful outcomes along with the risk of skin atrophy and scar depression and recurrence.