How Doctors Can Make Those Scars Scarcely Noticeable
During childhood, scars are badges of courage, proof that you are indeed gutsy enough to skateboard or do wheelies.
Later, scars can make you self-conscious, even though they are reassurance that your body’s healing abilities are intact.
Some scars fade naturally with time, but others don’t. Those around knees and elbows are especially likely to stand out because skin around joints moves frequently and gets less chance to heal.
Now, physicians have more options to make scars less noticeable.
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The Process: “Please, doctor, sew it up without making a scar.”
It’s a plea heard over and over by Dr. Mark Labowe, UCLA assistant clinical professor of plastic surgery and chief of the division of plastic surgery at Santa Monica Hospital Medical Center. And it’s impossible, he tells patients.
There will always be a scar after a cut or incision, no matter how deft the surgeon, Labowe says. At best, it will be just a trace of a scar or one that’s barely visible.
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The Operation Route: Sometimes a scar can be best minimized by surgery. A surgeon cuts it out and rejoins the wound to make the next scar less noticeable. One way to do so is to manipulate the direction of the new scar so it will fall into a natural wrinkle, thus all but disappearing.
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Laser Treatments: A special type of carbon dioxide laser can make elevated, red acne scars less noticeable in two ways, says Dr. Laurence David, a Hermosa Beach dermatologist who specializes in the approach. “We try to reduce (the scar) to the level of the skin and also take the red out,” he says.
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The Sandpaper Option: Another option is dermal abrasion, more commonly called dermabrasion. With a power-driven instrument, the physician removes the top layer of the skin so that it is brought down to the level of a depressed scar, thus evening out irregularities. “The depth you can dermabrade is very restricted,” says Dr. Kelman Cohen, professor and chairman of plastic surgery at the Medical College of Virginia. Dermabrasion sometimes is used as a follow-up treatment after scar surgery, adds Dr. Robert Kotler, a Beverly Hills plastic surgeon.
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Injection Option: Collagen can be injected into a scar to fill in the depressed areas, raising them to the same level as nearby skin. But the treatment gives only temporary results, doctors say, and some patients are allergic.
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Other Routes: Cosmetic cover-ups can disguise scars, the American Academy of Dermatology says. Some physicians even suggest makeup after scar-revision surgery to improve appearances until healing is complete.
A chemical face peel can make scars less noticeable, Kotler says, “but it’s not as effective for scars as for wrinkles.”
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Scars Gone Really Bad: Some scars are out of control, such as hypertrophic scars, which become very red and itchy, says Dr. Ross Rudolph, head of plastic and reconstructive surgery at Scripps Clinic and Research Foundation, La Jolla, and associate clinical professor of plastic surgery at UC San Diego. Keloid scars grow outside their normal boundaries. A patient with a pierced ear can end up with a keloid the size of a walnut on the earlobe, Rudolph says.
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The Payoff: Gabriel Alfredo says he had widespread acne scars that made him feel very self-conscious. “I thought there was nothing I could do,” says the 28-year-old Los Angeles man, who later heard about laser treatment. “There was no pain,” he says. He considers the $5,000 outlay worth it. “I feel 75 or 80% improved,” he says.
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Caveats: Among questions worth asking potential physicians who provide scar treatment:
* Are you board certified in your specialty? (Scar revision is often performed by plastic surgeons and dermatologists.)
* May I see before-and-after photos? (But remember, says David, the only before and after that matter are yours.)
* What percentage of your practice is devoted to scar revision?
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The Future. . .: Growth factors, natural substances important to the healing process, are under study as treatments to minimize scarring, Cohen says. “Within the next decade, I believe there will be agents on that market that will control the formation of scars biologically,” Cohen says. “The knife and the sandpaper will be out the window.”
The Post-Cut Treatment
How to minimize scarring after a cut:
* Wash the affected site well. Bacteria can worsen a scar.
* Don’t rub greasy ointments into a cut right away.
* Get an evaluation by a medical professional to determine if stitches or other measures can help.
* Keep the injured area out of the sunlight at first or it might become darker than surrounding skin.
* Once the scar has formed, be sure to wear sunscreen--especially on the scarred area--and keep the area moisturized.
* Take adequate amounts of Vitamin C and zinc, which promote healing. But don’t overdose.
