Chance to heal scars from without and within

As the owner of a hair and makeup studio, Nena Davis follows the latest beauty trends -- but she hesitates to try some of them herself. She’d love to wear her hair up from time to time, for example, but she always leaves it down to help conceal scars on her face and neck that resulted from a car crash.

Davis was 12 at the time, riding in the back seat of a car driven by her brother when it veered off a cliff. “I went through a window and slid down the side of a tree,” she says.

When she woke up, she was in the hospital with a fractured neck and deep cuts and abrasions.

“It was horrible, and it scarred the whole right side of my face,” says Davis, who’s now 29. The disfigured areas include raised scar lines and patches that resemble burn scars.

Going through her teen years with the scars wasn’t easy. At a time when many adolescents freak out at the sight of a zit, Davis had bigger issues.

“You know how people are,” she says. “It’s a cruel world. People were always staring and asking what happened.”

Sometimes people called her names. “I would just try to ignore them,” she says. And to this day, people still stare, she says.

It was in her late teens that Davis realized the scars wouldn’t diminish on their own, so she began consulting doctors. She’d make an appointment with a dermatologist or plastic surgeon who inevitably would tell her there wasn’t much that could be done to minimize the scarring, she says. So she would wait another couple of years and try another doctor, to little avail.

“It was so emotional and depressing not to find anyone” who could help much, she says.

In her early 20s, she tried dermabrasion and microdermabrasion to resurface her skin but says they didn’t make a big difference.

Now, though, Davis says she’s finally starting to see better results, albeit slowly, through a combination of other treatments she’s been receiving for the last year.

Several approaches are available to people with scars, but choosing the best one depends on several factors. Among them are the cause of the scar -- such as acne, burns, accidents or surgery -- and its severity, age, location and color. These factors also play a role in how successful treatment can be, but in any case, scars can never be completely erased.

Extensive scars like Davis’ can be particularly difficult to minimize. But one of her dermatologists, Dr. Ronald Moy, says he is hopeful that she’ll see a 50% improvement from a series of 10 laser treatments that she is undergoing in his office.

Because Davis is black, she’s not a good candidate for traditional laser treatments that remove the entire top layer of skin and may cause pigmentation problems in people with dark skin, says Moy, a clinical professor of dermatology at UCLA and past president of the American Society for Dermatologic Surgery.

He also says surgery to cut out scar tissue and carefully close the new wounds, as is often done for people with surgical scars, isn’t a good option because Davis’ scars cover a large area, and the surgery might worsen the scarring.

So he’s using the newer Fraxel laser, which works in a novel way. “This laser punches tiny little microscopic holes into the surface of the skin,” Moy says. With this approach, only 20% of the top layer is removed at one time, and this appears to prevent pigmentation problems, Moy says. It’s not clear why, but he speculates that the pigment cells left behind may fill in the new holes and prevent discoloration.

In Davis’ case, Moy is using the laser to remove thicker scarred areas. “It makes things smoother, and it evens out the pigment,” he says.

Davis says the laser treatments, which involve numbing shots beforehand, leave her skin a little irritated and sensitive for a couple of hours but the discomfort is bearable. “Pain for beauty,” she says.

She is also seeing Dr. Marcia Glenn, a dermatologist at Odyssey MediSpa in Marina del Rey, who administers chemical peels and steroid injections into the raised scars to help shrink and flatten them.

Glenn says these approaches yield “moderate” effects, which is why she referred Davis to Moy for the additional laser treatments.

Davis, of course, is hoping that the combination of treatments will yield a more dramatic improvement. Given her experiences, she has a keen understanding of the connection between appearance and selfesteem. In fact, it’s a big reason she went into the beauty business. “I really like to make people feel good about themselves, about their appearance,” says Davis, who has given free haircuts to underprivileged girls and makeup consultations to local women who can’t afford such services.

She still has a few more laser treatments to go. But so far, she says, her skin is smoother and the scars are less prominent. Moy says the final results could take months to become evident.

“It’s coming along,” Davis says. “I feel like I’m getting some results. I feel better. I feel more confident.”