A scar occurs when the skin is in the process of recovering from an injury or the result of an accident, surgery, a burn, or acne. Once a scar forms, it is permanent but may be made less visible or relocated surgically.
Most people are self-conscious about facial scars. Due to recent advances in cosmetic plastic surgery procedures, facial scars can be treated effectively.
Due of its location, a facial scar is often considered a cosmetic problem. There are several ways to make a facial scar less noticeable. Often it is simply cut out and closed with tiny stitches, in many layers, leaving a thinner, less noticeable scar.
Some facial scars can be softened using a technique called dermabrasion, a controlled scrapping of the top layers of the skin using a hand held, high speed rotary wheel. Dermabrasion leaves a smoother surface to the skin, but it will not completely erase the scar.
Z -Plasty is a surgical technique used to reposition a scar so that it more closely conforms to the natural lines and creases of the skin, where it will be less noticeable. Skin grafting, flaps, low- dose steroid injections can also help in selected cases.
Keloids are thick, puckered, reddish, itchy clusters of scar tissue that grow beyond the edges of the wound or incision. They are often red or darker in color than the surrounding skin.
Keloids are most common over the breast bone, on the earlobes, and on the shoulders. They occur more often in dark skinned than in those who are fair. Keloids are often treated by injecting a steroid medication directly into the scar tissue to reduce redness, itching and burning. In some cases, this will also shrink the scar. This steroid is works locally and does not spread in the body. But some women may experience heavy pariods, in that case the next injection is deferred. It must be remembered that injections are given monthly, usually for minimum 6 months. Further course depends on response. If steroids do not work, other injections like 5-FU can be tried. Botox may help by shrinking the sweat glands of the skin. Other injections like verapamil can be added for improved effect of steroid. KELOIDS are rarely operated. Only ear lobe keloids under steroid injection cover respond to operations. Follow up to see if the keloid is coming back is very crucial in such cases
Other non keloid scars and hypertrophic scars
If steroid treatment is inadequate the scar tissue can be cut out and the wound closed with one more layers of stitches. This is generally performed under local anesthesia. You should be back to work ; depending upon location of your scar; in a day or two and the stitches will be removed in a few days.
Surgery can reduce the size of your scar or reposition it. Sometimes this involves cutting out your scar and replacing it with a skin graft from a healthy part of your body. If a skin graft is used after a scar is removed, you will always have a different patch of skin there instead of the scar.
Prevention of scars: It is difficult to prevent certain scars however there are measures you can take to reduce your risk of scarring.
If you have acne or chickenpox, try not to scratch and pick at it. In case of burns, removal of dead skin and early coverage will reduce the scarring. If you have suffered a burn or you are having surgery and have a family history of severe scarring, tell your surgeon so that he or she can use methods to reduce your risk of forming keloid scars, such as using pressure dressing or silicone gel sheeting on the healing wound.
Moisturisers help restore the skin’s smoothness, softness and flexibility by helping the skin retain moisture. Keeping your skin well moisturised during pregnancy may help to reduce stretch marks.
PARAMETERS FOR FACIAL SCAR REVISION?
A person considering facial scar revision must realise that there is no way to remove scars completely. The entire effort of the surgeon is to remove the appearance of the scar either by disguising it or relocating it, or minimizing its prominence. Skin color and type, age, and type of scarring, are all important factors that must be part of the discussion prior to surgery.
HOW TO DECIDE WHETHER OPT FOR FACIAL SCAR SURGERY?
The surgeon will examine the scar in order to decide upon the proper treatment and inform you of outcomes that can be expected from facial scar revision surgery. The reason could be from cosmetic to medical. Different scars require different scar removal treatment. Some facial scars can be unattractive simply because of where they appear on the face, while others affect facial expressions. All l possibilities will be discussed in the initial consultation along with risks involved for each type of scarring. Since scars are very individualistic and the patients attitude towards scar is personal, maximum improvement in facial scars may require more than one procedure, and more than one technique may be employed.
Other treatments for scars include Fractional CO2 laser, dermaroller, fat grafting. A completely personalised approach with evaluation of improvement to decide further course of treatment is required. Sometimes it may be impossible to modify a scar and all efforts may go in vain.