Scarring is part of the natural healing process after injury to the skin. The appearance of a scar is dependent on many factors including the location of the wound, your healing process and type of injury. Scarring, no matter how severe can be improved by various methods including the use of silicone gels, lasers and anti-inflammatory injections. Depressed scars can be treated with fillers or fat transfer. Matching the procedure to the scar type will give the best outcomes.
- Scarring is highly variable and can present in many ways
- Some scars are depressed, some are raised and itchy
- Some scars turn brown, whilst others turn purple or red
- Genetics, scar location, and ethic background all play a role in scar formation
- The type of treatment is dependent on the type and location of the scar
- Facial scars caused by surgery, car accidents/ trauma, or acne can be significantly improved
- Surgical scars can be reduced or prevented by early treatment
- Pressure tapes or silicone sheets after surgery can reduce scaring
- Scars on the face respond much better to treatment than scars on the limbs
- Self harm scars are very hard to treat- only mild improvement can be seen with this form of scarring
Yes. The majority of scars can be improved in some way. Scars from surgery, car accidents, dog bites, or trauma can all be improved. Scars on the face respond best to treatment, whilst old scars on the limbs respond slowly. Surgical scarring (especially facial scars) can be improved by 70-90% with laser treatment.
Lots! If your scar is raised, I use an Erbium laser to flatten out the scar line. Most patients will require only one treatment. If redness is present I use a V BEAM laser. I work in with Plastic Surgeons in Brisbane, Gold Coast and Toowoomba to revise surgical scars following skin cancer surgery. In most cases I can improve scars by at least 70-80%. Some patients require one treatment, others multiple treatments depending on the scar type.
Unfortunately, self harm scars are very difficult to treat- this is due to several factors, including the site (forearm scars = scarring on limbs, a difficult site to treat), the colour of the scar (these are often white, so pigment can not be placed back into the scar line), and thirdly the areas are often wide spread (hence laser resurfacing has to be conservative or skin will not heal). Scar treatment Brisbane still has no reliable answer for self-harm scars.
Fractional CO2 laser can be trialled on these scars, however results are poor- often only a 30-40% improvement at maximum with 4-5 treatments.
Additionally scars that are white can not be treated, as laser can not replace loss pigment. The surrounding skin can be treated to make the scar less obvious, but the colour of the scar will remain white indefinitely. Recent medical articles suggest that cosmetic tattooing gives the best results for these type of scars.
Scarring is a natural process of skin healing, however in some people excessive healing occurs- this lead to keloid or hypertrophic scars. In others, a lack of collagen occurs, and this leads to atrophic or depressed scars.
Genetics, age, ethnicity, wound site, and the type of wounding all play a role in the type of scarring that occurs.
Treatment will depend on the type and location of your scar.
- Laser treatment is my most frequently performed procedure for scars. Lasers can treat atrophic or depressed scars, raised scars, acne scarring, and red scars. I can choose from fractional CO2 or erbium lasers, or fully ablative lasers for raised facial scars. Vascular lasers such as VBEAM can be effective for red scars, early scars, and keloid scarring.
- Anti-inflammatory injections are useful for raised or keloid scars. Most patients will need between 2-5 injections to flatten the scar. Injections can also relieve the itch and pain associated with keloid scarring.
- Silicone dressings with either a sheet or gel can help with early surgical scars. Additionally maintaining a constant pressure on early scars with bandages, and tape can help prevent scars.
- RF or RadioFrequency can be used for the treatment and prevention of early scars such as acne scarring in patients on Roaccutane.
Erbium laser can be used for scar treatment Brisbane.
The type of scar and location will dictate the best procedure for your scars. In most cases of facial scarring, laser resurfacing is the best treatment, especially for surgical or traumatic scars. (The exception is if scars are keloid or hypertrophic)
Hypertrophic or keloid scars are best treated with intralesional steroid injections.
Red scars from surgery, acne or trauma can be markedly improved with V BEAM vascular laser. Patients will often need 3-4 treatments every 1-2 weeks for best results.
Recover following scar revision will depend on the site and the type of scar revision treatment.
- Fully ablative Erbium and or CO2 treatment – 7 to 10 days
- Fractional CO2 or Erbium laser – 3-7 days
- VBEAM vascular laser – 12 hours
- Anti-inflammatory injections – nil recovery time
- RF or RadioFrequency eMatrix- 24 to 48 hours (Acne scar prevention treatment)
I will discuss the expected recovery time during the examination and planning stage of your appointment.
Atrophic scars are indented scars that are depressed and lie lower than the surrounding skin. These scars are usually due to chicken pox, acne, or skin grafts. Treatment for atrophic scars including fillers, dermal fillers or fat grafting.
Keloid scars are lumpy, often itchy scars that lie above the surface of the skin. Treatments include laser (for early scars or keloid prevention), or steroid injections. The aim of treatment is to flatten these scars.
Fillers such as Juvederm are great for indented and atrophic scars
Raised scars can be either hypertrophic (with in the scar line) or keloid (extending beyond the scar margins). This type of scarring can be treated with laser (if scars are early or red), however injections with anti-inflammatory steroid solutions form the mainstay of treatment. Injections can reduce symptoms of keloid scars such as pain and itching. Most patients will need a series of injections every 5-6 weeks to flatten the scar. Keloid scars can never be totally removed, flattening of the scar is the aim of treatment.
Prevention of further keloid scarring is very important, especially if future surgery is planned. The early use of silicone sheeting, strapping and V Beam laser treatment is best for prevention.
Scar Treatment Brisbane
The aim of treatment in this case is to raise the depressed tissue. This can be achieved by several methods including-
- Laser resurfacing via multiple fractional CO2 laser. This process stimulates your body’s cells to produce collagen. This inturn raises the scar over several months. Ideally this treatment is used for rolling and atrophic acne scars. Fractional lasers or energy RF Microneedling with INFINI can give permanent results.
- Dermal grafting
- Fat Grafting
The type of acne scar and your skin colour will determine what is the ideal treatment. My rule is that optimal outcomes are achieved by matching a treatment to the scar type, and not the other way around. I have written an entire website on acne scar treatment (www.acnespecialists.com.au).
Treatments for acne scars include the following-
- Fully ablative laser resurfacing- ideal for scars at the same level. Suitable for fair skin patients with box scar and rolling scars. Often I combine fully ablative Erbium laser with fractional laser resurfacing.
- Fractional laser. I use either erbium or CO2, but also have a Fraxel 1550 machine for rolling and atrophic acne scars.
- V Beam Vascular laser- this is useful following ablative laser, but also an excellent treatment for red acne scars.
- RF or eMatrix. This treatment uses radiofrequency to treat and prevent scars. Best used in early acne scars
- TCA CROSS- an excellent method of treating deep ice pick scars.
- Surgical techniques – these include punch excision, punch elevation, dermal grafting, and subscion.
- Fillers- this is one of my favoured techniques for scar revision as results are instant, and downtime minimal. Fillers are great for rolling and atrophic scars. New fillers last well over one year.
- INFINI RF with PRP is the latest method to treat acne scars. Healing is accelerated with growth factors from PRP
Acne scarring is one of my subspeciality interests as new technology brings better treatments that are safe and effective. This field is constantly evolving.
More on treating acne scars
Scar treatment Brisbane- Dr Davin Lim uses INFINI RF combined with PRP as well as fillers such as Juvederm and Restylane to treat atrophic acne scars.
Planning is the key. If you scar easily, early treatment of your surgical scar (examples include planned skin cancer surgery and c-sections) will give the best outcomes. Scarring can be reduced by-
- Following instructions given by your Specialist surgeon
- This includes pressure dressings, taping and silicone sheets
- Early V BEAM laser to the scars
- Early dilute steroid injections if the scars are lumpy.
Scar revision with injections and lasers can flatten scars and decrease redness. 3-5 sessions are needed.
Scar Treatment Brisbane- costs and Medicare
The cost of scar revision will depend on many factors, most importantly the type of scar and the procedure performed.
As a guide-
Laser resurfacing for scars $1,290- $4500
Injections and or lasers for keloid scars $120 out of pocket
Fillers for depressed scars and acne scars $990 out of pocket
Most scar procedures conducted under a Specialist will carry a Medicare Rebate. Scar treatment Brisbane can be subsidised by Medicare
By Dr Davin Lim
Laser and Aesthetic Dermatologist
Almost all forms of scarring can be improved. Scar treatments are challenging as we have to be experts in all forms of scar revision. This means training in surgical methods such as subscion, excision and revision, laser resurfacing with both CO2 and Erbium laser, as well as Fractional lasers and vascular lasers for red scars. Some scars require chemical such as steroids to flatten them out, whilst depressed scars require either fat grafting or replacement with dermal fillers. Each scar presents as a unique challenge with an optimal treatment. Matched correctly some scars can be completely removed.
I must say that scar revision is my favourite procedure, as results really do change lives.
‘Scars have the strange power to remind us that our past is real.’