In any surgery involving an incision to the skin, some scarring is inevitable. For some patients, this is mild and the scar tissue quickly fades to a pale line. For others, the scar tissue continues to grow over time and become prominent and discolored. There are many therapies available for reducing scars after they develop and to prevent too much scar tissue from developing in the first place. Here are several approaches a dermatological surgeon may use to minimize scars:
Silicone Gel Sheets
This material has been in use for over 20 years to reduce scarring. The adhesive flexible gel sheeting may be clear or have a fabric backing to make it more durable. It is designed to provide an extra layer of protection to the skin once a wound is fully closed and dry. The sheet keeps the skin moisturized as it heals. This is a property of the silicone gel itself – the sheeting doesn’t contain any topical medications.
This type of bandage is used to reduce the appearance of both hypertrophic and keloid scars by making them flatter and softer. The redness of the scar tissue may also be reduced. Sheeting may be used on old scars as well as new ones. Maximum results typically take several months of continuous use to become apparent. Some mild skin irritation may occur from the use of this type of sheeting. These sheets are available for purchase over the counter. They shouldn’t be confused with pressure bandages for treating burns. Pressure garments should only be used under the direction of a physician.
Steroids may be injected or applied topically for raised scars. If surgical revision is attempted to reduce the size of a scar, steroids are often used as an additional therapy to help prevent excessive scar tissue from recurring. Such treatments may continue for up to 2 years after surgery since this is often the length of time it takes for a scar to fully mature.
For atrophic scars that appear as dimples or craters in the skin, injections of dermal filler may be used. These provide volume under the scar and push it upward. Fillers are absorbed over time – so they have to be repeated to remain effective. Because of this, these injections are usually done on facial scars about which a patient might be particularly self-conscious.
Surgery, laser treatment, dermabrasion, and other revision techniques are available for scars that are resistant to less invasive therapies. These procedures may carry the risk of making scarring or discoloration worse for some skin types, so they are only recommended on a case by case basis.