Lasers are used more often than ever to help treat scarring after surgery. Do they really work? Dr. Anthony Youn addresses this question in the following video.
Some parts of the body scar better than others -- your tummy, for instance. Dr. Anthony Youn explains in the following video.
Surgery scars are difficult to heal, but silicone is one ingredient that you should be using on your scar to help promote better healing. Dr. Anthony Youn elaborates in the following video.
Almost everyone agrees that sun protection is crucial for good healing of scars after surgery. Dr. Anthony Youn tells us some creative ways to protect your surgery scar -- even when you're wearing a bikini.
Some people believe massaging a scar after surgery will help it heal faster. Is this really the case? Dr. Anthony Youn shares his thoughts on the subject in the following video.
Your scar is scored on 3 dimensions: redness, pigmentation, and elevation. Each of these dimensions has an index score ranging from 0 to 100, with 0 indicating least severe and 100 indicating most severe.
The index scores were created as an easy-to-use scale to help quantify your scar. It helps make it easy for you to track whether your scores are improving, and by how much.
This index scores should not be used in place of direction by your physician or healthcare provider.
You could easily be right! Accurate results require accurate photos. Please be sure to closely follow the instructions in the FAQ section titled taking good photos.
Click and move your mouse over the image to "paint" over your scar. Avoid "painting" hair into the region of concern. Do "paint" over all of the scar that's visible in the photo, and include a little background skin.
Photos should be in .jpg format, and up to 2MB in size. In general, higher resolution leads to a better analysis.
Good lighting is important! We recommend taking your photo indoors in a well lit space. Try to avoid lighting which creates shadows in the photo. Also, try to be consistent; take your photos in the same place with the same lighting each time.
It's important that after cropping your condition is well represented in the photo. Please try to zoom in as much as possible. For a long scar, it's better to zoom in on one part of the scar than to try to fit the whole scar in the frame.
A scar is a permanent patch of skin that grows over a wound. It forms when the body heals itself after a cut, scrape, burn, ore sore. Scars also appear after surgery that cuts through the skin, infections such as chicken pox, or skin conditions like acne. Scars may be depressed (atrophic) or raised (hypertrophic and keloids.)
A total of 100 million patients develop scars in the developed world alone each year as a result of 55 million elective operations and 25 million operations after trauma.
Scars form when the dermis (deep, thick layer of skin) is damaged. The body forms new collagen fibers (a naturally occurring protein in the body) to mend the damage, resulting in a scar. The new scar tissue will have a different texture and quality than the surrounding tissue. Scars form after a wound is completely healed.
There are different kinds of scars:
Atrophic: This kind of scarring occurs when underlying structures supporting the skin (for example, fat or muscle) are lost. Some surgical scars have this appearance, as do some scars from acne. Some atrophic scar may appear when the skin stretches rapidly (for example, as in growth spurts or during pregnancy). In addition, this type of scar can occur when the skin is under tension (near a joint, for example) during the healing process.
Hypertrophic or Keloids: The body produces too much collagen resulting in raised scars called hypertrophic scars or keloid scars. Keloid scars result from an overproduction of collagen that grows beyond the margins of the original wound. Both types of scars are more common in younger and dark-skinned people.
Atrophic: Atrophic scars may be flat and pale. Some atrophic scars can have a sunken or pitted appearance. This kind of scarring occurs when underlying structures supporting the skin (for example, fat or muscle) are lost. Some surgical scars have this appearance, as do some scars from acne. Some atrophic scars also can appear as stretched skin. Such scars result when the skin stretches rapidly (for example, as in growth spurts or during pregnancy). In addition, this type of scar can occur when the skin is under tension (near a joint, for example) during the healing process.
Hypertrophic Scars. Hypertrophic scars are thick, red, and raised, however, unlike keloids the scar remains within the boundaries of the original incision or wound.
Keloid. Keloids are thick, protrusive mounds of scar tissue and are often red or darker in color than the surrounding skin. See table 1 for differences between hypertrophic scars and keloids.
Contractures. Burns or other major injuries may form a scar that pulls the edges of the skin together, a process called contraction. The resulting contracture may affect the adjacent muscles and tendons, restricting normal movement.
Fig 1. Atrophic Scars (Left: pitted - Center: stretched - Right: atrophic, post acne)
Fig. 2 Hypertrophic scar after abdominal surgery
Fig.3 Keloid scar after vaccine on shoulder
Table 1. Differences between hypertrophic scars and keloids
Atrophic Scars: There is no topical treatment that can prevent or remove atrophic scars. Retinoic acid
Hypertrophic scars and Keloids: The best treatment to prevent the formation and to reduce some signs and symptoms associates to this type of scars is 100% topical silicone. It comes in gel or spray. The most effective is the one that dries itself in seconds, allowing the use of other cosmetics like sunscreens, moisturizers and make-up, on top of it.
Atrophic scars: These lesions can be treated with a procedure called microneedling and some types of laser to stimulate collagen. A procedure called subcision is used to remove the fibrous tissue of scars attached to deeper tissues. Sometimes derma fillers can be used to fill in depressed scars. The best results are obtained with the combination of procedures.
Hypertrophic scars and Keloids: Intralesional corticosteroids and cryotherapy with liquid nitrogen are the most common for the treatment of this type of scars. Some other procedures including scar revision, radiotherapy, intralesional 5-fluoruracilo, lasers have been used with variable results.
http://www.webmd.com/skin-problems-and-treatments/guide/scars. Consulted 02.12.12
http://www.aafprs.org/patient/fps_today/vol18_1/vol18_1pg4.html. Consulted 02.12.12
http://www.skincarephysicians.com/acnenet/depressed_acne_scars.html Consulted 02.12.12
Gupta S, Sharma VK. Standard guidelines of care: Keloids and hypertrophic scars. Indian J Dermatol Venereol Leprol 2011;77:94-100
Gauglitz GG, Korting HC, Pavicic T, Ruzick T, Jeschke MC Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies Mol Med 2011;17: 113-125
Wolfram D, Tzankov A, Pulzi P Piza-Katzer H. Hypertrophic Scars and Keloids: A Review of Their Pathophysiology, Risk Factors, and Therapeutic Management Dermatol Surg 2009;35:171-181
http://www.nlm.nih.gov/medlineplus/scars.html#cat3 Consulted 02.12.12
http://www.webmd.com/skin-problems-and-treatments/guide/scars Consulted 02.12.12
De Giorgi V, Sestini S, Mannone F, et al. The use of silicone gel in the treatment of fresh surgical scars: a randomized study. Clin Exp Dermatol. 2009;34:688-93.
Sebastian G [Therapy for pathologic scars (hypertrophic scars and keloids)] JDDG [J Dtsch Dermatol Ges], 2004; 2: 308-12