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Specific Types of Scars Require Specific Treatments

Anyone with visible scars knows how debilitating they can be but with the technology & expertise found at Skinspirations, at least most scars can be improved. The staff at Skinspirations uses a combination of methods, depending on the type of scar, including lasers, light devices, microneedling, subcision (loosening the fibers under the skin that pull a scar inward) and medication injections. These treatments can reduce the appearance of scars by up 90% depending on the type of scar.

Different Methods Work Best for Different Types of Scars

With experience, we have found that the following techniques determine the type of treatment that will give the best results for specific scar types.

Does a depressed scar look smooth when stretched to the sides?

Scars that look smooth when pulled to sides, do best with subcision vs. laserIf the skin looks smooth when you pull a scar from the sides and stretch it out, then there is tethering underneath the surface, pulling inward, and no surface treatments like lasers or chemical peels will release that pull. Cutting the part of the scar under the skin, called subcision, will release it, and it can be done almost painlessly with a tiny needle. Because blood acts like glue, we use a dermal filler to hold the skin up until any bleeding has resolved, to prevent it from re-tethering back down. Another benefit to using a filler with subcision is the anesthetic that's in it, which makes the treatment very tolerable. In most cases, only two or three treatments of subcision and a temporary filler are needed to produce permanent improvement in the scar, although a permanent filler like Bellafill can be used if desired.

Does the scar look the same when stretched to the sides? Surgical scars usually do best with fractionated ablative laser treatments
Scars that do not appear improved by stretching them apart, like icepick, surgical or chicken pox scars, are due to defects at the surface of the skin and won't be improved by subcision or fillers.

Depending on the type of defect, they can usually be improved by using a fractionated ablative laser, like our Profractional, to replace a fraction of the fibrous scar tissue with normal, new soft skin. Since only about 10 - 20% of the scar is being replaced with each treatment, it usually takes several sessions to produce marked improvement. Another treatment to help improve surface scars, and with no downtime, is microneedling. Our SkinPen microneedling device produces thousands of tiny holes in the scar that are replaced with normal, soft skin, and like the Profractional, best results are seen with a series of treatments.

"Is the scar thicker & elevated above the level of the surrounding skin?

Scars elevated above surrounding skin often need several types of treatments.Scars in some body areas where there's friction or pull can grow thicker than the surrounding skin, which makes them more unsightly than if they were flat. A series of injections of a medication called 5-fluorouracil (5-FU) with or without a steroid medication will often flatten these hypertrophic or keloid scars. Surprisingly, a small amount of Botox injected around the perimeter of the scar will also help reduce the size of the scar.

Is the color of the scar different from the surrounding normal skin color?

It isn't uncommon for the color of a scar to be either darker (hyperpigmented) or lighter (hypopigmented) than the surrounding skin, or persistently red. Hyperpigmentation and redness can usually be improved with IPL treatments, unless the baseline skin color is dark. Hypopigmentation is more difficult to improve but fractionated ablative lasers like our ProFractional are sometimes successful in restoring normal color where the pigment has been lost.

Combination Therapies for Scars

Especially with acne scars, sometimes there are several different types of scars that respond best to different treatments. These treatments require a combination of techniques but since we do all of the known effective scar treatments, they can usually be done during the same session. An example is a traumatic scar that has areas of thickening or hypertrophy. We use the Profractional over the entire scar to replace a percentage of scar tissue with normal skin, and paint 5-FU over the hypertrophied area where it will travel down the vaporized columns & decrease the thickness.

If you'd like our opinion on the best strategy for your scars, contact us for a complimentary consultation by registering online here or by calling 727-571-1923.

Before & After

  • Before and after scar subcision with dermal filler