Scar Management

 

Important information

First, it is important to know, that scars mature over a long period of time on their own. In an adult, it takes 1-2 years for the scar to fully mature. During this time the scar will get flatter, softer and more pale in color. In children this takes several years. 

What is the process like?

Scar treatments include pressure garments, silicone sheets, injections and surgery. Pressure garments are custom made and have to be worn 23 hours a day, every day typically for several months or even up to a year. These are most commonly used with burn patients or other patients with significant scar overgrowht (hypertrophic scars or keloids). When garments are not enough, silicone sheets are added for more pressure and moisture.

Triamcinolone injections are used for thick scars. It is injected with a needle inside the scar. The injection may be painful and often local anesthetics are used before injections. The triamcinolone injection is typically repeated every 6 weeks. Sometimes one injection is enough, but often several injections are needed to obtain favourable resuls. It is important to know that not everyone responds well to these injections. Injections typically make the scar flatter and softer, but do not change the direction or width of the scar.

Quite often patients want their scars surgically corrected. This can be done in several differrent ways.

  • Scar excision: the scar is cut out and repaired. Often the wound can then be primarly closed with sutures or glue. This is typically done to wide, ugly scars.

Sometimes scars are so wide or big that closure by sutures is not possible. In these cases either:

  • skin grafts or

  • artificial skins are used to obtain better cosmesis.

If the scar is tight (contracted) it may cause restrictions in range of motion. Also, the scar may be visible because it goes against the natural skin tension lines. In these cases a procedure called

  • z-plasty may be done to either give more lenght to the scar and reducing tightness or changing the direction of the scar to make it less visible.

  • Fat grafting can be used to soften scars and correct indents.

  • Lasering can be used to soften and flatten scars and reduce redness.

    Book a consultation to find the best option for your needs.


Before and After photos

BEFORE: Thick burn scar with limited range of motion to knuckles and fingers

BEFORE: Thick burn scar with limited range of motion to knuckles and fingers

AFTER:  Full range of motion achieved

AFTER: Full range of motion achieved

AFTER: Reconstructed with artificial skin.

AFTER: Reconstructed with artificial skin.

Showing the suppleness of the scar

Showing the suppleness of the scar