SCARS CAN BE OF VARIOUS TYPES:
- sunken and hollowed out
- from healing
- the keloids
What Does A Scar Involve?
Alteration of the state and integrity of the skin, scar tissue develops subcutaneous adhesions, decreased elasticity (keloids) and mechanical traction on the tissue of the affected area.
The consequences of scars can therefore be summarised as:
- mechanical damage, which causes loss of elasticity
- damage/energy block.
- There are various solutions to eliminate scars.
After the visit with one of our doctors, we will define the best therapy for you.
Massages with creams prescribed by the specialist, for example, can help the scar to heal completely and without leaving too apparent imperfections.
Scar compression is intended for specific dressings of hypertrophic and keloid lesions.
The occlusion with silicone gel sheets is helpful for lightening scars.
There are also:
- laser therapy (which flattens the lesion making it less visible)
- cryotherapy (freezing of the scar with liquid nitrogen)
- dermabrasion (mechanical smoothing of the surface layer)
- the infiltration of fillers (collagen and hyaluronic acid reduce the depth of the scar).
Then there are other possibilities such as:
- intralesional cortisone injections
- injections of interferon directly into the scar to reduce its size
- injections of fluorouracil
- steroid Injections
Scars can also be reduced with surgical treatments such as:
- cosmetic microsurgery
- intralesional excision of the scar
- complete excision
- repair with proximity flaps or grafts (for large lesions).
Scar Treatment With Chemical Peeling
Peeling refers to a procedure whereby a substance is applied to the skin that literally “exfoliates” it.
It helps the elimination of the most superficial skin layers.
In this way, the deeper layers emerge, the less damaged, and the skin appears smoother and more uniform.
The peeling can occur mechanically, for example, passing a granular product on the skin or chemically by applying a substance to the skin for a few minutes to promote skin exfoliation.
The peeling system is very suitable for acne scars.
This method irradiates the skin area with the laser to facilitate the detachment of the superficial, damaged skin layers and stimulate the production of new, smoother tissue.
The lasers suitable for erasing scars are the carbon dioxide (CO2) laser or the Erbium laser.
These types of lasers emit energy radiation absorbed by the water contained in the most superficial layer of the skin.
The water evaporates, and the dehydrated cells detach from the skin surface as if vaporised.
In this way, the deeper layers of the skin are stimulated, rich in collagen fibres, responsible for the soft and smooth appearance of the skin.
The effect is similar to that obtained with chemical peels.
The laser, however, can be dosed with extreme precision depending on the type of skin to be treated.
The surgery is performed without any anaesthesia as it is painless.
Eventually, the treated skin is subject to a slight redness which will disappear thanks to the application of soothing and decongestant products.
Each treatment must be followed by a treatment at home based on protective masks and creams and collagen to allow perfect skin surface regeneration.
The laser is a fairly aggressive treatment, which requires more spaced applications: no more than once every two months.
To make the treatment more effective, it is possible to apply silicone sheets, a substance that naturally promotes skin regeneration.
Laser dermabrasion is particularly suitable for solving the problem of acne scars.
Intralesional infiltrations also known as steroid injections are small injections carried out with a thin needle that does not cause pain: the person, at most, feels a tingling sensation in the points where the needle penetrates the skin.
It is a system especially suitable for raised scars, that is, protruding above the skin surface.
A cocktail of steroids is injected under the skin, substances that derive from cortisone and stimulate the production of substances—such as enzyme lactase and fibres.
In this way, the scars themselves tend to flatten and, therefore, to be less evident.
After any Steroid Injections, compression MUST be carried out to make the result even more satisfactory: a plaster is applied that holds an occlusive gauze firmly on the scar, which presses on the scar to flatten it even more.
The number of sessions varies according to the scar’s severity; usually, three to eight are sufficient.
One session per month should be performed.
Scar Treatment with Filler
The scar care system with fillers injects minimal amounts of soft material corresponding to the “holes”, which blends perfectly with the skin to give it a pleasant and natural aesthetic appearance.
Corticosteroid injections are used to treat raised scars, like keloids and hypertrophic scars.
Corticosteroids suppress inflammation and mitosis while increasing vasoconstriction in the scar resulting in flattening of the scar and reduction of pain or itchiness of the scar.
The specific corticosteroid for keloid and hypertrophic scar treatment is Triamcinolone acetonide suspension—10 to 40 mg per mL is injected intralesionally.
However, it will eventually flatten 50 to 100 per cent of keloids, with a 9 to 50 per cent recurrence rate.
Newer keloids are more responsive to therapy than older, established lesions.
A Course Of Steroid Injections For Keloid
A specific steroid has been used for keloid treatment for many years.
Triamcinolone Acetonide is the most specific steroid used to stop the growth and flatten keloid, hypertrophic and raised scars.
Different concentrations of Triamcinolone acetonide range from 10-40 mg/ ml, suitable for treating various types of raised scars. Our doctor will examine your scars and select the best-suited concentration of Triamcinolone for you.
As the maximum result of injection will be at one month after, we usually recommend having the injection once a month until the keloids are entirely flat.
Then patients can observe if the keloid grows back or not. Top up injections may be needed if the keloid grows back. The risk of recurring keloids depends on many factors, including the severity of the keloid itself.
- You will have a detailed medical consultation and examination by our experienced doctor before the treatment.
- A topical or local anaesthetic may be applied/ injected to help reduce the discomfort of the injection before the steroid injection.
- Steroids will be injected into the scar tissue.
- The treated areas will be covered with plasters which should be kept on for at least one hour.
- A review appointment will be scheduled for one month after the treatment.
How Many Injections Will I Need?
The exact number of steroid injections sessions needed is difficult to determine.
It is recommended you should have an injection once a month until the keloid is completely flattened.
Then you can observe if the keloid grows back. If it starts to grow back, you may need to have the steroid injection to maintain the flattening effect.
Depending on the severity of the keloid, most of the keloid that has been treated shouldn’t recur.
However, if it does start to grow back, you may need further injections every few months or years.
You may expect some discomfort at the treated areas for the first one to two days.
Mild swelling of the scars can be expected the next day.
Then the scar will gradually flat down over the next four weeks to see the maximum result of the injection.
What Happens After the Steroid Injections treatment?
You may experience some discomfort in the treated areas over the next few days.
Mild swelling of the scars can be expected the next day.
Then the scar will gradually flat down, and over the next four weeks, you will see the maximum result from the injections.
There are many factors involved in the chance of keloid recurrence, including severity, location etc. Yet, on average, 70% of our patients have been successfully managed without recurrence of the keloids.
Risks and complications
Common risks and complications are just temporary for a steroid injection, including local side effects like discolouration, skin thinning, and depression on the treated area and around the area.
It rarely becomes a permanent effect. However, if you have large keloids that need large amounts of steroid injection, it may cause some systemic side effects, although it’s rare.
It is the most classic system to intervene above all on particularly disfiguring keloids.