Scar Remodeling - bliniq

Scar Remodeling

Scars form as part of the healing process after your skin has been cut or damaged. The skin repairs itself by growing new tissue to pull together the wound and fill in any gaps caused by the injury. Scar tissue is made primarily of a protein called collagen.

Scars develop in all shapes and sizes. Some scars are large and painful, while some are barely visible. People with dark skin (especially people with African, Asian or Hispanic heritage), as well as red-haired individuals, are more likely to develop keloid scars. Keloids are raised scars that grow and extend beyond the injured area. Depending on their size, type and location, your scars may look unsightly and may even make it difficult to move.

Not all scars require treatment, and many fade away over time. If a scar is bothering you or causing pain, treatments can help.

Scars don’t get removed they are made less noticeable so a better term used for scar reduction is scar remodeling. Scar management depends on several factors:

  1. Depth of the scar
  2. Width of the scar
  3. Weather it’s crossing a joint or not
  4. Is the scar raised from surrounding area or not?
  5. Cause of scarring
  6. Is it causing any functional deformity or not?
  7. Is it associated with hypertrophic scarring/keloid formation?

Treatment modalities available for scar remodeling are:

  1. Surgical scar revision: Used for wide linear scars
  2. Laser: Used for shallow scars over a wide area like acne scarring over cheeks etc.
  3. Triamcinolone injections: Used for hypertrophic scarring or keloid formation
  4. Skin grafting/Flaps: Used for burn scar contracture across joints.
  5. Z-Plasty/W-Plasty: For linear scar revisions or burn contractures.
  6. Subcision with fat injection: Used for acne scarring or burn scars over wide areas.

Serial excision: For very wide scars


Scars are part of the body’s healing process. As part of your immune system, your skin is the barrier to protect you from germs and other harmful substances. When skin is injured, the body creates new tissue made of collagen to help reseal itself.

Collagen plays many important roles throughout your body, including plumping up your skin and helping your cartilage protect your joints. When a scar develops, collagen fibers repair damaged skin and close any open areas. The new tissue protects you from infection.


Can scars be treated?

Several treatments can make scars smaller or less noticeable. Your healthcare provider may recommend one treatment or a combination. Scar treatment depends on several factors, including:

  • Type, size and location of the scar.
  • Whether the scar is causing you pain or affecting your ability to move.
  • Your age and the age of the scar.
What are the treatments for scars?

Treatments can reduce a scar’s size or appearance, but the scar will never completely go away. Some treatments prevent a scar from forming as a wound heals. Scar treatments include:

  1. Dermabrasion: A common acne scar treatment, dermabrasion removes the top layer of skin by gently “sanding” the skin. The procedure softens and smooths the skin and can improve the appearance of scars.
  2. Injections: Your healthcare provider injects medication directly into the scar, making it smaller and flatter. Corticosteroid injections can reduce the size of keloid scars. Your healthcare provider may inject drugs that treat cancer, such as bleomycin (Bleo 15k™) and fluorouracil (Adrucil® or 5-FU), to flatten scars and reduce itching and pain.
  3. Laser treatments: Several types of laser and light treatments can make scars (including acne scars) less noticeable. Laser treatments use a particular wavelength of light to cause a particular action in the skin. The V beam is a pulsed dye laser at 595 nm (nanometers) that targets small blood vessels in the skin. Sometimes the scars remain pink or red because the new blood vessels that developed to heal the wound never receded once their job was done. This laser can cauterize the small vessels from the inside out to remove them from the scar and allow the pink or red color to fade. This action may also help the scar flatten if it’s too thick or thicken if it is too thin. Other lasers (such as the Fraxel laser) can vaporize small columns of tissue within the scar to break up the collagen fibers and allow the scar to remodel and become more flexible. The treatments can also help with pain, itching and sensitivity. Laser treatments may cause hyperpigmentation (skin darkening) or hypopigmentation (skin lightening) in people who have dark skin. Talk to your healthcare provider about side effects before starting treatments.
  4. Pressure therapy: An elastic bandage, dressing or stocking puts pressure on a wound during the healing process. The pressure prevents a scar from forming or decreases its size. Massage therapy can also help break up scar tissue and allow it to remodel.
  5. Scar-revision surgery: A range of surgical procedures can remove a scar, improve its appearance or transplant skin from another area (skin graft). This is an exchange of one type of scar for a different, more preferable scar.
  6. Topical creams and ointments: Applying silicone ointment to a scar may make it smaller or prevent it from forming. Or your healthcare provider may recommend applying corticosteroid cream or a silicone gel sheet to the area. If you have dark skin, ask your provider about using a skin-lightening cream with hydroquinone to lighten scars.

Q1 Does scar revision really work?
A1 Scar revision helps in making the scar less noticeable and more cosmetically appealing; however, it does not completely erase it. Scar revision is also useful in restoring a poorly healed scar. Scar revision may include both surgical and non-surgical techniques.

Q2 Can you get surgery to fix a scar?
A2 Scar revision is plastic surgery performed to improve the condition or appearance of a scar anywhere on your body. The different types of scars include: Discoloration or surface irregularities and other more subtle scars can be cosmetically improved by surgery or other treatments recommended by your plastic surgeon.

Q3 Is scar revision surgery painful?
A3 You may instead be given local anesthesia to numb the surgery area. With local anesthesia, you may still feel pressure or pushing during surgery, but you should not feel any sharp pain. Your surgeon may make an incision around the scar to remove it.