Facial Scar Treatment

A facial scar treatment procedure pertains to any surgical or non-surgical procedure that aims to remove, minimize, or improve the appearance of scars on the facial area. There are a number of different facial scar treatments and the best one depends on the type of scarring the patient has. In general, non-surgical facial scar treatments tend to be resurfacing-type procedures done manually with the help of chemicals, lasers or other procedures. Surgical facial scar treatments are procedures in which the scars are surgically removed or cut out.

TYPES OF SCARS

The different types of facial scars include raised scars, indented scars, and flat scars.

• Raised scars are either hypertrophic scars or keloid scars.
• Indented scars are classified as ice pick scars, boxcar scars, and rolling scars. An ice pick scar is a very small, narrow, or deep scar that looks like a needle. A boxcar scar tends to have either a round or square shape. A rolling scar gives the skin a bit of an undulating or wavy appearance.
• Flat scars are neither raised nor indented. They just have a texture that is different from the rest the skin.

TREATMENT OPTIONS

The treatment of facial scars includes surgical and non-surgical options.

The non-surgical options include dermabrasion/microdermabrasion, microneedling, laser treatment, chemical peels, and PRP (Platelet-Rich Plasma) application. These treatments are often used for indented scars and perhaps on some flat scars as well. The first-line treatment for raised scars are usually medications that are directly injected into the scars, the most common one being corticosteroids.  Laser treatments, surgical excision, radiation therapy and cryotherapy are alternative options. Occlusive dressings and compression therapy may also be helpful.  

Scar excision or scar revision is procedure in which a scar is surgically removed, in other words the scar is cut out and the opening is closed with stitches.  After scar excision, there will still be a scar but the goal is to have a more cosmetically appealing scar.  Punch removal is a popular technique for ice pick scars other narrow scars.  In punch removal, a hollow bladed instrument is used to punch the scar out from the skin.

It is important to remember that facial scar treatments will not get rid of the scar completely. It is like trading in one scar for a potentially better-looking scar.

TREATMENT COMPARISON

Whether a surgical or non-surgical approach is more reliable and effective depends on the type of scar being treated and the ability of the body to heal itself. Two patients who wish to undergo laser treatment for their boxcar scars will not get results that are identical to each other. Everybody has a different response to injury and injury stimulation so the results vary greatly. Scar treatment is not a one-size-fits-all model.

LIMITATIONS

The goal of facial scar treatments is to get the skin looking as normal as possible. There are instances where patients get really good results, and there are some who do not get good results. Even if the improvements are great, one limitation of scar treatments is that the skin cannot be made to look 100% normal. The surgical technique does not get rid of the scar completely and trades one scar for a better-looking scar. In theory, the non-surgical approach keeps the scar and makes it look better. The main limitation of facial scar treatments is the variable results.

RECOVERY

Surgical and non-surgical techniques are both associated with downtime and a recovery period.  When a patient undergoes surgery, stitches will be put on the face and necessitates a downtime of five to seven days. The downtime for the non-surgical treatments depends on the treatment being performed.  For example, there may be no downtime after injections but up 7 days, or even more, for some of the laser treatments. Downtime most commonly includes swelling and redness, but may also include bruising, peeling and some discomfort.  The recovery period also depends on other factors such as how big the scar is and where it is located.

RESULTS

All facial scar treatments take a little bit of time to produce improvements. Some people might require only one treatment while others might need a series of treatments. About three months after the treatment, the patient will start to see the results of non-surgical approach. With the surgical options, the new (and hopefully better-looking) scar that replaces the original scar will take about a year to fully heal. Only then will the patient see its full final appearance.

FINAL THOUGHTS

Multiple treatments might be required if the patient opts for non-surgical facial treatment. With surgical, a single treatment is usually enough because the surgeon is just cutting the scar out and stitching it up. The patient should consult with a board-certified physician in order to determine if a surgical or non-surgical approach is the best option to treat the scar.

Written by Cosmetic Town Editorial Team- AA

Based on an exclusive interview with Sejal Shah, MD in New York, NY