What To Do With A Scar

2 Nov

My friend Nicole had a thyroidectomy and she was asking me about what to do with the scar to help it heal. The neck is a tough area, so I directed her to ask a dermatologist, but I told her I’d research it a little. Scars can be very bothersome to people, especially when they can’t hide them. My friend Amy’s son just required a couple of stitches from a hockey accident. I told him not to worry though. Chicks dig scars. Fact.


Scars are visible signs that remain after a wound has healed. They are unavoidable results of injury or surgery, and their development can be unpredictable. Poor healing may contribute to scars that are obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your appearance. Scars may be raised or recessed, different in color or texture from surrounding healthy tissue or particularly noticeable due to their size, shape or location.

I assisted in a scar revision surgery from a tummy tuck done in New Jersey that did not heal well. This woman went in to have the abdominal muscles repaired from her pregnancy, and left with a whole new embarrassing problem that still kept her out of a bikini.

What Causes Scar Tissue

One word: Trauma. Whether you fell of your bike or barstool, had surgery, were in a car accident, decided to take the brakes off your rollerblades even though you didn’t know how to rollerblade and you decided to start with going downhill (I like to live dangerously… what can I say… I was 13). I have a few scars that particularly bother me.

So you fall and you bleed. What happens? In the LK abridged version (for all intensive purposes):

Treatment can depend on what type of scar you have. These are several different types of scars including:

  • Hypertophic: Raised and red scars that cover the site of the original injury. Just your basic run of the mill scar.
  • Keloid: result of overly aggressive healing process, extending beyond the site of the original injury. (Interesting fact from Dr. Russo: 50% of people with Japanese heritage form keloid scars.)
  • Contracture: results from a burn when the skin tightens and can impair muscle and nervous tissue.
  • Acne: result from severe acne.

Treatment Options

As you are healing from a wound… proper nutrition is very important!
The healing process places extra demands upon the body. Adequate protein intake and vitamins are essential for wound healing.

  • Vitamin A is essential for replacement and healing of epithelial tissues
  • B-vitamins are needed by cellular enzyme systems
  • Vitamin C is essential for production and maintenance of collagen and development of new blood vessels
  • Vitamin D is needed for bone healing and formation
  • Vitamin E may help prevent some types of tissue scar
  • F, G, H, I, J are nonessential. There are no such vitamins. Interesting that they skipped out on these letters. I wonder why. (I digress).
  • Vitamin K is essential in the blood clotting process.

Topical Treatments

  • Creams/Ointments/Gels
    • Topical Vitamin E while the wound is healing. The process of massaging the cream during application is also good for the scar. I think it’s the main ingredient in Mederma. Which according to the box (see picture below) it is the #1 recommended product for scars. I’m not sure if this is true or not. I’m just saying that’s what the box says.


    • Corticosteroid or Antihistamine creams if scars are itchy or sensitive.
    • Retinol (More on Retinoic Acid (my fav!) can minimize post-scar formation pigmentation. Use 30 days after the scar has formed.
    • Silicone gel sheets can be placed over a wound when it has healed. I am using these right now on my breast augmentation incision. I will let you know how it turns out!

  • Tension and Pressure
    • Bandaging a wound applies pressure to the area.
    • Steri-strips applied to keep the wound closed as it heals.


Minimally Invasive Procedures

  • Stitches and Staples:
    • For wounds that require a visit to the ER, you may get stitches or staples. Follow your home care instructions if you do wind up in an ER (or if instructed to do so by a doctor or nurse). Not only will it decrease the likelihood of a scar, but it will also decrease the likelihood of things like infection. Yup. It’s true.
    • I highly suggest requesting a plastic surgeon stitch a facial wound. I know it’s the last thing you think about when bleeding profusely from a head wound, but they really do the best work, at the very least, much better than the ER intern who has never done it before. It’s your face. They can practice elsewhere.



  • Injections:
    • Steroid injections can be used for protruding scars. I actually had a scar on my back injected. The area was numbed with lidocaine and then injected with a corticosteroid. It took about 6 weeks to see a difference (sorry no pictures of before and after!). It can take several treatments to work. Which reminds me I should probably have it injected again.
  • Laser:
    • Vascular lasers may be used to lighten scars that are pink to purple in color. It may also facilitate the flattening of raised, red scars.

Surgical Revision

There are many options under this category including skin grafts, excision or laser surgery.

The tummy-tuck scar surgery I assisted in was an excision. The scar tissue was numbed with local anesthesia, which was difficult due to the fact that the tissue is fibrous, making it hard for the anesthesia to localize through the area. After the patient was numbed, a cauterizing tool was used to remove the scar tissue. The wound was re-stitched and a steroid impregnated tape was applied with a pressure dressing over it. The whole procedure took about 30 minutes.

I have also seen CO2 laser scar revision for acne. There is a lot of down time with this, but the end result is really nice.

Treating Acne Scars

I think it’s something like 3 out of 4 people suffer from acne some form of acne some time in their life, so acne scars are an issue for SO many people. Acne marks that are left behind after a breakout heals (usually reddish or brownish in color) will eventually fade without any intervention. But… most people will pick at acne with their fingernails, which causes a lot of damage to the skin and can also introduce bacteria to the site. Don’t do it. You will make it worse and increase the likelihood of scarring. A person’s acne needs to be under control before scars can be treated. Retinol. Cough.

Depending on the severity of the scarring, there are several possible avenues of treatment. I’d stay away from over the counter products when it comes to acne scars. First, they’re not going to help any, and second they can irritate the skin making a scar even more noticeable.

  • Mild scars: Microdermabrasion. and chemical peels (‘Tis the Season for Chemical Peels!.) will help with mild issues of the texture and tone of the skin.
  • Moderate scars: Laser skin resurfacing is recommended. I had this done at the office. It HURT. It usually takes between 3 and 10 days for the skin to heal completely.

I get asked all the time to put filler into a scar. Personally, I think there are better options. In order to inject filler, the scar tissue needs to be excised (yes, it is as uncomfortable as it sounds). It’s the same idea as numbing a scar with an anesthesia, the tissue just does not allow liquids (or gel’s like fillers) to penetrate evenly. This is my personal experience, but I know it is very common so I guess maybe some people have a better technique? I’m not sure.

  • Severe scars: CO2 laser can only be done by a doctor, under anesthesia. There is a lot of downtime with this procedure, unfortunately, but it yields fantastic results (I’ve seen it done a few times). I have never seen or heard of grafts for acne scarring.

XOXO, LK

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One Response to “What To Do With A Scar”

  1. GSB November 2, 2012 at 5:55 am #

    Great informative article… Thanks!

    Sent from my iPhone

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