Skin is a seamless organ, like a fine cloth protecting valuable assets. Imagine a piece of silk. Just one small tear can make a big difference in how it looks. And it’s the same with skin. Any burn, injury, or other trauma, such as surgery, can cause a scar.
Now a scar isn’t bad if it’s small or in a location that’s easy to conceal. But when it’s not, you may wonder if there’s a way to treat it, other than hiding it under your clothes, that will make it go away or at least change how it looks.
The truth is the scar will never completely go away. But there are some methods that can help reduce its size and change its appearance.
How Does Scarring Happen?
Scarring is a natural part of the healing process after an injury. Its appearance and its treatment depend on multiple factors.
The depth and size of the wound or cut and the location of the injury matter. So do your age, genes, sex, and ethnicity.
What Are The Types of Scars?
These are several different types of scars including:
These scars are the result of an overly aggressive healing process. They extend beyond the original injury. Over time, a keloid scar may hamper movement. Treatments include surgery to remove the scar, steroid injections, or silicone sheets to flatten the scar. Smaller keloids can be treated using cryotherapy (freezing therapy using liquid nitrogen). You can also prevent keloid formation by using pressure treatment or gel pads with silicone when you are injured. Keloid scars are most common among people with dark skin.
If your skin has been burned, you may have a contracture scar. These scars tighten skin, which can impair your ability to move. Contracture scars may also go deeper, affecting muscles and nerves.
These are raised, red scars that are similar to keloids but do not go beyond the boundary of the injury. Treatments include injections of steroids to reduce inflammation or silicone sheets, which flatten the scar.
If you’ve had severe acne, you probably have the scars to prove it. There are many types of acne scars, ranging from deep pits to scars that are angular or wavelike in appearance. Treatment options depend on the types of acne scars you have.
What Are Possible Treatments for Scars?
Scar treatments may include:
Over-the-counter or prescription creams, ointments, or gels These products can be used to treat scars that are caused by cuts or other injuries or wounds. If you are under the care of a plastic surgeon and your scarring is from cosmetic or plastic surgery, ask your surgeon if over-the-counter treatment is an option. If not, there are prescriptions that may help. Often, treatments can include steroids or certain antihistamine creams for scars that cause itching and are very sensitive. Likewise, if you have scarring from severe acne, ask your dermatologist for advice. Your doctor can also recommend or use pressure treatment or silicone gel sheetings to help treat scars or as preventive care.
Surgical removal or treatment
There are many options to treat deeper scars depending on your particular case. These include skin grafts, excision, dermabrasion, or laser surgery. In a skin graft, the surgeon uses skin from another area of your body. This is often used with people who’ve had burns. If you’ve got scarring that impairs function, surgery can help address the functional problems. If you’ve recently had surgery that has caused scars, it is best to wait at least one year before making a decision about scar treatment. Many scars fade and become less noticeable over time.
You may get steroid injections to treat scars that stick out, such as keloids or hypertrophic scars. Your doctor may use this on its own or with other treatments.
Skin Pigmentation Treatment
Sun damage, hormones, skin trauma, ageing and congenital disorders can cause unsightly skin pigmentation. With lasers and lightening creams, it’s possible to fade or remove dark marks and achieve a more even skin tone.
What is skin pigmentation?
Pigmentation is essentially a darker area of the skin, which appears when excess melanin is produced. Sun spots, freckles, birth marks and marks caused by pregnancy, the contraceptive pill, chemical peels or acne are all common skin pigmentations.
- Pigmentation is either epidermal (superficial), dermal (deep), or mixed.
- UV exposure, hormones, skin trauma and congenital conditions can all cause excessive skin pigmentation.
- We use lasers and lightening creams to treat pigmentation.
- The treatment we use will depend on your preferences and the pigmentation type.
What causes skin pigmentation?
Usually skin pigmentation or hyperpigmentation is caused by the melanin-protective system being overwhelmed. When this happens, excess melanin is produced, resulting in dark pigmentation marks.
Common causes of skin pigmentation include:
- UV radiation: With Australia’s high UV levels, excessive exposure to the sun can cause pigmentation.
- Hormones: some pigmentation such as melasma or chloasma can be caused by pregnancy or the contraceptive pill.
- Trauma: Acne, chemical peels and other skin trauma can cause post-inflammatory hyperpigmentation.
- Birthmarks: Some marks occur naturally at birth or appear in childhood or adulthood.
Types of skin pigmentation
Most skin pigmentation is one of the following:
Epidermal (superficial) :
Usually close to the skin’s surface and caused by sun exposure. Includes non-cancerous sun spots (solar lentigos), freckles and cafe-au-lait macules.
Dermal (deep) :
Commonly found in the dermal layers. Includes hori’s macules, and naevus of ota.
Mixed dermal/epidermal :
Also known as post-inflammatory hyperpigmentation. It travels through both the superficial and deeper layers of the skin. Usually caused by acne, laser hair removal, chemical peels and skin trauma
Using lasersLasers can be an effective way to treat skin pigmentation, with some having little or no impact on the normal skin that surrounds the pigmentation. This is achieved by selective photothermolysis, which is the way the laser wavelength is attracted to the pigmented skin. In this way, the laser can treat the pigment without disturbing or damaging the normal skin around it. The wavelengths that are attracted to the pigmented skin range from 532 to 1064 nanometers (nm)
We use two types of lasers:
Millisecond pulse width lasers : These emit pulses of light, which disrupt the melanin in the pigment by thermally heating it. Each pulse lasts for just a few milliseconds (1 millisecond = 1/1000th of a second). The Gemini laser and the Candela V-beam pulsed dye laser are both millisecond pulse width lasers.
Q-switched lasers : These emit nanosecond pulses of light (1 nanosecond = 1 billionth of a second). The light is attracted to the melanin and heats the pigment to disrupt it. The short pulses shock the pigment, so that it breaks down. The lasers require fewer treatments than millisecond pulse width lasers. They are also seen as being more aggressive and effective, which can mean a longer recovery time and a higher chance of post-inflammatory hyperpigmentation. The Sinon Ruby laser and the Medlite laser are both q-switched lasers.
Using topical lightening agents
Applying sunscreen daily is the first step in treating skin pigmentation. Exposing your skin to the sun’s damaging rays can worsen existing pigmentation and increase your risk of developing skin cancer.
Here are our top sunscreen tips:
- Use a physical sunscreen, as it contains titanium dioxide and zinc oxide. The cream sits on the skin for lasting protection.
- We do not advise using chemical sunscreens, as they are absorbed into the skin and need to be reapplied after two hours.
- Apply two coats of sunscreen to ensure no spots are missed.
- Apply sunscreen every day, even when it’s cloudy as UV light is still present. Avoid direct sunlight, especially during the middle of the day.
- Seek shade and cover up with a hat and protective clothing.
We also use topical lightening agents to help reduce skin pigmentation. These work by inhibiting the enzymes that produce melanin (skin pigment). They also stimulate the skin to flush out existing dark spots. Common lightening agents include hydroquinone, kojic acid, paper mulberry bark extract, retinoids, and glycolic acid.