Laserklinik DRes Steinert

		Scars are areas of fibrous tissue, replacing normal skin. They occur only in the case, if the upper skin layer, the epidermis, has been damaged.   This happens as a result of surgery, accidents or burns including chemical burns.   Operations are sometimes unavoidable. Special incision and suturing techniques have been developed to make the scar completely or partially inconspicuous.   While making incisions, especially in the case of removing skin lesions, the attention is paid to the so-called lines of minimal skin elasticity.   With regard to sutures, the intracutaneous suture is considered to be standard for the most parts of the body today. It is placed about one millimetre under the skin and is sutured using a thread. Normally, just a light line remains. However, there can also be constitutionally good or bad wound healing. Thickened scars occur more often in certain body regions, also after burns connected with deep damaging of the dermis. Furthermore, scars appeared due to accidents heal not so well in general, because the edges are mostly fringy and must be corrected or trimmed.

Patience plays an important role in scar treatment. Scars can also change weeks later, even up to a year. In most cases, the initially intensive redness, caused by increased blood circulation in the fresh connective tissue, will reduce by itself.

Especially in the area of joints characterised by great tension this can also lead to restrictions of movement.

Act quickly, if there are any changes.

It is possible to avoid cosmetic scar surgery, if you act in time in the case of conspicuous scarring. The indications are the unusual feeling of tension, formation of bulges, haemorrhaging, flat spreading or continuous crust formation in the scar area.

Problematic scarring

Atrophic scar:

The wound heals poorly, not enough new connective tissue fibres are built. A “sunken scar”, lying below the skin level, appears.

Hypertrophic scar, keloid:

The overproduction of connective tissue fibres leads to the formation of bulges. The scar rises above the original skin level, but it is restricted to the area of injury. Bulgy scars are often characterised by paraesthesia, as for example, sensation of numbness, due to the fact that skin nerves unfavourably grow together.

Keloid scar: high overproduction of connective tissue fibres leads to the formation of growths over the wound. Such a scar pattern develops only after a longer period of time, for instance, when the affected body region is exposed to great skin tension.

Dehiscent scar:

It occurs, if the affected body region has been exposed to tension too quickly or in the case of enormous skin tension, especially over the large joints and at the back. The scar bursts or ruptures with the time over and over again. Without bleeding or weeping, it becomes a broad optically disturbing scar.

Treatment methods:

If thickenings and bulges begin to appear, it is necessary to start with cryotherapy (treatment using fluid nitrogen) as early as possible. In addition, one can apply cortisone cream; with prominent formation of bulges, one can even inject cortisone crystal suspensions into the thickened scar.

In the meantime, there are also silicone wound dressings. One can apply silicone cream to the smaller lesion focuses. Compression therapy using a corsage is often indicated for large surface scars (especially burn injuries).

The vessels making the scar shimmer red can be lightened with the help of a pulsed dye laser. In this way the blood supply of the scar and, thus, its tendency to thicken is decreased.