Scars

Scars may be poorly positioned, widened, raised or even painful. They can appear brown on fair skin, white on darker skin, or red or purple, sometimes sunken. Every scar has its own history, cause and evolution. Each scar develops in a unique way depending on many factors : age, skin type, location and cause of the injury. The same wound may leave a fine, discreet mark in one person, while becoming thick or hypertrophic in another.

For this reason, a personalized assessment is essential before any treatment. To plan the most appropriate repair, I need to know the scar history and examine it, as well as assess the quality of the surrounding skin. Certain skin types are predisposed to keloid scars, which thicken and extend well beyond the initial area. Conversely, atrophic scars may appear when the skin does not produce enough collagen to regenerate. In these cases, tailored solutions can help reduce these imperfections and achieve a more even skin appearance.

Sometimes, dermatologic surgery is not the most appropriate treatment, and I may instead recommend special dressings, creams, laser treatments or injections, which I perform very regularly. Burn scars may also benefit from specific treatments.

A scar results from a complete breach of the skin involving the epidermis, dermis and hypodermis, or from an abrasion or burn reaching at least the dermis. Skin tissue has the ability to regenerate, and a complex cellular process begins to enable healing. A scar evolves for about one year before stabilizing. Indications for correction are considered from that point onward. Even though the skin has remarkable regenerative capacity, some scars remain unattractive or uncomfortable over time.

Itching, skin tightness or sensitivity to touch are all signs that may justify specific care. Scar management begins early with appropriate measures: hydration, massage, strict sun protection and, when necessary, the use of specific dressings to limit scar thickening. When a scar becomes bothersome after its maturation phase, surgical or medical correction may be considered to optimize its appearance and integration into the surrounding skin.

Before any intervention, a careful analysis of the scar structure allows selection of the most appropriate solution.

Before one year of evolution

You may consult so that all measures can be implemented to minimize the final scar.

After one year

The repair technique varies depending on the type of scar :

• Surgical revision and local plastic techniques for wide, thick or poorly positioned scars. A hypertrophic scar that remains thick and raised can be improved by surgical excision followed by fine, meticulous closure. In addition, silicone dressings or fractional laser sessions can further refine the final result.
• Injections for sunken, overly dark or raised scars. Sunken scars, often resulting from severe acne, surgery or deep trauma, may benefit from hyaluronic acid injections, which restore volume and improve skin texture.
• For hyperpigmented or depigmented scars, depigmenting treatments or chemical peeling sessions can help rebalance skin tone.

Combining several techniques may sometimes be beneficial.

Scar revision is performed in the medical surgical office under local anesthesia. The duration is often less than one hour.

Recovery is painless and requires only a few hours off work. Simple local care is needed for one to six weeks after the procedure. Specific dressings are applied to promote optimal healing, and personalized recommendations are given to limit the risk of scar recurrence.

Strict sun protection is essential, as exposure to ultraviolet rays can cause hyperpigmentation and make the scar more visible.

Results are visible after one week at the first follow up visit in the medical surgical office. The outcome is considered definitive only after at least six months of evolution. Scar progression is monitored over several months.

It is unfortunate to live with an unsightly scar because you were once told that nothing could be done. Medical and surgical techniques evolve, your skin changes, and what was not possible ten years ago may sometimes be achievable today.