While Scars are a natural and essential part of the healing process in that they help protect wounds from additional physical damage, they are not necessary and are often unsightly once a wound is closed. Scars develop following a multitude of circumstances including burns, cuts, surgery, and as a result of disease such as acne. Dr. Loucas has had years of experience treating various types of scarring. He likes to emphasize to patients that a series of treatments and a combination of treatment modalities often give the best results. Injections with a dilute steroid solution have been effectively used for years to treat thickened scars (Hypertrophic scars and Keloid). These types of injections are not used in flat or depressed scars. These scars are best treated with a combination of laser surgery: V-beam and Smooth beam laser. Scar subcision is another excellent modality Dr. Loucas uses when a scar is depressed. Scar subcision is a procedure where scar tissue under the scar is broken up with a device that releases the scar tissue, allowing it to elevate again.
DIFFERENT TYPES OF SCARS
- Icepick scars: Ice pick scars are common amongst those who have had acne. Dr. Loucas states these scars lie deep in the skin. Due to the depth of these scars, surgical repair of these scars is often the best option to help improve their appearance. This procedure is a relatively simple office based procedure. It is performed with local anesthetic, often only requires one or two stitches for each scar, and is often pain free post treatment
- Boxed scars: These scars usually are larger than ice pick scars, have a flat base and sharp edges, and are often a result of severe acne, but can occur from any injury. As their name suggests, they look like a box in shape and form. The treatment of these scars when shallow is best accomplished with a combination of modalities, including: scar subcision, and laser surgery with the V-beam and Smoothbeam lasers. If they are deep, then surgical repair is probably the best option.
- Rolling scars: Rolling scars are usually associated with acne. These scars are often wide yet shallow in appearance. These scars are often very responsive to a combination of Kelocote Scar Gel, laser surgery with a combination of V-Beam and Smoothbeam lasers on the same day, and scar subcision can often help elevate the depressed scar and improve its appearance. Dr. Loucas has had great success in treating these types of scars.
- Hypertrophic scars: These scars usually form as a result of surgical procedures, severe injury, or acne. These scars protrude from the skin and are often red in appearance. These scars respond extremely well to injections of a diluted steroid solution (this will soften the hard thickened tissue). Dr. Loucas states these injections have been used for many years and have been shown to help reduce the thickness of a scar, in conjunction with laser surgery. The V-beam and Smooth beam lasers have been shown to be two of the most effective lasers to improve the texture, coloring, and thickness of a scar.
- Keloid Scars: These scars appear as a hard lump or growth in the skin that appear as a scar that has “overgrown” from the site of the initial scar. These scars occur due to excessive production of “bad collagen” by your skin cells called fibroblasts. These scars are more severe and sensitive than hypertrophic scars, and are the most difficult type of scar to treat. They often occur in darker skinned individuals after trauma, surgery, or acne. The initial treatments include a series of injections with a diluted steroid solution at approximately monthly intervals. Dr. Loucas often will combine the steroid solution with a small amount of a solution called 5-Fluorouracil to improve outcomes. He will also use laser surgery with the V-beam and/or Smooth beam lasers in combination with injections to improve outcomes.