Scars

Scars develop through trauma and inflammation. They consist of level differences or colour variation. If they grow above the adjacent skin level they are called hypertrophic scars and keloids. If the are sunken into the tissue they are called atrophic.

Scars can hardly ever be made to disappear completlely, often times, however,  they can be improved

Hypertrophic scars and keloids

this type of scar develops because their is an individual disposition for this type of scarring.
Hypertrophic scars are best treated with intralesional cortisone injections into the scar tissue. This makes the scars flattr and softer but often more red through the dilation of blood vessels. Thes "broken" vessels can be treated with lasers. At times it may make sense to cut out hypertrophic scars, immediately followed by an S-ray treatment to prevent another hypertrophic scar from developping. It seems unwise to only surgically treat a hypertrophic scar, because this may increase the size of the scar.

Atrophic Scars

Atrophic scars develop as a consequence of acne or schicken pox. They come in various forms:

• Saucer shaped
  Typically they flatten when you pull the adjacent skin. Unlike previously where dermabrasion, deep peels or laser skinresurfacings were used to treat these scars, today the gold standard treatment is fractionated lasertherapy. We use a medical laser with an infrared light (Erbium YAG) for this kind of treatment. Its effect is based on the fact, that the holes that are "drilled" into the skin are followed by remodelling of collagen which is thighter and hence improves the scars. At the same time skin texture is improved.
  
  Fractionated lasertreatments are serial treatments in monthly intervals. Typically  4-6 treatments are necessary for a good improvement. After a puse of 6 months you will decide whether or not more treatments should follow. There is a 3-4 days social down time associated with this type of treatment.
  
  Saucer-shaped scars may also be filled with biologically degradable hyaluronic acids 

  

• «Boxcar-Scars»
  They have steep edges and a flat bottom. This type of scar is best appoached by ablative lasertheray in local anaesthesia (numbing). In this way the edges get flatter and the bottom of the scar is raised. There is a band-aid needed for about 7 days.

  

• Ice-Pick Scars
  They are steep and deep. They typically are best removed surgically (punch-exzisions)

  

The treatment of atrophic scars can be performed step by step (litte to no social down time) or in one or two goes (social down time). Often the treatment is a long-term endeavour. Therefore it is our goal to discuss the possibilities realistically with you. Also it is most important that your expectations meet reality. Atrophic scarring can not be made invisible but improve.

Coulour Changes of Scars

Further information