Treatment available for unsightly scars - Sioux City Journal

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Sometimes scars can be points of pride ("I got this in a bar fight and you should have seen the other guy!") and sometimes they can be excused away "(I scratched the chicken pox on my face as a child, even though my mother told me not to!"). And then, there are those individuals who would love to see their scars eliminated.

According to Dr. Kelly Gallego, a Sioux City plastic surgeon and member of Tri-State Specialists, LLP, there are a number of physical and psychological reasons why a patient might want to have a scar revised.

"A scar might remind them of a past traumatic experience," he said. "Other scars are unsightly and patients don't like how they draw attention to themselves. Still, in some more severe cases, scars can be symptomatic causing itching or pain."

Scars occur at sites on one's body where an injury penetrates to the deeper, thicker layer of the skin. This includes surgical incisions, lacerations, deep burns and other types of wounds. Some scars are thin, light in color and barely noticeable. Gallego pointed out that others, such as keloid and hypertrophic scars, can be wide, raised and a real source of concern for some patients.

"These unsightly scars, examples of overhealing, are more common in certain skin types and involving certain areas of the body," he said.

As a plastic surgeon, Gallego believes it is much more efficient to prevent poor scars than it is to treat them.

"For surgical scars, prevention includes sound surgical technique and adequate prevention of infection," he said. "Tension on the closure can be decreased by taping incisions and by using dissolving sutures which remain in the wound for a minimum of six weeks. Patients are frequently encouraged to massage their scars to make them softer and flatter."

However, even with the best efforts to prevent them, Gallego acknowledged, problem scars can still occur.

"The most commonly used methods to treat those are surgery, silicone dressings, pressure, and corticosteroids," he said. "Other methods include radiation, cryosurgery, lasers, vitamin E, and other topical medications. Often treatments are combined to decrease the likelihood of recurrence."

Gallego cautioned sooner is not always better when deciding on scar removal.

"It really depends on the scar," he said. "In most cases, it is best to wait at least one year from the time of healing before proceeding with a scar revision. With children, it is best to wait until the child is at an age where they can cooperate with the care."

And not all scars should be revised, Gallego added.

"All scar revision procedures are a trade-off in that patients are trading an unsightly scar which draws attention to itself, for one which is hopefully thin, flat, and easily hidden," he said. "Scars are never really eliminated completely. Some patients with hypertrophic or keloid scars may be poor candidates for surgery because the risk of recurrence might be unacceptably high."

A common cause of facial scars is acne, which affects up to 80 percent of teens, and about 5 percent of adults.

Gallego suggested the best way to prevent acne scarring is to treat acne early and aggressively.

"Treatment regimens typically include topical and oral medications," he said. "In some cases laser treatment can also be helpful. Other preventative measures include not picking scabs, using Retin-A, and avoiding direct sunlight on the face."

For those who shy away from surgery or who might not have the resources to pay for surgery, Gallego listed a few types of treatment that might lessen the prominence of a scar.

"During the last couple of years, a lot of effort has gone into the production of topical scar treatments," he said. "Topical silicone sheeting and silicone containing ointments and bandages have been shown to improve the appearance of some scars."

29 Sep, 2011

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