How scars form and change
When the skin is cut or torn, the body heals by forming scar tissue. A scar keeps changing for many months: it is often red and firm in the first weeks, then gradually softens, flattens, and fades. Scars generally take a year or more to mature.
Because of this, the timing of scar revision matters. Treatment of a scar that is still maturing may be limited to non-surgical care. Surgery is often considered once the scar has matured, unless the scar is causing a functional problem that needs earlier treatment.
Scars that may be evaluated
- Wide or stretched scars
- Raised (hypertrophic) scars and keloids
- Sunken (depressed) scars
- Scars that distort nearby features, such as the eyelids or lips
- Scars that tighten and restrict movement (contractures)
Evaluation
The evaluation looks at the scar’s cause and age, its size, color, and texture, its position relative to the natural lines of the face, and whether it affects function. Dr. Kayem also reviews factors that affect healing, such as medical conditions and medications. The goal of the evaluation is to decide whether treatment is appropriate, which approach fits the scar, and when.
Treatment options
Options depend on the scar and may be combined:
- Non-surgical care during maturation, such as silicone products, sun protection, and massage
- Injections for some raised scars
- Fillers for some sunken scars
- Skin resurfacing, such as dermabrasion, to smooth the surface of some scars
- Surgical revision, in which the scar is removed and the skin is closed again with techniques that reposition or break up the line of the scar so it is less noticeable
Any scar revision carries risks, including the possibility that the new scar will not be less noticeable than the original. Dr. Kayem will discuss what can reasonably be expected for your scar.
Insurance
Scar revision for scars caused by injury may be covered by insurance in some cases. Coverage depends on your plan, so check with your insurance carrier.
For smaller skin concerns, see Mole and Scar Removal. Scars from facial injuries are also discussed on Facial Trauma.
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Available in Beverly Hills and Las Vegas.
Also in Otolaryngology (ENT)