SCARRING
Our Vancouver doctors have a special interest in scar management and many years of experience working with different scar treatment options.
What is a Scar?
Scarring occurs after injury to the skin when fibrous connective tissue replaces the normal skin as part of the healing process. Scar tissue is made up of collagen fibers that have become cross-linked and lined up in a single direction rather than the evenly distributed collagen of normal tissue. This cross-linking and polarization make the collagen inelastic and white in appearance, causing the uneven, thickened and firm appearance of scars.Scar Causes
Accidents, surgeries, burns and skin disease (such as acne) are all well known to cause scars. Some lesser-known forms of scarring include self-inflicted scars, piercing and stretch marks.In general, the more severe the injury is, the worse the scar will be. Certain parts of the body, such as the chest and shoulders, are more prone to scarring and/or form certain scar types more readily.
Scar Types
Besides normal formation, there are several different types of scars:- Hypertrophic – A thickened, red raised lump above the surrounding skin; occurs when the body overproduces collagen.
- Keloid – A tough scar that grows (and possibly continues to grow) beyond the boundaries of the original wound; varies in colour and can be painful or itchy.
- Atrophic – A recessed or sunken scar due to a loss in the underlying skin structure support (such as fat or muscle).
- Stretch marks or striae – Caused by the tearing of the dermis (middle layer of skin); initially seen as red or purple lines, gradually fading to a lighter colour.
In some cases age and skin type can produce different scar types. Younger skin typically tends to have a stronger wound healing response and therefore can form larger, thicker scars. Darker skin types tend to form hypertrophic scars more readily.
Scarring Problems
Scars often lack elastic tissue and oil glands, making them more itchy, painful and prone to irritation. Hair follicles often do not grow back within scar tissue, although when hair follicles do grow back within a scar it can cause even more problems with ingrown hairs and folliculitis post-injury.Redness (erythema) associated with scarring is related to new blood vessel formation in the first few months after scarring occurs. The redness is due to inflammation secondary to the healing process and will often resolve on its own, however this can take years to completely resolve. In some cases there will always be some colour to the scar.
Scar Treatment
The recommended scar treatment in our Vancouver clinic will depend on several factors such as the scar type, skin type, age of the scar and your goals (i.e. smoothing the skin and scar, reducing redness, etc). In general newer, red scars can be treated effectively and affordably with a vascular laser to help stimulate and regenerate the tissue. Older scar rejuvenation may utilize the Fraxel laser.
Fraxel Lasers
The Fraxel family of lasers offers versatility, with the ability to treat a wide range of issues from acne scarring, pigmentation, facial wrinkles and stretch marks. Fraxel re:store technology utilizes two different laser wave lengths: one targets damaged skin on the surface and while the other reaches deep into the skin to stimulate collagen remodeling. As a result it can change the elasticity, pore size, texture and tone of your damaged skin. Generally a series of 4-6 treatments may be required. The Fraxel re:pair laser offers more rapid results in fewer sessions, but involves more downtime than the Fraxel re:store laser treatments.
Gemini Laser
The Gemini laser is usually utilized for acne sufferers, redness and rough skin texture such as superficial scars. This vascular laser utilizes two frequencies (dual wavelength) making it an ideal laser for the treatment of different skin conditions at once. It can be used to treat blood vessels, pigmentation and to stimulate collagen regeneration for refining skin texture.
Vbeam Laser
This is a pulsed-dye laser that is very effective in the treatment of vascular issues such as redness (rosacea, spider veins, port wine stains) and scar treatment. The Vbeam treatment will also stimulate collagen growth, making the skin look healthier and younger.
Dermal Filler
Dermal fillers are used to raise any indentations in the skin—an issue with atrophic scars, such as acne scarring. Semi permanent fillers, such as Artesense, or less permanent hyaluronic acid-based fillers are used in order to create a long lasting correction. Repeated injections may be needed over time to achieve the ideal look.