Page 53 - IDF Journal 2023

I always stress that scars can be improved with certain measures but not completely erased. Once assessment
is complete, I provide patients with a detailed treatment plan which might include one or more of the below treatments. Baseline photographs are taken, post-care instructions are given, and if needed, patients are booked for a laser test patch.
Subcision is pulling a scar up from beneath the skin surface. This procedure is used for rolling bound-down scars. Using a special needle (Nokor needle) the scar tissue fibres are cut from underneath the skin creating a controlled wound in the dermis and thus new collagen will
be stimulated and lift the scar during healing. The procedure is done under local anaesthetic and minimal recovery time is needed. Bruising is possible in the first week.
Intense pulse light (IPL) using a vascular filter is available as a ‘quick fix’ to temporarily treat symptoms of post- acne redness. There is no downtime but multiple sessions may be needed one month apart.
Fractional resurfacing lasers create microscopic wounds for better skin, smoother texture, and improved scarring. One week indoors post-treatment for
the ablative CO2 lasers and a detailed consultation is needed. Ablative lasers (fractional CO2 lasers) cause microscopic laser punctures with light to the skin’s
surface to stimulate new cell regeneration, whereas non-ablative lasers don’t affect the surface of the skin, but rather create columns of microscopic injury underneath the skin’s surface. Both will stimulate collagen resulting in improvement in scar appearance. Non-ablative lasers are better tolerated with much less downtime, however, more sessions are needed compared to the ablative lasers to reach the same endpoint.
Platelet Rich Plasma (PRP) is derived from whole blood by centrifugation. Platelets are naturally rich in growth factors which can be extracted and injected where we want them to work. PRP promotes wound healing and improves collagen production thereby improving the appearance of scars. This procedure carries minimal downtime and no side effects.
Microneedling uses a motorised device to push tiny needles into the skin and create microscopic wounds. This stimulates collagen production and reduces wrinkles and scarring.
This procedure can be combined with PRP. Microneedling also carries minimal downtime but there may be 3-4 days of redness.
Steroid Injection is a technique used for hypertrophic and keloid scars. Multiple injections are needed 3-4 weeks apart depending on the thickness of the skin. They are used to thin the scars to make them flatter.
Scar excision is possible if the location and the skin texture allow it. Surgical excision of some scars yields better cosmetic results than laser treatment. Once the whole scar is removed, neat cosmetic suturing is done. Later, after the skin fully heals, lasers can be used to further improve the appearance of the scar and any suture marks.
Dermal Fillers can be used for atrophic scars. Dermal fillers like hyaluronic
acid can be injected to fill the volume
of the scar. They also boost the skin’s innate ability to repair itself. This is not
a permanent solution since fillers are dissolvable.
Dr Hiba Injibar MD Consultant Dermatologist
Dermatologic surgery, Aesthetic dermatology, laser surgery
Fellow American Academy of Dermatology FAAD
Founder, Medical Director and Lead Consultant
Dermasurge Clinic
W: www.dermasurge.co.uk
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