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Is There Hope For Old Scars?
You
have this patch of skin that grew over a cut when you were a child. As you
become more conscious of how you look, the visible scar on your body is now a
bothersome thought. Is there a way to remove this old scar?
A scar forms when your body heals itself. If the wound heals
within two weeks, minimal collagen will be deposited and no scar will form. If
the healing takes longer than 4 weeks, a scar will form. Semi-occlusive
silicone ointments and sheets are used to speed up healing and prevent scar
formation. Other factors are your age, sex, ethnicity, and your inherited
tendency to scar.

How
your scar looks depends on its location and how big and deep your wound is. Scars
are often thicker, pinker, redder or shinier than the rest of your skin.
What
we usually call a keloid is usually just hypertrophic
scar, not yet in the magnitude of a keloid. This kind of scar does not breach
the boundary of the wound. When the scar extends beyond the site of injury, it
is medically termed a keloid.
When the scar is indented or sunken, or has a pitted
appearance, it is called atrophic. This
type is often associated with acne, chickenpox, and other infections. Contracture scars are caused by burns, which
cause the tightening of the skin. Serious burn scars are beyond the scope of
this article.
What can we do with
old scars? The truth is, the scars will not go away completely, but there are
methods that can reduce their size and appearance.
1) Collagenesis involves
repeated puncturing of skin with a microneedling device. The infusion of serum
to even out discoloration, like collawhite serum, improves the effectiveness of
the procedure.
2) Fractional Lasers, such as
CO2 or Er:YAG offer the best result for atrophic and acne scars. Multiple
sessions are usually required.
3) Dermalfillers using
collagen or hyaluronic acid provide
instant but temporary relief for pitted and sunken scars. Re-injection of
filler is required every year or so. Artefill is permanent filler, but in
inexperienced hands, this could cause permanent disfigurement.
4) Keloid Injection with
corticorsteroid will flatten and soften hypertrophic and keloid scars. The
steroid is injected into the scar itself, so there is minimal side effect. Repeat
sessions may be needed.
5) Chemical Peels such as TCA
can be used, with the depth of the peel controlled depending on the kind of
scar being treated.
6) Scar
Revision
is a process of cutting the scar tissue out. After the excision, the new
wound is usually closed up to heal, assisted by silicone sheeting to speed up healing
and prevent new scars from forming.
Consultation with a doctor is the first step in determining the best
scar treatment option for your specific case. Do not self-medicate, and do not
waste your money on creams and potions claiming to erase scars completely.
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This was published in the February 12, 2013 issue of Manila Bulletin, Lifestyle Section. The author , Fred C. Reyes, is the CEO of SkinStation. He received the 2011 Outstanding Chemist Award from Professional Regulations Commission for his achievements in the field of cosmetic chemistry. He can be reached at fred.reyes@skinstation.ph. 

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