Scarring is the process by which wounds are repaired. Damage to the deeper layer of the skin, the dermis, is required to produce a scar. Damage to only the epidermis, the most superficial layer of skin, will not always produce a scar. Scars produce a structural change in the deeper layers of the skin which is perceived as an alteration in the architecture of the normal surface features. It is not just a change in skin color. Fetal tissues and mucosal tissues have the ability to heal without producing a scar. Understanding how and why this is possible could lead to better surgical scar outcomes. Since scars are part of the normal healing process, ordinary scars are not treated. Only when superficial scars become cosmetically undesirable do they require treatment. This would include scars in those who are predisposed to develop keloids, as well as scars in anatomical regions known to produce thick scars and scars that produce a significant, unpleasant distortion of adjacent anatomical structures. Thick scars and keloids often flatten out after injections of steroids directly into the fibrous scar tissue. They can respond to the chronic application of pressure and the application of sheets of silicone rubber. Thick scars can be flattened by dermabrasion, which utilizes abrasive devices to sand down elevated scars. Certain types of depressed scars can be elevated by the injection of a cosmetic skin filler. Certain types of facial scarring respond well to forms of laser treatments. Occasionally, surgical revision of scars can result in a different scar that is much more cosmetically desirable. Since it takes about a year for scars to mature, it is frequently prudent to wait before starting any invasive surgical revisions.
The best ways to treat scar with non evassive surgery are:
Can scarring be prevented? Scarring is an integral part of the healing process. Assuming the wound does not become infected, physicians plan excisions to minimize the cosmetic defects produced by scars. This can be accomplished by orienting the wound in such a way so that it will not perturb other structures, so that the scar can be camouflaged by hiding in wrinkle lines or near other anatomical structures. It is also important to minimize the tension necessary to close the wound surgically.