Atrophic Scars

Atrophic scars represent a small subsection of scars that can form after an injury or insult to the skin. They are most commonly associated with acne scarring, but can be precipitated by other types of skin injury as well. Typically atrophic scars appear depressed from the level of the surrounding skin.

The healing process following damage to the skin is complex and involves several stages. In the ‘proliferative’ phase, the cells in the skin produce connective tissue to fill the damaged area which is what produces the final ‘scar’. The main substance produced in this stage is a protein called collagen. In atrophic scar formation, there is insufficient production of collagen, meaning that there is not enough of the replacement tissue to bring the scar level with the skin. There are a number of different subtypes of atrophic scars:

Ice pick scars – these are very narrow and usually ‘v-shaped’ extending deep within the skin surface
Boxcar scars – these are usually wider in appearance and have more of a ‘U’ shape. They can be shallow or deep within the skin.
Rolling scars – these are typically gentler and wider depressions in the skin with a rounded edge.

Mr Ioannis Goutos is an expert plastic surgeon with extensive experience in all areas of scar treatment; he places particular emphasis on the psychological factors affecting patients in their everyday lives. He uses this to create individualized treatment plans for each patient to achieve optimal results.

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About this condition

Whilst atrophic scars are most typically associated with acne scarring, the following can also result in formation of a depressed scar:

Skin cysts
Chicken pox
Lacerations (cuts) or incisions in the skin, from either injury or surgery (particularly following surgical removal of moles or other skin lesions)
Burns

Risk factors associated with developing atrophic scars includes having a family history or previous occurrence of atrophic scarring. People who suffer with connective tissues disorders such as Ehlers-Danlos syndrome are also higher risk for developing atrophic scars.

If you are worried about developing atrophic scarring or know that you have a tendency to form atrophic scars, there are a number of measures that can be taken to help reduce your risks. If you are known to suffer from acne, then early treatment from a specialist can reduce the risk of scarring. Ensuring that any skin cysts or chicken pox are kept clean and well maintained can help prevent scarring from infections. It is also important to seek appropriate wound care advice following an injury or burn to ensure good primary healing of the wound.

Atrophic scarring can have a significant impact on self-esteem for some people and can affect social and professional interactions.

Although difficult to manage, there are a number of treatment options that can be used to improve the appearance of atrophic scars including:

Injection of fat or soft tissue fillers underneath the area of scarring
Chemical peels to promote skin regeneration
Needling techniques which help to promote the production of collagen in treated areas
Laser treatment (in particular vascular and resurfacing lasers), which improve colour and texture of the skin
Surgical methods – including removal and closure (excision) or freeing up areas of scarring using a needle (subcision).

The most appropriate procedures are discussed on a case-by-case basis and will depend on the characteristics of the scarring and your own scar treatment goals. In some cases, repeated treatments or a combination of techniques may be used for the best outcomes.

Testimonials

Mr Goutos is delighted to share some of his patient and peer feedback on their experiences of his services.

Louise Steel

2023-08-16

Mr Goutos performed keloidectomy surgery on both my earlobes, and I am so grateful to have been referred to him. From the first consultation, through surgery, and now my 3-month follow-up, I have nothing but good words to say.

Luke Ward

2023-07-10

This man is an extremely intelligent, professional gentleman. He will set realistic expectations from the beginning and will not ‘beat around the bush’ so-to speak. From the initial consultation to post-surgery, it has been a rollercoaster ride. However the high level of expertise & professionalism Mr Goutos maintained has been impeccable. All I can say to any other individual considering treatment with Mr Goutos, is that you are in incredibly safe hands. And on top of this, he has a great sense of humour. I wish nothing but the best for this man, and the best results for his future patients.

Mauricio Lucas

2023-07-06

Outstanding Doctor - Exceptional Expertise I recently had the pleasure of consulting and also going through surgery. Dr. Goutos removed a large class of keloids from my back and chest, and without a doubt, I can confidently say that he is the best doctor I have ever had the privilege of seeing. From the moment I entered his practice, I was immediately struck by his professionalism, knowledge, and exceptional bedside manner. Dr. Goutos possesses an extraordinary level of expertise in his field, and his technical skills are truly remarkable. His ability to diagnose and treat medical conditions is unparalleled, and I have personally witnessed his remarkable success in improving the health and well-being of countless patients. What sets Dr. Goutos apart is his genuine care and concern for his patients. He takes the time to listen attentively, ensuring that he understands every aspect of the medical issue at hand. He communicates clearly and effectively, explaining complex medical concepts in a way that is easy to comprehend, which greatly helps in alleviating any concerns or fears. One aspect that impressed me greatly was Dr. Goutos' commitment to staying updated with the latest advancements in his field. He incorporates cutting-edge techniques and treatments into his practice, ensuring that his patients receive the highest standard of care available. This dedication to continuous learning and improvement is a testament to his unwavering dedication to his profession. Additionally, the support staff at Dr.Goutos' practice deserves recognition for their exceptional service. They are friendly, compassionate, and highly efficient, ensuring that appointments run smoothly and patients feel comfortable throughout the entire process. Overall, I cannot emphasize enough how fortunate I feel to have found Dr.Goutos' exceptional skills, genuine care, and unwavering commitment to his patients make him a truly outstanding specialist. I wholeheartedly recommend him to anyone seeking top-notch medical care.

Kashmala Khan

2023-01-26

Mr. Goutos and his team did an amazing job reversing a scar I had on my forehead. This was a very old scar and had bothered for many years. The laser treatment and fat transfer procedure has changed my life and given me so much confidence. I would definitely recommend him, he is a fantastic and very skilled surgeon. Thank you so much!

Javier

2023-01-14

Mr Goutos and his team removed some lipomas from my arms. The initial consultation right through to the aftercare was professional, sensitive and genuine. Mr Goutos put me at ease right from the start, discussing my history and background and then discussing the various options for the incisions and sutures. The incisions were quick, efficient and professional. I felt completely at ease knowing I was in expert hands. The incisions were extremely neat and have closed and scared really well. I had a number of questions after the operation and one of the sutures became infected. Mr Goutos was quick to make an appointment for me, see me and deal with the infection and offered for me to see him again if the infection didn’t calm down. He was genuinely empathetic to my needs and took time to check each scare, explain things and assure me along the way. He didn’t at any point, make me feel I was asking silly questions or too many. I highly recommend Mr Goutos for his exceptional incisions and suturing as well as his professional conduct, caring approach and after care. The whole experience was smooth and easy and I am very grateful for what he has done for me.

Ieva Lihovida-Yarlett

2022-12-07

We came to see Dr Goutos a few month ago to remove invasive spider nevus on my 9 year old sons nose . After a lovely consultation with Dr Goutos , he suggested to do several laser treatment sessions. After a few sessions we already noticed a massive improvement. On the final laser treatment session the spider nevus was completely gone. Thank you to the Dr Goutos for tackling the problem so rapidly and with great results!

Amy Munson

2022-10-27

We took our 4yr old daughter to Mr Goutos following an accident which resulted in a small burn scar on her cheek. Mr Goutos gave us various options and we went for laser treatment. After 4 appointments the scar has gone! The care that Mr Goutos gave us was exceptional and so good with children. He made us feel very comfortable and confident in his ability. I would recommend him to anyone if they were looking for a doctor in that particular field. Can't thank him enough.