What are my management options for an old scar?

A number of different techniques are available to improve the appearance and function of long-standing scars including the use of our laser and needling techniques.  These modalities can address certain concerns including red or brown discolouration, contour (elevations or depressions) as well as texture (the way the scar feels) to the touch.  Soft tissue manipulation techniques can also be invaluable in improving tough scar tissue with little pliability/softness.

Evidence suggests that scar massage can have a number of beneficial effects, including the improvement of pain and itching in patients with healed burns.  Massage can also improve the appearance and function of tethered scars (i.e., when the scar appears ‘stuck’ to underlying layers beneath the skin and the overlying skin is pulled downwards).  The type of massage as well its frequency needs to be tailored according to specific scar characteristics and ideally supervised by a specialised scar physiotherapist.

One of the commonest operations for problematic scars is called a ‘surgical revision’. This involves removing the existing scar and creating a new one with a different configuration.  In most cases a procedure called a ‘Z or W plasty’ is recommended.  This results in a wavy appearance, which helps achieve better camouflage with the surrounding skin as well as tends to reduce stretch/widening compared to a straight line scar.  Other surgical options may include the use of skin grafts (i.e., skin taken from another part of the body and secured to the site where the scar is), tissue expanders (i.e., inflatable balloons inserted around the scar to generate extra skin, which are used around a scar revision site) or a dermal template (use of special synthetic product, which acts like artificial new skin).

There are a wide variety of ways that scars can be camouflaged including commercially available foundations/creams.  These are available in different colour shades and can be applied to a whole range of different skin types.  Alternatively, patients may choose to have an appointment with a qualified camouflage therapist, during which an analysis of their scar skin type will be undertaken and patch test done using a varied pallette of products. The aim is to achieve a professional camouflage result.  Some patients prefer to cover their scars using medical tattooing; this involves using medical grade pigments, which are injected into the skin by a qualified medical tattooist.