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How to Minimise Scars When Creams Don’t Work

How to Minimise Scars When Creams Don’t Work

Permanent scars from a burn or a previous surgery can often cause emotional distress, especially when put on display on our face or often exposed parts of our body for everyone to see. What can you do when chemical peels and over-the-counter creams don’t seem to work, and you’ve tried almost every possible home remedy to minimise scars recommended on the internet?

Scarring is part of our body’s natural response to tissue damage. When we get wounded, collagen builds up in the area to help strengthen the wound. This formation may form a scar over time -- and sometimes scars eventually fade and smoothen out, but other times they don’t. Each year in the developed world 100 million patients get scars, some of which cause considerable problems. [1]

Fret not, because there are a variety of treatments available to help improve your scar’s appearance and help make it less visible.

Types of scars

There are different types of scars and oftentimes, a combination of treatments are used to produce the best outcome. 

Mature scars

Although mature scars usually aren’t itchy or painful anymore, they could still be unsightly or hinder your movement. Surgical revision of these scars usually help make them less visible. Sometimes, this can be accompanied by a postoperative dermabrasion treatment. 

Mature scars

Keloids or keloidal scars

These scars are difficult to treat and manage, and often grow much larger than the original injury that caused the scar. Keloids can be surgically removed. However, they often return even after surgical treatment, and so your doctor may suggest additional injections, surgical revision and possibly localised radiotherapy.

Hypertrophic scars

For hypertrophic scars, excess connective tissue accumulates in the area of the original wound. [2] Hypertrophic scars are generally milder than keloid scars and do not grow beyond the area of injury. Early hypertrophic scars should not be treated too soon and it is good to check in with your doctor before starting any treatment.

How do I know which treatments are best for my scar?

Scar revision surgery is a common surgical procedure that helps minimise the scar - making it less visible by allowing it to blend in with your skin’s natural tone and texture. In some cases, it could also help restore function and mobility to the scarred area. This procedure can be performed under local anaesthesia, IV sedation or general anaesthesia, depending on the severity of the scar and your level of comfort.

Many factors and techniques come into play when undergoing scar revision, such as the type of incision made, how the tissue is handled, layered wound repair, and how the bleeding is minimised. One common surgical technique for scar revision is a Z-plasty, where the scar is redirected into better alignment with the natural skin fold to make it less noticeable. 

Other important factors to consider when undergoing a scar revision is how long you have had your scar, your level of health and your medical history.

It will also be good to note that if these scars were caused by trauma, burns or medical surgery, they can be categorised as medical procedures and therefore, could be partially covered by Medisave.

How do I know which treatments are best for my scar?

In addition to surgical interventions, corticosteroids, or steroid injections can be used to treat some keloid and hypertrophic scars. These are injected a number of times over a course of several weeks to months, depending on the severity of the scar, to reduce swelling and flatten it. It also helps these scars from recurring after surgical treatment. 

Other forms of treatment are localised radiation therapy (RT), cryotherapy or botox (botulinum toxin) injections. In less severe cases, or if pigmentation is more of an issue, treatments like laser therapy or dermabrasion will suffice. 

Side effects and downtimes vary and are dependent on the types of treatments and severity of the scar. Therefore, it is important to communicate both your needs and concerns with your doctor. Visit your plastic surgeon for a thorough and detailed consultation so that they may tailor a scar revision treatment specific to your needs and the characteristics of your scar.

  1. Bayat, A., McGrouther, D. A., & Ferguson, M. W. (2003). Skin scarring. BMJ (Clinical research ed.)326(7380), 88–92. https://doi.org/10.1136/bmj.326.7380.88
  2. Schmieder, S. J., & Ferrer-Bruker, S. J. (2017). Hypertrophic scarring.