What is depressed scars? Among all kinds of superficial scars, depressed scars are a special type of scars, which belong to physiological scars, unlike scars and hyperplastic scars that can aggravate and recur, depressed scars often affect the aesthetics in some more conspicuous parts. These scars are mainly divided into three types from the causes of formation: 1. there are adhesions below the scar, forming a depression, which is more obvious when the muscles are active; 2. there are no adhesions below the scar, and there is more tissue loss below the scar, which is generally larger in scope; 3. there are no adhesions and tissue loss, but only epidermal depressions with different degrees of defects, which are most common in scratches, pockmarks, etc. Today, we will mainly discuss this first type of depressed scars. Because this type of scars are most often seen after trauma where there are adhesions between the lower part of the scar and the deep muscle layer, and the middle fat layer is often missing, when the muscle moves, the adhesion cords will drive the surface scar and the surrounding normal skin, and a depression will appear. This is also the most asked scar by parents of children, especially the frontal trauma scars, nine out of ten of which will be depressed, because the lower frontal fat layer is weak, even if the suture is fine, it is easy to have adhesion depression. How to prevent depression scars? First of all, plastic layered fine sutures are used as much as possible after trauma, which is the measure that can prevent adhesion depressions to the maximum extent. Secondly, if adhesion depressions have formed after wound healing, there are some early prevention methods circulating among the people, such as local massage and hot compress, etc. However, clinically, these basically cannot reverse the formation of adhesions, and over-stimulation of scars has the risk of hyperplasia, so care still needs to be cautious. Finally, all the current topical anti-scar creams and patches cannot solve the problem of adhesions and depressions, but only play a role in inhibiting scar congestion and growth, so they should also be treated sensibly and scientifically. How to treat this kind of depressed scars in the future? 1, through the needle knife minimally invasive loosening stripping subcutaneous adhesions Advantages: does not cause new incision trauma, leaving only the eye of the needle, quickly healed, simple and quick operation. Disadvantage: often after loosening and improvement, adhesions will appear again after a period of time, sometimes it needs several operations that may gradually improve, sometimes it is also possible to inject autologous fat or hyaluronic acid under the skin locally after loosening to strengthen the prevention of re-adhesion, but this is relatively costly, and there is still a certain chance of re-adhesion after the filler is absorbed. 2.Direct excision of the scar and re-layering of the wound with fine sutures can be used Benefits: The most effective way to completely solve the adhesion depression scars, and at the same time, the original more obvious scars can be excised, and there is a chance to return to a flat fine line scar, or even become less obvious. Disadvantages: The surgical operation is more demanding, time-consuming and expensive, more traumatic, and of course there is a certain chance of re-adhesive depressions in some areas, but the extent should be reduced. When should the child be treated or with what kind of treatment? Premature treatment is generally not recommended for children because they are pain intolerant and have difficulty cooperating with either surgery or post-operative care. If the child is old enough to cooperate, the first minimally invasive treatment can be tried to improve the scar, and direct surgical incision is not recommended, as there is still a risk of the scar widening as the child grows and develops. If the child is an adult, then both methods can be considered. Can laser or anti-scar medication improve the depression? Personally, I believe that neither lasers nor medications can improve such depressed scars, so I advise you to get rid of your illusions about the various medications that are advertised to do so.