Scar is a collective term for the appearance morphology and histopathological changes of normal skin tissues caused by various traumas, and it is an inevitable product of the repair process of human trauma.
It includes.
1.Superficial scar
2.Proliferative scar
3.Atrophic scar
4.Keloid scar
1, Superficial scar.
It is a kind of superficial scar on the skin, mostly formed after skin abrasion, superficial skin infection or II degree burns.
The appearance of keloid scar is rougher than normal skin, there may be pigmentation changes, local softness and flatness, no obstacle to body function, and the scar will gradually become inconspicuous with time, so it usually does not need treatment.
2.Proliferative scar
Any injury involving the deep dermis, such as deep Ⅱ degree or more burns, cutting wounds, infections, the donor area after cutting medium-thick skin pieces, etc., may form hyperplastic scar.
The scar is significantly higher than the surrounding normal skin and is locally thickened and hardened. In the early stage, the scar surface is red, flushed or purple due to capillary congestion. Itching and pain are the main symptoms and usually do not cause serious functional impairment. The hyperplastic scar often continues for months or years before degenerative changes occur. Congestion decreases, color lightens, the scar becomes softer and flatter, and itching and pain diminish and disappear. The length of this proliferative period varies depending on the person and the site of the lesion.
In cases with light skin tone, short history (less than 1 year), red and raised, they can be treated with hormonal injections immediately after pulsed dye laser irradiation. Surgical scars should be treated with the 585nm laser on the first day after stitch removal to safely and effectively improve the texture and appearance of the surgical scar.
The treatment needs 3-5 times with 6-8 weeks interval to repeat the treatment, 20% can be faded.
3.Atrophic scar
It occurs in patients with large degree III burns, after healing of long-term chronic ulcers, and after electric shock injuries in areas with less subcutaneous tissue, such as scalp and anterior tibial area. The injury is usually severe, involving the entire skin and subcutaneous fatty tissue.
Clinical manifestations: The scar is hard, flat or slightly above the skin surface, and closely adheres to deep tissues such as muscles, tendons and nerves. The scar has very poor local blood circulation and is light red or white in color. The epidermis is extremely thin and cannot withstand external friction and weight-bearing, which can easily break down and form a chronic ulcer that does not heal.
Indications for fractional laser treatment are trauma, surgery, and acne depression scars.
Post-treatment precautions.
After treatment (about 2 hours), if the treatment area is painful or swollen, you may do ice treatment or apply designated repair cream. Avoid other cosmetics or masks.
During the recovery period (2-3 days after treatment), repair cream must be applied consistently. If black dots appear on the treatment area, do not pick them and let them disappear naturally; pay attention to sun protection, do not apply irritating or therapeutic cosmetics, and minimize the consumption of food or drinks with high pigment content. Use special cleanser or regenerating cream for washing face or makeup.
Sunscreen should be used for sun protection after scabbing. Use topical antibiotic ointment until the scabs fall off and avoid contact with water to prevent infection. Avoid sweating, sauna and strenuous exercise, which can be done after the scabs have completely fallen off.
4.Keloid scars
It is a benign skin tumor caused by excessive proliferation and hyaline degeneration of connective tissue after skin injury. Patients are mostly scarred, and people of color are more prone to develop.
Clinical manifestations: It is usually found in the sternal region. The lesions are elevated on the skin surface, exceeding the original injury site, crab foot-like outward extension, smooth and shiny surface. Burn and scald injuries can become large lesions, and can affect the function of the limbs in severe cases.
Differentiate from hyperplastic scar, the latter does not exceed the original injury area, no crab foot extension, lesions can be flattened after one to several years.
Treatment is more difficult. Early radiation therapy is available; hormone injections are effective; surgical excision can be combined with local hormone injections and radiation therapy; topical hormone and retinoic acid cream can relieve symptoms.