An Introduction to the Treatment of Scarring

Even with the large amount of basic and clinical research in plastic surgery, dermatology and burns, no method has been found to allow normal skin to grow out of a wound. Therefore, the goal of scar treatment is to make the scar as flat as possible, as close as possible in color and texture to the surrounding skin, without adhesions or pulls on the deeper tissues, and as narrow as possible in width if it is a linear scar, parallel to the skin lines or hidden in the skin folds. A scar that meets these criteria is visually less noticeable and is less likely to be noticed by others in daily life. But even if you want to achieve these goals, it is never easy. From the time of trauma, including standardized wound treatment, cleaning and disinfection, meticulous suturing by the doctor, moisturizing, sun protection and dermatological treatment during the dry period of scarring are indispensable. For mature scars with obvious abnormalities in their appearance, re-surgery may be required. Recent advances in medical lasers have provided another safe and effective means of treating keloid scars, allowing us to treat the appearance of a scar that is clearly abnormal in a more minimally invasive manner, resulting in an appearance that is close to that of normal skin. Laser devices for skin problems have been in the clinic for more than a decade, and their most important feature is that they are highly selective, precisely targeting a single component within the skin, such as the emerald laser for melanin treatment, which is widely used for pigmentation. Dye laser for hemoglobin is used for vascular diseases, carbon dioxide laser for moisture is used for facial rejuvenation and so on. The depth and extent of penetration of laser heat is precisely controlled, allowing the laser to produce a therapeutic effect while limiting thermal irritation of the skin to a safe level. Laser treatment of scarring has the following aspects: 1. grinding of raised scars; 2. loosening of scars that form contractures and pulls; 3. treatment of depressed purpura, which results in a flatter arrangement of disturbed collagen and a proliferation of atrophied collagen: 4. early intervention in postoperative epileptic scars to accelerate redness in the scar and to increase its flatness; and 5. ablation of abnormally proliferated purpura.