Dr Winkler | Scarring – which treatment is right for you
post-template-default,single,single-post,postid-21966,single-format-standard,ajax_fade,page_not_loaded,,select-theme-ver-3.3,wpb-js-composer js-comp-ver-6.9.0,vc_responsive

Scarring – which treatment is right for you

Unless you go through life wrapped in cotton wool, chances are that you have a scar or two. Everyone has one somewhere, whether it’s from a childhood tumble, having a mole removed or the dreaded stretch marks most of us suffer from after childbirth or losing weight.

The good news is that all scars naturally improve with time. Secondly, there is always something you can do to remedy scars (even if it’s a bit of self tan!), but it’s important to understand at what stage of the healing process you are. On the flip side, everyone’s skin is different and people heal in different ways so one can’t take a one-size-fits-all approach to treating scars. Age, skin tone and genetics all play a role in how your scar will appear.


The earlier you treat a scar, the better

With treating a scar, we don’t mean slathering on oils and booking your appointment with a plastic surgeon a week after your fall or surgery. Scars take time to heal. Even if they look ‘ready’ on the surface, you need to give your body a chance to repair all the tissue underneath.

We often compare the healing process of a scar with that of building a road. There are months of prep work involved in laying the foundations and lots of stages to go through. If you think of how much need to happen before you paint the stripes onto the road, that’s how much is involved in the healing of your skin. And that’s why it’s important to stay patient and let your body complete its natural healing process. Therefore, as a rule, we advise patients to wait at least one year before commencing any treatments.


During that time, apply the 4 M’s of early scar management:

  1.  Moisture: Keep the wounds closed until they are healed and sealed, ± 2 weeks. Then apply aqueous cream (no Vitamin E oils at this stage). Products that can be used once the wound is sealed:
    – Retinoid creams
    – Scar Science or other wound healing creams
    – Silicone plasters or gel
  2.  Massage: Massage and pressure dressings speed up the maturation of the wound.
  3.  Micropore tape. Taping the wound for up to 3 months prevents friction across the wound.
  4.  Meticulous sun care. Sun exposure will darken the scar and a dark scar is more obvious and more difficult to camouflage compared to a light scar.

Recent scars and the types of treatments available

As we mentioned before, scars that are about six months to one year old are seen as new scars and will usually still be red. They respond well to these types of laser treatments:

  • Fractional laser resurfacing: With this treatment, the laser penetrates the skin and stimulates new collagen production and collagen remodeling, resulting in a faster healing process.
  • Pulsed dye laser (PDL): The PDL works by delivering an intense beam of light to the redness in the blood vessels on or just below the skin. This light is converted to heat which causes the blood vessel to shrivel, decreasing the redness of the scar.


Treating older scars

Even scars that are a number of years old can be rejuvenated or, if necessary, surgically removed or disguised.

  • Surgical scar revision: Sometimes, the angle of a scar can be improved upon – for example, disguising it in a wrinkle or crease. Your plastic surgeon can surgically remove an old scar and even out any lumps and bumps. This is only done once the scar has matured.
  • Medical needling (Dermapen): A roller containing numerous fine needles punctures the upper layers of the skin to create controlled micro ‘injuries’. By harnessing the skin’s natural ability to repair itself, this therapy encourages it to release growth factors that naturally stimulate new collagen production.


Keloid scars: a combination of treatments

Keloid scars are notoriously difficult to treat and no single treatment has been proven to work in all cases. Keloid scars develop during the healing process after a skin injury. They are mainly composed of collagen and have a rubbery, shiny, raised appearance. We usually advise a combination of treatments, many of which slows down the ‘overhealing’ process to stop inflammation to the skin area. These include steroid injections, needling and silicone gel pressure dressings.


If you’d like to find out which treatment is right for you, please get in touch with us to set up an appointment with Dr Winkler.


Tel: +27 (0) 87 630 0183
Email: dr@drwinkler.co.za