Scars are the body’s natural process to heal those nips and tears to our skin that we all experience throughout life. Any burn, injury, surgery or other trauma to our skin can cause the formation of scar tissue.

A scar isn’t such a bad thing if it’s small or in a location that’s easy to conceal, but you might want a way to treat those scars instead of hiding them under clothing. Though scars never completely go away, there are methods that can help reduce their size and appearance.

Q: How do scars form?

A: Scars form when the dermis (deep, thick layer of skin) is damaged. The body forms new collagen fibers (a naturally occurring protein in the body) to mend the damage, resulting in a scar. The new scar tissue will have a different texture and quality than the surrounding tissue. Scars form after a wound is completely healed.

Q: Are there different types of scars?

A: Yes, actually there are. Most scars are flat and pale. However, in cases when the body produces too much collagen, scars can be raised.

Some scars can have a sunken or pitted appearance. This kind of scarring occurs when underlying structures supporting the skin (for example, fat or muscle) are lost.

Scars also can appear as stretched skin. Such scars result when the skin stretches rapidly (for example, as in growth spurts or during pregnancy).

Q: Can scars be treated?

A: Although scars cannot be completely removed, their appearance can be improved to some extent. Methods for improving the appearance of scars include:

  • Chemical peels remove the uppermost layer of skin (epidermis) leading to exfoliation and the alleviation of certain skin conditions including superficial acne scars.
  • Dermal fillers, such as Juvederm or Restylane, can be used to temporarily raise atrophic scars to the level of surrounding skin, reducing their appearance.
  • Dermabrasion involves the removal of the surface of the skin with special equipment. Dermabrasion is useful when the scar is raised above the surrounding skin, but it is less useful for the treatment of sunken scars.
  • Microdermabrasion is a much less invasive form of dermabrasion, but is minimally useful for very superficial scars.
  • Laser treatments, are similar to dermabrasion and remove the surface layers of the skin using different types of lasers. Newer types of lasers may achieve more subtle results by working on the collagen in the dermis without removing the upper layers of skin. This advancement results in little down time as opposed to traditional laser resurfacing and dermabrasion, which requires a longer recovery.
  • Corticosteroid injections may help to soften the appearance of keloid or hypertrophic scars through a long-term course of injections.
  • Surgery can be used to alter a scar’s shape or make it less noticeable. Surgery is not recommended in cases of hypertrophic or keloid scarring (raised scars) because there is a risk of recurring scars as well as more severe scarring that results from the treatment.

There are a thousand wives’ tales and many over-the-counter remedies, but if you have a scar and are considering treatment, call a dermatologist.

Dr. Oswald Lightsey Mikell, certified by the American Board of Cosmetic Surgery, is the owner of Dermatology Associates of the Lowcountry.