MANILA, Philippines - It has been said that a one-millimeter scar on the face is a one-kilometer scar on the heart. After having been in the practice of cosmetic dermatologic surgery for over 19 years, I can vouch for the truth of this statement. Thank God that, in the past few years, many new lasers and procedures have been developed that can practically erase these unsightly marks. Here is an update on the latest techniques in treating a variety of scars as presented at the recent meeting of the American Society of Dermatologic Surgery in Phoenix, Arizona.
Acne Scars
While most people outgrow acne by the age of 25, many are plagued by the unsightly scars these pimples have left behind. The Fraxel laser is the best way to resurface acne scars on Asian skin. It is a fractional laser that lasers only 20 percent of the skin per treatment (thus the name “fractional”), leaving behind healthy skin surface that helps heal the treated skin quicker. This means the treatment has no downtime. The number of treatments required is eight to 12, depending on the severity of the scars. Sessions are spaced out every four weeks and each treatment produces noticeable improvements.
Pitted scars (or ice pick scars) are best treated by a technique called “punch grafting.” This involves punching out the deep but narrow scar and replacing it with skin from the back of the ear which is usually smooth and a perfect color match. If the scars are not too deep, there is a fascinating and easy way to make pitted scars disappear. A 90-percent concentration of trichloroacetic acid is applied with a sharpened toothpick right smack in the middle of the scar. The scar immediately closes and shrinks, very similar to what happens when you touch a makahiya plant. When done properly, results are almost magical but this procedure should only be performed by a physician with lots of experience because scars can actually get worse if too much acid is applied.
Keloids And Hypertrophic Scars
These lesions are usually the most bothersome of all because not only are they thick and red, they are also painful or itchy. The V-Beam or vascular laser is used to shrink the blood vessels in these scars in order to decrease the thickness and redness. This treatment is followed by the fractional (Fraxel) laser to further shrink the scar and resurface the skin. The keloid gradually contracts and flattens until it is hardly visible. Four to five sessions are required wherein both lasers are used.
Chicken Pox Scars
These scars are soft and depressed and disappear when the skin is deliberately stretched. The best way to treat these depressed scars is to inject skin fillers that contain hyaluronic acid. A more permanent solution would be to harvest some fat from the outer thighs and to transplant it to the affected area. In both methods, the idea is to push the depressed scar upward until it is level with the surrounding skin.
Hyperpigmented Scars
These marks are actually not true scars but a brownish to black discoloration of the skin and they are rarely elevated. If you have a lot of marks that you can trace back to childhood scrapes and falls, or even insect bites, the use of bleaching agents such as Cosmelan, a product from Barcelona that contains licorice, argireline, and azaleic acid, can remove these blemishes. Applied twice daily, marks peel off and lighten. As a bonus, Cosmelan can also be used for dark underarms, elbows and knees.
Post-Surgical Scars
Surgical procedures can sometimes produce unsightly scars that are usually dark and elevated. In most cases, resurfacing with lasers is all that is necessary. However, some scars are more complicated and require surgical re-excision (ideally with a carbon dioxide laser) in order to make the scars more linear, thin and faint. This is especially true for surgical scars resulting from trauma. Discolorations may be remedied by bleaching or pigmenting creams, depending on the color of the scar. A piece of advice: prevention, of course, is worth a pound of cure. After any surgery, proper wound care including the use of occlusive dressing ensures that scars heal optimally.
Although it has not yet reached the level of perfection, the good news is that these new treatment options can improve scars by up to 80 percent. So if your scars are a source of insecurity and lack of self-esteem, head to your nearest dermatologist and give yourself a dose of self-confidence!
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Dr. Vicki Belo recently presented two medical papers in this year’s convention of the American Society for Dermatologic Surgery (ASDS) in Phoenix, Arizona. Dr. Belo, who has been a member of the ASDS for the past 15 years, gave talks on the treatments of stretch marks and keloids. She has become an in-demand speaker in medical conferences abroad (Istanbul, Guam, Georgia, Milan, California, Paris, Honolulu), after two papers from the Belo Medical Group were published in two international journals. A paper on “Photodynamic Therapy” was published in the US Journal of Dermatologic Surgery. Another paper on “Aptos Thread Facelift” also came out in the American Journal of Cosmetic Surgery.
For more information on the products and services mentioned above, call 819-BELO (2356) or e-mail info@belomed.com.