According to the University of Maryland Medical Center, your age, heredity and skin color will affect how your wounds heal, in addition to factors like the size and depth of your injury. While large, thick scars often require surgery, smaller discolorations can often be treated with non-invasive cosmetic procedures.
Types of Scars
According to the Cleveland Clinic, the four main types of scars are keloid, hypertrophic, contracture and acne scars. Thick, glossy keloid scars protrude beyond the boundaries of your wound. Hypertrophic scars have the same texture as keloids but don't extend beyond the wound and often display a red coloration. Contracture scars usually appear on burn victims--as the skin heals, it may shrink and tighten, forming scars that affect movement or nerve function. Acne scars range from superficial discoloration to deep pitted marks.
Scar Revision
Doctors call scar surgery "revision," during which they reduce your scar tissue, reduce the look of your scar and restore any missing function of the nerves lying beneath the scar. The University of Maryland Medical Center says that doctors can often surgically remove all of your scar tissue, as often happens with keloids. For hypertrophic scars, doctors may remove excess scar tissue and create skin flaps that heal in the direction your skin naturally folds for a less noticeable scar. When scars won't heal, doctors may use skin grafting to replace damaged skin with healthy skin cut from a different part of the body.
Nonsurgical Alternatives
Your doctor can also use a combination of injections and cosmetic procedures to treat your scars. The Cleveland Clinic says that steroid injections can shrink scars, making them small enough to treat with nonsurgical procedures. The American Academy of Cosmetic Surgery adds that dermabrasion--the process of abrading away layers of damaged skin--can work alone or in conjunction with scar revision. Other non-invasive procedures that act on the surface of the skin include laser therapy, light therapy, bleaching agents and chemical peels.
Topical Treatments
If you have swollen hypertrophic scars, your doctor may treat you with silicone gel sheeting. According to the University of Maryland Medical Center, this is the only form of topical treatment proven to help treat scars. Although applying vitamin E directly to a wound site has become a popular folk remedy, no hard evidence exists to prove this works and it may end up prolonging the healing process and even irritating your skin.
Considerations
The Cleveland Clinic advises you to wait at least one year before undergoing surgery to treat or remove a scar, especially those caused by surgical incisions. Most scars change over time, often fading to the point where they don't bother you as much. The University of Maryland Medical Center agrees, noting that faded scars may be easier to treat. Some types of scars aren't likely to change, however, and should be addressed. These include keloid scars, scars that disrupt natural movement and scars that form at angles to normal fold lines in your skin.
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