Large noticeable scars may become less visible over time and some scars can be treated with steroids to relieve symptoms such as tenderness and itching. For these reasons, many surgeons recommend waiting a year or more before undergoing scar revision.
Our UF surgeons will discuss the possible methods of treating your scar, the risks and benefits involved and the possible outcomes. Because insurance doesn’t usually cover cosmetic procedures, it is important to check with your insurance carrier prior to scheduling a consultation. However, if a scar revision is performed to minimize scarring from an injury or to improve ability to function, the procedure may be partially covered by insurance.
The surgeons of UF Health treat the following scars:
Keloid scars are described as thick, puckered, itchy clusters of scar tissue that grows beyond the edges of a wound or incision. Often red or darker in color than the surrounding skin, keloids appear after a wound has healed and form when the body continues to produce collagen, a tough, fibrous protein.
Keloids can be treated by injecting a steroid medication directly into the scar tissue to reduce redness, itching, and burning. In some cases, this may also shrink the scar. If steroid treatment does not reach the desired outcome, the scar tissue can be cut out and the wound closed with stitches. This is generally an outpatient procedure performed under local anesthesia. Because keloids have a tendency to recur, repeated procedures may be required every few years.
Hypertrophic scars are similar to keloids because they are thick, red and raised. Hypertrophic scars remain within the boundaries of the original wound or incision, while keloids spread beyond. They often improve on their own over time or with the help of steroid applications or injections.
Hypertrophic scars can often be improved surgically. The procedure involves removing excess scar tissue and repositioning the incision so that it heals in a less visible pattern. Depending on the scars location, this surgery may be done under local or general anesthesia. Steroid injections may be administered during surgery and at intervals for up to two years afterward to prevent the scar from reforming.
Contractures develop when the loss of a large area of skin forms a scar that pulls the edges of the skin together. This contraction process is often caused by burns or other significant injuries. Contractures may affect adjacent muscles and tendons which causes the restriction of normal movement.
Correcting a contracture usually involves cutting out the scar and replacing it with a skin graft or a flap. In some cases, if the contracture has existed for some time, physical therapy may be necessary after surgery to restore full function.
Facial scars, whether hypertrophic or not, are frequently considered a cosmetic problem. There are several ways to make a facial scar less obvious. Often it is simply cut out and closed with tiny stitches, leaving a thinner, smaller scar. If the scar lies across the natural skin creases, it may be repositioned to run parallel to these lines, making it less noticeable.
Some facial scars can be softened using a technique called dermabrasion, a controlled scraping of the top layers of the skin using a hand-held, high-speed rotary wheel. Although it won’t completely erase a scar, dermabrasion leaves a smoother surface to the skin.
With any kind of scar revision, the degree of improvement depends on the size and direction of your scar, the nature and quality of your skin, and how well you care for the wound after the operation. Some scars appear worse following surgery and final results may not be apparent for a year or more.