Scars are the visible marks that remain on the skin following an injury (burn, chemical, mechanical), as the healing mechanisms of the body are activated, to maintain the structural and functional integrity of the skin that has been damaged. Incomplete healing may result in scarring which creates deformation and has a poor aesthetic outcome.
Hypertrophic scars are usually asymptomatic, have intense red color, are raised and thus limit the wound borders. They appear shortly after the injury. They usually improve over time and their color gradually becomes pale.
The main treatments that are successfully applied in our clinic are the following ones:
Intralesional injection of steroid solutions or 5 FU.
Injectable steroids are injected directly into the site of the scar and reduce the formation of collagen fibers and elastin, as they limit the release of inflammatory response. Similarly, 5-fluorouracil is an antimitotic agent which reduces the local proliferation of fibroblasts thereby reducing its size and improving the appearance of hypertrophic scars and keloids. The injections are administered once a month. The number of repeat cycles depends on the “response” of the wound to the treatment.
Application of topical steroids in combination with pressure dressings
Mild hypertrophic scars and small keloids can be treated with the use of topical, slow acting, steroid formulations that relieve symptoms, i.e. intense itching and tension sensation (pulling) at the site of the scar.
Topical application of gel or silicone in combination with occlusive dressing
The appearance of hypertrophic scars – keloids can be improved with the use of Fractional CO2 Laser, which causes the production of new collagen and elastin, aiming at the remodeling of the deformed lesion. Scars and keloids become smoother and their color is significantly improved.
The use of liquid nitrogen at temperatures that cause cellular anoxia, leads to cellular damage and ultimately to the degradation of the hypertrophic tissue of the scar.
The application of chemical solutions causes a controlled chemical burn aiming at the exfoliation of the superficial layers of the epidermis and ultimately, the flattening of the hypertrophic borders of the scar. They improve the texture and color of keloids and hypertrophic scars.
Intralesional injection of 5-FU, IFN-a
These injectable treatments inhibit the proliferation of fibroblasts, reduce postoperative scarring, and they have been proven to be effective in the prevention and treatment of hypertrophic scars and small keloids.