Raised Scars

Treating raised scars involves a variety of approaches, depending on the type and severity of the scar. Here are some of the most effective treatments:

Topical Treatments:

1. Silicone Gels and Sheets: Silicone products are widely used to flatten and soften raised scars. They work by hydrating the scar tissue and reducing collagen production over a period of time. Consistent use over several months can significantly improve the appearance of hypertrophic and keloid scars.
2. Corticosteroid Creams: Topical corticosteroids can help reduce the inflammation and also can decrease the size and redness of raised scars. They are often used in combination with other treatments for better results.

Professional At-Clinic Treatments: 

1. Injections:  Corticosteroid Injections – Directly injecting corticosteroids into the scar tissue can help shrink and soften hypertrophic and keloid scars. Multiple injections over several months are usually required for optimal results.   5-Fluorouracil (5-FU) and Bleomycin: These chemotherapeutic agents can be injected into the scar to reduce its size. They are often used in combination with corticosteroids for more effective treatment. They help in shrinking down the amount of collagen
2. Laser Therapy: Pulsed Dye Laser (PDL) – This laser targets blood vessels in the scar tissue, reducing redness and improving the appearance of raised scars. PDL is particularly effective for hypertrophic scars. Fractional Laser Resurfacing: This technique uses fractional lasers to create micro-injuries in the scar tissue, promoting collagen remodeling and flattening the scar. It is effective for both hypertrophic and keloid scars but requires multiple sessions. Usage of ablative CO2 laser or Ablative Erbium laser helps to shrink the collage along with remodelling of scar. Radiofrequency: Usage of intralesional Radiofrequency along with CO2 laser can help to ablate the papular acne scars, which even helps to minimise the scarring.
3. Cryotherapy: Cryotherapy involves freezing the scar tissue with liquid nitrogen. This treatment can reduce the size of hypertrophic and keloid scars by causing the scar tissue to die and slough off. Cryotherapy is often used in combination with other treatments, such as corticosteroid injections.
4. Surgical Options : Excision – Surgical removal of the scar tissue can be an option for large or particularly problematic scars. However, there is a risk of the scar re-forming, sometimes larger than before. Combining surgery with other treatments, such as corticosteroid injections or silicone sheets, can help reduce this risk. Laser-Assisted Scar Revision: This technique combines surgical removal of the scar with laser treatment to reduce recurrence and improve the cosmetic outcome.
5. Pressure Therapy – Pressure garments or dressings are used to apply constant pressure to the scar tissue. This can help flatten and soften hypertrophic and keloid scars over time. Pressure therapy is commonly used for burn scars and is most effective when started soon after the wound heals.
6. Radiation Therapy – Low-dose radiation therapy is sometimes used for severe keloid scars that do not respond to other treatments. Radiation helps reduce collagen production and can prevent the recurrence of keloids after surgical excision. However, due to potential long-term risks, it is generally considered a last resort.

Prevention of Raised Scars:

Preventing raised scars involves proper wound care and minimizing factors that contribute to excessive collagen production. Here are some preventive measures:

1. Wound Care: Keeping the wound clean and moisturized can promote proper healing and reduce the risk of hypertrophic or keloid scarring. Using silicone sheets or gels as soon as the wound starts healing can also help.
2. Avoiding Tension: Minimizing tension on the wound by using appropriate dressings or immobilizing the area can prevent excessive scar formation.
3. Early Intervention: For individuals prone to keloids, early treatment of any skin injury along with inter lesional corticosteroids or other preventive measures can help reduce the risk of developing raised scars.
4. Sun Protection: Protecting healing wounds and scars from sun exposure can prevent hyperpigmentation and also reduce the prominence of the scars.

Raised scars, whether hypertrophic or keloid, can be a significant cosmetic and psychological concern. Understanding the underlying causes and exploring the available treatment options can help individuals manage and reduce the appearance of these scars. From topical treatments and injections to laser therapy and surgical options, a variety of approaches can be tailored to meet the specific needs of each patient. Consulting with a dermatologist or plastic surgeon is essential to develop an effective treatment plan and achieve the best possible outcomes. With proper care and appropriate interventions, the impact of raised scars can be significantly minimized.