Think of the skin as a really expensive garment that covers your body. Any tear, mark or stain does take away from the overall beauty of the skin. While scars and marks are definitely battle trophies, but they can also mar your looks and in some cases, become itchy, painful or unsightly. This is when they need to be treated or reduced. I say ‘reduced’ and not ‘removed’ because a 100 per cent clearance is not possible, no matter what anyone may claim. This is because a scar is the remnant of an injury or trauma or surgery that has permanently changed the quality and character of the skin.
Another thing to remember is that the treatment of scars depends on size, site, and type of scars. It is imperative to consult a good dermatologist as only he or she can give the right advice so you may make an informed choice. The results of any treatment – whether medical, surgical or simply home remedy based vary from person to person but a good scar (shallow, recent, over thin skin) will improve better than bad scars.
There are several methods to scar removal. The basic principle behind any method of scar removal is firstly to control the damage of the skin, followed by the body’s own repair mechanism.
Based on my experience, and results with patients, here are the three most common, and effective methods of scar removal:
This is a simple, old and effective method for scar removal. In this method, tiny needles or pins are used for controlling the damage to the skin. Most types of acne scar can be significantly improved with a course of derma roller treatments performed at home. Small, shallow scars can usually be removed entirely. Deeper scars may not completely disappear, but it is possible to smooth them out and make them much less noticeable. The derma roller (or derma stamp) works by causing a ‘mini-trauma’ to the skin, activating the skin’s healing process. New collagen and elastin are produced, creating brand new skin cells that will fill out any pitted scars or indentations. At the same time, scar tissue is ‘tricked’ into dividing and is gradually broken down.
After a few treatments, scar tissue starts to contract and hyper-pigmentation begins to fade. The derma roller also thickens the skin, which simultaneously makes scars less visible. With time and continued treatments, most scar tissue is removed and replaced with smooth, healthy skin. Under medical supervision by a dermatologist, this procedure requires 6-10 sessions, once every month, depending on the severity of scarring. There is very mild pinpoint bleeding that stops within 15 minutes. The swelling takes a day to subside. 2-3 days of downtime is essential after every session for the skin to react positively. This treatment is the least costly of all scar-removal procedures and is available with all dermatologists. However, the major disadvantage is that derma rolling does not have deep penetration, and therefore is not good for deep scars. Also, the popularity of derma rolling has decreased with the advent of more advanced treatments.
2. CO2 laser treatment
In this method of scar removal, a laser beam is used for controlling skin damage. CO2 laser is a powerful laser that penetrates deeply into the skin and is better at removing thicker and deeper scars. Swelling, pinpoint burns and mild scabbing are common. Therefore, downtime for recovery is usually about a week or two. 4-6 sessions are ideal depending on the nature of scarring. While results are visible after each sitting, the procedure also can be painful. Dermatologists usually give local anaesthetics before the therapy. While this method is excellent for both shallow and deep scars, it may lead to some pigmentation, especially on Indian skin.
3. Microneedling RF Technique (MNRF)
Microneedling is similar to derma rolling, but it has the added punch of RF (Radio Fractional) energy. RF energy is delivered in the deep skin, not in the upper skin so there is no damage on the upper layer of the skin. By protecting the surface layer of the skin from heat energy, the risk of pigment change in the skin of colour is eliminated, and the downtime is reduced. For patients with deeply sunken-in scars (Box car and Ice Pick scar types), elevation of these deep scars usually occurs prior to RF Microneedling, which will help to put the finishing touches on skin texture and smoothness. RF Microneedling uses very tiny micro-needles (smaller than the diameter of a hair) to deliver safe radio frequency energy into the deeper layer of the skin where collagen and elastin fibres form support structures. The polarity of the energy emitted creates arcs of energy between the microneedles, delivering energy below the skin’s surface to remodel the skin without the visible top-layer downtime of previous technologies. RF Microneedling targets the skin’s underlying support system of collagen fibres and restructures any areas that have damage due to acne scarring. Rebuilding the skin’s support system allows the epidermis, the top-most layer of the skin, to be smooth and strong. There is only a couple of days of downtime, with mild redness on the skin and no severe swelling (like in the case of CO2 laser). The only thing is that micro-needling RF takes 2-3 extra sittings in comparison to CO2 laser.
Text by Dr B L Jangid
Dr B L Jangid, MD Skin is one the top dermatologists of Delhi, with more than 10 years of experience in new treatments, technology and research into skin and hair problems, skin surgeries, hair transplant surgeries, Lasers and anti-ageing. He practices at SkinQure in Saket. You can follow him at @skinqureindia.