SCAR TREATMENTS

What is a scar and how are they caused?
Scarring is an integral part of the body’s natural healing process after a trauma, injury, surgery or conditions such as acne or stretch marks.

When an injury affects only the outer layer of skin or the epidermis, the body is able to rebuild the tissue with minimal scarring. However, when an injury affects the deeper layers of the skin or the dermis, rebuilding is more complicated due to the fact that the body has to first lay down a protein called collagen. It is this process that usually results in a scar.

As the injury continues to heal, new blood vessels form and the collagen fibers even out. This ultimately leads to the scar fading as time progresses. A wound is not classified as a scar until it is completely healed.

From a medical standpoint, there is no need to pay any attention to a scar. Once properly healed, a former wound that is now a scar has no potential of becoming infected or causing any further medical complications. Cosmetically unappealing scars may cause psychological stress, in which case one may opt to have it removed.

Conventional treatments for scar removal ranged from surgery and dermabrasion to cryotherapy and liposuction as well as several other therapies. The results from these procedures, however, were often less than satisfactory.

At Advanced Skin clinic we pride ourselves on continuously updating our technology and training our doctors so that we can provide our patients with the latest and most affective forms of treatment. In the field of scar removal, we employ several different treatment modalities and medical devices depending on amongst other things the size, shape, depth, and location of the scar, amongst other things. Call to schedule a consultation with one of our cosmetic dermatologist who will be glad to advise you about different treatment options.

Acne scars can remain a nuisance for many years after the actual acne condition has subsided. Acne scars can occur as the skin heals from pimples, whiteheads and blackheads that form when oil, bacteria and dead cells get stuck below the skin’s surface. When dealing with acne scars, two factors have to be taken into consideration. The first is the removal of damaged skin followed by the production of new collagen which will improve the skins texture.

We prefer combination approach for treating acne scars to maximize the treatment results. We combine different treatment modalities in one session depending on the severity of the acne scars. Such combination therapies include;

  • Subscision
  • Micro needling
  • Platelet Rich Plasma (PRP) Injections
  • Calming Face mask
  • LED Phototherapy

Conventional treatments for acne scarring have been chemical peels, topical agents and abrasion therapies. While these therapies may still be used in combination with microneedling in order to achieve the best possible results, micronedling have more or less taken over as they are minimally-invasive and have no recovery time especially for dark skin.

The microneedling technique has been utilized for the treatment of striae, surgical scarring, photoaging, and is now considered a standard treatment for mild (grade I/II) acne scarring. The needles traumatically create pores in the dermis, which stimulates the release of growth factors and cytokines. The growth factors and cytokines in turn stimulate collagen, elastin, and neovascularization.3 Studies and case reports have shown that microneedling physically breaks down acne scars and initiates collagen synthesis, specifically collagens I, III, and VII.4 Needling sessions are typically spaced 4 to 6 weeks apart.

We also do various acne scar revision techniques for severe acne scar cases such as Punch excisions, Filling depressed scars with filles or fat, subscision e.t.c.

TREATMENT OPTIONS

Treatment is determined based on the size, location, and symptoms of the keloid. While keloids on the face, chest, abdomen, and back are best treated with a combination of steroid injections and laser treatments, keloids that are larger and more raised or on the earlobes may benefit more from cryotherapy or surgery. Our providers utilize a combination of these treatment methods to give you the best results possible.

Treatment options:

  1. Intralesional Cryotherapy
  2. Steroid Injections
  3. Surgery
  4. Radiation

1. INTRALESIONAL CRYOTHERAPY

Cryotherapy refers to treatment with liquid nitrogen which can be delivered both externally and internally. External cryotherapy treats keloids from the outside. A pressurized spray canister is used to apply liquid nitrogen to the surface of the keloid. The liquid nitrogen freezes the keloid tissue and destroys its blood supply so that it can no longer grow. Eventually, the destroyed tissue falls off. External cryotherapy is typically the least effective treatment method for keloids.

On the other hand, with Intralesional cryotherapy, a type of internal cryotherapy, is an extremely effective method of treating keloids on the earlobes and larger, raised keloids. It has a 97% no-recurrence rate and does not pose a risk for pigmentary changes of the skin surrounding the keloid, unlike external cryotherapy. Intralesional Cryotherapy destroys the keloid from within by delivering liquid nitrogen through a probe that is inserted into the center of the keloid. The keloid is expected to shrink/flatten significantly within 2-4 months after the first treatment. The Intralesional Cryotherapy procedure is performed at Advanced Skin Clinic under local anesthesia, so there is minimal discomfort during the procedure. Duration of treatment depends on size and thickness of the keloid. The treated area feels tender for several days after the treatment and may require oral pain medication.

2. STEROID INJECTIONS

Intralesional Triamcinolone is a corticosteroid that is delivered directly into the keloid with a needle or Dermojet device. A series of Triamcinolone injections performed every 4 weeks can reduce inflammation, minimize symptoms, decrease size, and soften keloids that are firm to the touch. If adequate results are not seen with various strengths of Triamcinolone, an anti-cancer chemotherapeutic agent, 5-fluorouracil, can be injected in combination with Triamcinolone to increase effectiveness of injections.

Treatment is determined based on the size, location, and symptoms of the keloid. While keloids on the face, chest, abdomen, and back are best treated with a combination of steroid injections and laser treatments, keloids that are larger and more raised or on the earlobes may benefit more from cryotherapy or surgery. Our providers utilize a combination of these treatment methods to give you the best results possible.

Treatment options:

  1. Intralesional Cryotherapy
  2. Steroid Injections
  3. Surgery
  4. Radiation

Cryotherapy refers to treatment with liquid nitrogen which can be delivered both externally and internally. External cryotherapy treats keloids from the outside. A pressurized spray canister is used to apply liquid nitrogen to the surface of the keloid. The liquid nitrogen freezes the keloid tissue and destroys its blood supply so that it can no longer grow. Eventually, the destroyed tissue falls off. External cryotherapy is typically the least effective treatment method for keloids.

On the other hand, with Intralesional cryotherapy, a type of internal cryotherapy, is an extremely effective method of treating keloids on the earlobes and larger, raised keloids. It has a 97% no-recurrence rate and does not pose a risk for pigmentary changes of the skin surrounding the keloid, unlike external cryotherapy. Intralesional Cryotherapy destroys the keloid from within by delivering liquid nitrogen through a probe that is inserted into the center of the keloid. The keloid is expected to shrink/flatten significantly within 2-4 months after the first treatment. The Intralesional Cryotherapy procedure is performed at Advanced Skin Clinic under local anesthesia, so there is minimal discomfort during the procedure. Duration of treatment depends on size and thickness of the keloid. The treated area feels tender for several days after the treatment and may require oral pain medication.

Intralesional Triamcinolone is a corticosteroid that is delivered directly into the keloid with a needle or Dermojet device. A series of Triamcinolone injections performed every 4 weeks can reduce inflammation, minimize symptoms, decrease size, and soften keloids that are firm to the touch. If adequate results are not seen with various strengths of Triamcinolone, an anti-cancer chemotherapeutic agent, 5-fluorouracil, can be injected in combination with Triamcinolone to increase effectiveness of injections.

Keloids are among the most commonly treated skin ailments at Advanced Skin Clinic. These spontaneous and unsightly scars are a cosmetic nuisance and, when severe, can even be physically debilitating. It is well known that keloids are difficult to treat due to their high rate of recurrence. However, our patients have the opportunity to avoid this statistic. For appropriate candidates, we offer the Intralesional cryotherapy procedure, one of the recently approved treatment that has eliminated keloids without recurrence in over 97% of patients who have had the procedure to date.

Keloids are benign overgrowths of scar tissue that occur spontaneously at sites of trauma to the skin. They are most likely to develop on the frontal midline of the body, but also frequently occur on the earlobes. Some keloids are asymptomatic, while others cause varying degrees of itching, tenderness, and redness.

Keloids can be hereditary and are most common in individuals of African descent. Children are also at a higher risk for developing keloids. Treatment is recommended for symptomatic and actively growing keloids to reduce symptoms and prevent

TREATMENT OPTIONS

Treatment is determined based on the size, location, and symptoms of the keloid. While keloids on the face, chest, abdomen, and back are best treated with a combination of steroid injections and laser treatments, keloids that are larger and more raised or on the earlobes may benefit more from cryotherapy or surgery. Our providers utilize a combination of these treatment methods to give you the best results possible.

Treatment options:

  1. Intralesional Cryotherapy
  2. Steroid Injections
  3. Surgery
  4. Radiation

1. INTRALESIONAL CRYOTHERAPY

Cryotherapy refers to treatment with liquid nitrogen which can be delivered both externally and internally. External cryotherapy treats keloids from the outside. A pressurized spray canister is used to apply liquid nitrogen to the surface of the keloid. The liquid nitrogen freezes the keloid tissue and destroys its blood supply so that it can no longer grow. Eventually, the destroyed tissue falls off. External cryotherapy is typically the least effective treatment method for keloids.

On the other hand, with Intralesional cryotherapy, a type of internal cryotherapy, is an extremely effective method of treating keloids on the earlobes and larger, raised keloids. It has a 97% no-recurrence rate and does not pose a risk for pigmentary changes of the skin surrounding the keloid, unlike external cryotherapy. Intralesional Cryotherapy destroys the keloid from within by delivering liquid nitrogen through a probe that is inserted into the center of the keloid. The keloid is expected to shrink/flatten significantly within 2-4 months after the first treatment. The Intralesional Cryotherapy procedure is performed at Advanced Skin Clinic under local anesthesia, so there is minimal discomfort during the procedure. Duration of treatment depends on size and thickness of the keloid. The treated area feels tender for several days after the treatment and may require oral pain medication.

2. STEROID INJECTIONS

Intralesional Triamcinolone is a corticosteroid that is delivered directly into the keloid with a needle or Dermojet device. A series of Triamcinolone injections performed every 4 weeks can reduce inflammation, minimize symptoms, decrease size, and soften keloids that are firm to the touch. If adequate results are not seen with various strengths of Triamcinolone, an anti-cancer chemotherapeutic agent, 5-fluorouracil, can be injected in combination with Triamcinolone to increase effectiveness of injections.

3. SURGERY

Excision, or complete surgical removal, runs a high risk of recurrence. Often, keloids that develop after excision are larger than the original keloid. Therefore, excision is typically reserved for keloids on the earlobes or those too large for conservative treatments. We only perform excision of keloids on the earlobes. Firm keloids must be softened with a series of steroid injections prior to the procedure. During the excision, the site of the keloid is numbed with local anaesthesia and the keloid is subsequently removed with a shave technique. The procedure is followed by 3 postoperative steroid injections to reduce the risk of recurrence. The first injection is performed immediately after the excision and the following are given every 2 weeks thereafter.

PREVENTION

The best way to prevent keloids is to avoid elective procedures, including ear or body piercings, tattoos, laser treatments, or cosmetic surgery. If surgery is medically necessary, steroid injections delivered to the surgical wound after the procedure can be used as a method of keloid prevention. Postoperative application of imiquimod and pressure dressings may also reduce the risk of keloid formation.

To learn more about keloid scars, contact us today to schedule an appointment with our dermatologiststs.

Contact Us

FOR FURTHER INFORMATION CONTACT;

ADVANCED SKIN CLINIC

Ground Floor, Susie House, Plot 1001 Ggaba Road, Nsambya Central, Kampala. P.O Box 612, Kampala.

Tel:  0755-562430 (Office Line) or 0778-389002

Email: advancedskinclinic1@gmail.com

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