Scar Treatment

Scar tissue develops as part of the body’s healing process in response to an injury, infection, burn, or inflammation. While scarring is natural, the appearance of scars can negatively impact self-esteem and confidence. Luckily, Dr. Michele Green in New York City is an expert at improving the appearance of different types of scars, including hypertrophic scars and acne scars. Through the use of various non-invasive treatment options, such as cosmetic lasers, dermal fillers, chemical peels, and steroid injections, Dr. Green can significantly improve the cosmetic appearance of your scars. Atrophic scars are characterized by depressions in the skin that form due to a loss of collagen during the wound-healing process. Keloid scars are raised scars that occur when excess collagen is produced during the healing process. Unlike normal hypertrophic scars, keloidal scar tissue continues to grow beyond the limits of the initial trauma after the skin has healed. To obtain the best cosmetic results and avoid unwanted side effects, it is critical to have all types of scar treatment with an experienced board-certified dermatologist, such as Dr. Michele Green in NYC. Dr. Green is an expert in treating all different types of scars, including acne scars, stretch marks, surgical scars, keloids, and hypertrophic scars.

Laser skin resurfacing treatments, such as Fraxel and eMatrix, are considered some of the most effective for addressing atrophic acne scars and chicken pox scars. In contrast, laser therapy, such as VBeam laser, is the gold standard for eliminating redness associated with surgical scars, stretch marks, post-inflammatory hyperpigmentation, and keloids. Other popular scar treatment options include microneedling, dermabrasion, and chemical peels.  Dermal fillers, such as Restylane, Voluma, and Sculptra, can be performed with subcision to stimulate new collagen production and replenish volume loss. Botox and topical silicone gel sheets may also be suggested to prevent scar development. With so many treatment options available, it is essential to consult with an expert, board-certified dermatologist, such as Dr. Michele Green, who can help you create the treatment plan that works best for your skin condition and the specific types of scars you have.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic procedures, including scar treatments. She is consistently identified as one of New York’s best dermatologists by Super Doctors, Castle Connolly, and New York Magazine for her dedication to her patients and expertise. When you consult with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood regarding scar revision, she will work with you to create a customized scar treatment plan that best suits your skin type, the type of scar present, and your overall aesthetic goals.

What is a scar?

Scar tissue can take on many forms but appears on the skin due to the body’s natural healing process. Many different types of scars can form due to various adverse events, and these injuries can result in the appearance of various scars. Unlike those from cystic acne or chicken pox, the appearance of burns or surgery requires different treatment modalities. If the injury to the skin goes deeper than the top layer, the scar tissue that forms is often thicker than normal skin. For patients with a lighter skin tone, scars are typically pink or red when they initially develop and may fade away with time or become darker or lighter than the patient’s regular skin color. For patients with darker skin, scars can frequently look like dark marks on the skin’s surface. A scar can form on any part of the body, and the type of scar depends mainly on the origin of the injury or lesion, how your body heals, and the formation of the wound.

What are the different types of scars?

Various factors, including the origin of the injury, one’s genetics, and ethnicity, can influence scar formation. Different types of scars can have other appearances and textures, including the following:

Contracture Scars – Contracture scars are characterized by tightened skin that makes moving the affected area more difficult. These scars typically form after a large area of skin is damaged, such as with a burn, and can be a hindrance if the scar formation happens over a joint or if the scar tissue affects a muscle or nerve. Burn scars develop when burn-damaged skin creates excess collagen during the healing process. Burn scars may be characterized by tension, contour abnormalities, discoloration, and altered vascularization.

Atrophic (Depressed) Scars – Atrophic scars are also known as “depressed” scars because they are characterized by indentations or sunken patches of skin. These scars often form due to acne, cystic acne, or lesions relating to an illness like chickenpox. Three types of atrophic scars can occur: ice pick, boxcar, and rolling scars. Atrophic scars may become more visible with age as the natural loss of collagen further accentuates the indentations in the skin. Most acne scars are atrophic and fall into three major types: icepick, boxcar, and rolling.

Hypertrophic (Raised) Scars – Hypertrophic scars are inverses of atrophic scars. Characterized by raised skin, hypertrophic scars are caused by too much collagen produced during natural healing. While hypertrophic scars can fade over time, they will never truly flatten out. Hypertrophic scars will not grow beyond the area of the injury.

Keloid Scars—Keloid scars are also raised scars that differ from hypertrophic scars in that they grow in size past the area of the injury throughout the healing process and beyond. Red-headed patients and patients of African, Hispanic, or Asian heritage are more likely to develop keloid scars. The overgrown scars may affect a patient’s movement if the scar tissue grows over a joint.

Flat Scars – Flat scars are characterized by discoloration on the skin’s surface. These scars may be slightly raised when the wound healing occurs at first but will flatten out over time. The scar may begin as pink or red and become either hypopigmented (lighter) or hyperpigmented (darker) than the surrounding skin.

Stretch Marks – Stretch marks occur on the skin’s surface when the skin expands or shrinks rapidly over a short period, which can occur frequently due to pregnancy or rapid weight gain or loss. The stretching of the skin causes damage to the underlying tissue, resulting in a scar. At first, stretch marks often appear pink or red but will fade to a silvery color over time.

View more info about Types of Acne Scars.

Why do scars form?

Scar tissue forms when damaged skin undergoes the natural healing process. An infection, injury, burns, or inflamed skin tissue can result in scar development. Part of the healing process involves the production of a naturally occurring skin protein, collagen. Collagen is the most abundant skin protein, contributing to its structural support, firm foundation, and smooth texture. During the natural healing process, collagen fibers form tissues that knit the skin back together to repair the wound. The tissue that develops helps to protect the damage from infection, and it is this tissue that can lead to the appearance of a scar. When excess collagen is produced, the result is a keloid or hypertrophic scar. If insufficient collagen is produced, the result is an atrophic scar. The shape, size, and texture of a scar depend mainly on the cause of the wound and your age, genetics, and skin type.

What is the most effective treatment for scars?

The best way to determine which scar treatment options will be most effective for treating the types of scars you have, your skin type and tone, and for achieving your personal aesthetic goals is by consulting an experienced board-certified dermatologist, such as Dr. Michele Green in NYC. Dr. Green is an internationally renowned expert in cosmetic dermatology with over 25 years of experience providing some of the world’s most discerning individuals with the most cutting-edge scar treatments. Consulting an experienced healthcare professional regarding scar treatment is critical, as some treatment options aren’t suitable for patients of every skin tone or type. For example, using the wrong laser treatment for a patient’s skin tone can result in side effects such as hypopigmentation, hyperpigmentation, burning, or scarring. To ensure safety, efficacy, and optimal results, an expert like Dr. Green will assess your skin condition, thoroughly review your medical history, and review any previous cosmetic scar treatments you may have had. Depending on her evaluation, the location and type of scar, and your skin tone and type, Dr. Green will personalize a scar treatment plan that best suits your unique needs and aesthetic goals.

Some of the most popular non-invasive treatment options include steroid injections, laser skin resurfacing, Botox, and topical treatments such as silicone gel sheets, chemical peels, microneedling, and dermal fillers. The treatments that are available at Dr. Green’s office are the safest, most effective treatments available. Some dermatologists may offer options such as cryotherapy, a process by which scar tissue is frozen off with liquid nitrogen. Treatment options such as cryotherapy are outdated because they are less effective and have a higher risk of potential side effects. A plastic surgeon may also be able to perform surgical options, such as scar excision or a skin graft.

Can scars be removed with laser treatment?

Yes! Laser skin resurfacing is considered one of the most effective methods for scar revision. Laser treatments can be effective in reducing the appearance of various types of scars, including surgical, injury, acne scars, stretch marks, and burn scars, among others. While laser treatments are incredibly effective in improving the appearance of different types of scars, nothing can remove scar tissue completely. Scar tissue forms during the skin’s natural healing process and is evidence of permanent damage. However, utilizing just the right combination of treatment options can make your scar look completely unnoticeable, improve skin elasticity in the treated area, and reduce any symptoms that may be associated with the scar, such as pain and itchiness. Various laser treatments are available for scar revision that work via different mechanisms to improve the appearance of scars. Consulting with an expert in cosmetic dermatology, such as internationally renowned, board-certified dermatologist Dr. Michele Green in NYC, is the best way to understand which laser treatments best suit your skin condition and the types of scars you have.

VBeam Pulsed Dye Laser treatment

The VBeam Pulsed Dye laser treatment is considered the gold standard when it comes to reducing visible redness, including that which is associated with various types of scars, such as acne scars, surgical scars, stretch marks, keloids, burn scars, and post-inflammatory hyperpigmentation. This laser treatment operates on a wavelength of 595 nm, which exclusively targets the red pigment in the skin while the surrounding skin remains unaffected. As it is used to target redness, VBeam is also an excellent treatment option for correcting the appearance of broken blood vessels, rosacea flare-ups, and other pigmented lesions. This laser treatment also helps to flatten the raised hypertrophic scars and keloids.

The VBeam does not involve any downtime, meaning patients can resume their normal daily activities immediately after the procedure. Most patients note that the VBeam laser treatment is painless, describing the sensation as akin to a rubber band snapping against the skin. It is also equipped with a Dynamic Cooling Device, which emits a burst of cool air before each laser pulse to enhance the comfortability of the laser treatment for the patient. Patients who are sensitive to the laser treatment or who have a large area of the body treated may choose to use a topical numbing cream to minimize any potential discomfort further. Dr. Green will prescribe the numbing cream to your selected pharmacy, and it should be applied to the entire treatment area one hour before your laser treatment. Once you arrive at Dr. Green’s dermatology office for treatment, the cream will be removed and your skin sterilized. Most patients require an initial series of 4-6 VBeam laser treatments to achieve their ideal results. To maintain the best results, Dr. Green recommends limiting sun exposure in the treated area and layering two types of broad-spectrum sunscreen to ensure optimal coverage: first, a chemical sunscreen, followed by a mineral sunscreen.

Fraxel Laser treatment

Dr. Green often refers to the Fraxel laser treatment as the “magic eraser” for its unique ability to target a wide range of skin conditions, including the appearance of scars. The Fraxel operates on two distinct wavelengths of light, 1550 nm, and 1927 nm, to effectively improve skin texture and tone, depending on the patient’s needs and goals. In regard to improving the appearance of scars, Fraxel is most suitable for treating atrophic or depressed scars, such as surgical or acne scars and stretch marks. With the 1550 nm wavelength, the Fraxel creates controlled, precise micro-injuries in the dermis. This process stimulates new collagen production and, over time, a smoother, firmer skin texture and a reduction in the appearance of scars.

As a non-ablative fractional laser treatment, Fraxel leaves the outermost layer of skin intact, which significantly shortens the downtime required. Most patients have only a couple of days of downtime, during which they may experience common side effects in the treated area, like mild redness, swelling, or peeling. Most patients require a series of 4-6 Fraxel laser treatment sessions to achieve ideal results in regard to scar revision, with each treatment approximately one month apart. Patients with mild scars may require fewer treatments, and patients with more severe scars may require additional treatments. While the cosmetic results of the Fraxel laser treatment for scar revision are considered permanent, future collagen breakdown that occurs due to the natural aging process can not be prevented. As collagen breaks down, the appearance of scars that have been previously treated may become more pronounced. Many patients choose to engage with Fraxel maintenance treatment sessions to keep up the best results. When you have Fraxel laser treatment with Dr. Michele Green at her private dermatology office in Manhattan’s Upper East Side neighborhood, she will work with you to establish a treatment timeline that best suits your needs and goals.

eMatrix laser treatment

The eMatrix laser treatment is commonly used to eliminate the appearance of atrophic acne scars and stretch marks. The eMatrix uses bi-polar radio frequency energy to heat the dermal layer of skin while keeping the top layer of the skin intact. By bypassing the epidermis and delivering heat to the deeper layers of the dermis, eMatrix treatment minimizes the amount of downtime required and the potential of encountering unwanted side effects that tend to be associated with more aggressive treatments, such as skin discoloration and scarring. There are approximately two days of downtime associated with the eMatrix, during which patients may experience common side effects such as mild redness, swelling, peeling, or the sensation of heat in the treated area. The eMatrix is a highly effective laser skin resurfacing treatment that is safe for patients of all skin types and tones, including darker skin tones, who can be more susceptible to encountering these unwanted side effects with other laser treatments. It is crucial to limit sun exposure following eMatrix laser treatments, as the photosensitivity of the skin increases and it can become more susceptible to UV damage.

With each pulse of the eMatrix, radio frequency energy heats the dermis, resulting in controlled skin injury and the activation of fibroblasts that signal a wound healing response and produce new collagen. Collagen is a naturally occurring protein in the skin that provides it with a firm foundation and enhanced structural support. As new collagen is produced over time, the skin’s texture improves, and the appearance of scars reduces. Most patients require a short series of 4-6 eMatrix laser treatment sessions for optimal scar revision results, with each treatment session spaced approximately four weeks apart. Patients with more severe scars may need more treatment sessions. In addition to improving the appearance of scars, the eMatrix is commonly used to reduce the appearance of fine lines, wrinkles, sun damage, skin laxity, discoloration, and enlarged pores.

eMatrix for acne scars

Botox

Botox is one of the most popular non-invasive cosmetic treatment options for facial rejuvenation and the gold standard for eliminating the appearance of dynamic fine lines and wrinkles. Botox is commonly used for reducing fine lines on the forehead, between the eyebrows (glabella), and around the eyes (crow’s feet). One of the lesser-known yet incredibly effective applications of Botox is reducing the appearance of scars following cosmetic facial surgery. In a study illustrated by the American Academy of Dermatology, Botox was injected into half of the test subjects who received plastic surgery on their face. Immediately after the surgery, Botox was injected into the area. Researchers found that those patients had smaller and flatter surgical scars than those patients who did not receive the Botox treatment. Researchers postulate that this is due to how Botox limits movement surrounding the wound as it heals. This can help prevent the scar from becoming overly raised and reduce discoloration.

The cosmetic effects of Botox tend to last approximately four months, with many patients choosing to engage with regular maintenance treatments on a quarterly basis. It is important to have Botox injections with a board-certified expert, such as Dr. Michele Green in NYC. Dr. Green was among the first dermatologists in New York to offer cosmetic Botox injections, is an Allergan Platinum injector, and provides what have been described as the ‘best Botox injections in NYC.’

Dermal Fillers

Dermal fillers are cosmetic injectables designed for the enhancement of facial contours, the augmentation of certain features, the replenishment of volume loss, and the provision of a more youthful appearance. Dermal fillers can be an incredibly effective tool in scar revision, particularly for restoring volume to depressed scars. Dr. Green employs a wide variety of dermal fillers at her private dermatology office in NYC. To treat scars, she most frequently uses Restylane-L, Restylane Lyft, Juvederm Ultra Plus, Juvederm Voluma, and Sculptra. Subcision is commonly performed in conjunction with filler treatment for scar revision, which entails using the fine needle of the syringe to break up scar tissue and stimulate collagen production. Performing subcision with filler injections provides immediate and long-lasting rejuvenation results. The Restylane and Juvederm fillers are composed of a substance called hyaluronic acid, which binds with naturally occurring water in the skin to replenish lost volume instantly. The cosmetic effects of hyaluronic acid fillers tend to last 6-18 months, depending on the amount and type of filler used and the patient’s metabolism. Sculptra is a unique filler made of something called poly-L-lactic acid, which stimulates gradual collagen production in the treatment area. Most patients require about three treatment sessions with Sculptra filler to achieve their ideal results. The type of filler selected for your scar treatment will be determined by Dr. Green during your consultation, depending on the types of scars present.

Getting fillers with an expert injector like Dr. Green is simple, safe, and effective and requires no downtime, meaning patients can resume their usual daily activities after their injections. The most common side effects, if any, are mild swelling, tenderness, bruising, or redness at or near the injection sites, which resolve independently within several days of treatment. Patients who are very prone to bruising can take Arnika, an oral herbal supplement proven to prevent and treat bruising, for several days before and after their filler injections. Dr. Green recommends discontinuing any blood-thinning medications or supplements, including Ibuprofen, Advil, Aleve, garlic, vitamin E, and multivitamins, for two weeks before filler injections to best prevent bruising. When you have fillers with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood, she will provide you with all of the pertinent information required for achieving and maintaining the best results.

Restylane – 2 syringes for scar treatment

Chemical peels

A chemical peel is a non-invasive skin resurfacing treatment that accelerates skin cell turnover and increases collagen production to reveal a smoother, brighter complexion that is more even in texture and tone. Chemical peels can be an effective treatment option for active acne, post-inflammatory hyperpigmentation, and mild atrophic scars, such as depressed acne scars. There is a wide variety of chemical solutions that may be selected in varying strengths, depending on the patient’s skin tone and type and the severity and types of acne scars present. It is important to seek treatment from an experienced healthcare professional, such as board-certified dermatologist Dr. Green, to ensure that your chemical peel is safe, effective, and produces ideal cosmetic results.

During a chemical peel, the chemical solution is topically applied to the top layer of the skin. The solution reacts with the skin’s surface to exfoliate the skin’s outer layer. Patients with type I or II skin can tolerate deeper chemical peels. In contrast, patients with darker skin tones should use more gentle chemical peels to avoid unwanted side effects such as discoloration or scarring. Most patients require a series of chemical peel treatments to achieve their ideal results. The most critical aftercare consideration is limiting sun exposure in the treated area, as the skin’s photosensitivity will be higher, and it will be more susceptible to UV damage. Dr. Green will provide all of the aftercare information, including which skincare products to use, to ensure optimal results.

TCA Cross

TCA cross is a scar treatment that is reserved for a specific type of scar- atrophic ice pick acne scars. TCA stands for trichloroacetic acid, a chemical solution commonly used for chemical peels. This scar treatment works by stimulating the production of new collagen and elastin in localized areas. During the treatment, the healthcare provider deposits a small amount of highly concentrated TCA directly into the scar depressions with a tool like a toothpick. This differs from a TCA chemical peel, which involves applying the solution in a lesser concentration to the entire face. When placed directly into the deep scars, the TCA Cross triggers the body’s natural healing process, producing collagen and elastin, which fills the depressions. This treatment option is unsuitable for patients with Fitzpatrick type 3 or darker skin, as there is a greater risk of developing unwanted hyperpigmentation as a side effect. Dr. Green typically recommends 3-5 treatments for optimal results, each spaced 6-8 weeks apart. The production of new collagen can begin as little as four weeks following the treatment, with ongoing improvements to the skin surface for as long as four months following each treatment session.

Microneedling

Microneedling, also referred to as collagen induction therapy, is a cosmetic treatment option that can improve both skin texture and tone. Microneedling is a procedure that delivers controlled trauma to the skin’s surface via a handheld device containing tiny, sterile microneedles. These microneedles penetrate the epidermis, the outermost layer of the skin, inducing the skin’s natural healing process. This results in increased skin cell turnover and the stimulation of new collagen production. Collagen is the most abundant skin protein, contributing to its structural support, smooth, firm texture, and overall youthful appearance. In addition to improving the appearance of fine lines, enlarged pores, uneven skin tone, and dullness, microneedling can be an excellent treatment option for atrophic scars, which are characterized by depressions and develop when insufficient collagen is produced during the skin’s healing process. Most patients require an initial series of 4-6 treatment sessions, with each spaced approximately one month apart, to replenish collagen levels and improve the appearance of acne scars. Patients with more severe scarring may require additional treatments.

Microneedling is a safe and effective scar treatment option for all skin types and tones, and its effects can be further enhanced by pairing it with radio frequency energy or a special topical serum like platelet-rich plasma (PRP). PRP is serum derived from a sample of the patient’s blood, which is spun in a centrifuge to separate it from the red blood cells. It contains an abundance of natural growth factors and proteins involved in the healing process, promotes circulation, stimulates collagen growth, and accelerates skin regeneration. The PRP is applied topically onto the skin after the microneedling device and enters the microchannels it creates, allowing for maximum absorption.

Radiofrequency microneedling is an innovative treatment option that combines traditional Microneedling with radiofrequency energy to induce collagen production in multiple layers of the skin. The traditional microneedling aspect of the treatment stimulates new collagen production in the epidermis, while the radiofrequency does so in the dermis by delivering heat, providing optimal skin rejuvenation results. 

Dermabrasion

Dermabrasion is a treatment that entails resurfacing the skin with a rapidly rotating device, removing the top layer of skin. This process triggers the natural wound healing process, which involves new collagen production. This makes dermabrasion an effective treatment option for addressing depressed acne scars, pox marks, stretch marks, and surgical scars. When the top layer of the skin is removed, the new skin that is generated afterward is smoother, firmer, and tighter, and the appearance of scars is significantly reduced. Dermabrasion is recommended for patients with lighter skin tones, as patients with darker skin tones are more susceptible to developing unwanted side effects, such as skin discoloration or scarring, due to the procedure. Patients with active acne or other inflammatory skin conditions, such as a rash, cold sore, or blister, should not undergo dermabrasion until their symptoms have resolved in order to avoid exacerbating their condition or potential infection.

To ensure safety, efficacy, and optimal rejuvenation results, dermabrasion should only be performed by an experienced, board-certified dermatologist or plastic surgeon. A topical anesthetic should be used in the treatment area before the procedure to reduce potential discomfort. During the procedure, the healthcare professional will use a specialized rotary device with an abrasive tip to “sand” the top layer of skin away. After the treatment, patients should follow their healthcare provider’s instructions about skin care and can expect some redness, swelling, or tenderness in the treated area. The recovery time following the procedure is relatively significant compared to many other non-invasive treatment options for scar revision, requiring patients to take at least two weeks off of work to heal completely. Patients should avoid sun exposure and cleanse and dress their skin as instructed to prevent potential side effects.

What are the different types of scars that can be treated?

Many different types of scars can benefit from the non-invasive scar treatment options available at Dr. Green’s private dermatology office in New York City. Acne scars, surgical scars, stretch marks, post-inflammatory hyperpigmentation, and flat scars are among the types of scars that can be made completely unnoticeable with the right combination of treatment options. To treat these types of scars, Dr. Green may recommend a combination of treatment options such as laser skin resurfacing, chemical peels, microneedling, and fillers with subcision. She will determine the suggested scar treatment plan depending on your skin tone and type, as well as the severity, location, and types of scars present. Hypertrophic scars and keloids can also be treated with several non-invasive scar treatment options, though they are much more challenging to diminish effectively. Keloids, in particular, can be difficult to treat, as these types of scars involve continual collagen production and can often extend beyond the margins of the initial wound or damaged skin. To shrink keloids, Dr. Green may recommend treatment options such as corticosteroid injections, silicone sheets, or VBeam laser treatment.

How to remove flat scars

A flat scar may initially appear slightly raised and pink or red, usually flattening out and eventually appearing nearly the same color as the surrounding skin. However, it can take months to years for the pigment in a flat scar to fade. To expedite the healing process and eliminate the discoloration from a flat scar, Dr. Green may recommend treatment options such as the VBeam laser treatment or chemical peel, depending on whether the discoloration is pink, red, or a variation of brown. If the scar is relatively new, Dr. Green may recommend utilizing silicone sheets as the area heals to encourage it to heal flat as opposed to raised. If the scar has healed and is flat, smooth, and white, it is called a hypopigmented scar. In this case, the loss of pigment is due to a loss of skin cells that create pigment in the affected area and is usually permanent. The best way to determine which treatment options are recommended for removing the specific types of scars you have is to consult an expert, such as board-certified dermatologist Dr. Michele Green in NYC.

How to remove atrophic scars

Atrophic acne scars are the most common type of acne scar. They also are commonly associated with chicken pox or injuries that involve loss of skin tissue. Atrophic acne scars are depressions that develop when the skin’s natural wound-healing response produces insufficient new collagen. Since atrophic scars are incredibly common, there is a wide range of available treatment options for improving their appearance. The treatment options recommended for you will be dependent upon your skin condition and the types of scars present. There are three different types of atrophic scars, including icepick, rolling, and boxcar scars. Ice pick scars have a deep, narrow, v-shaped indentation and are the most difficult to treat due to their depth and shape. Rolling scars are shallow, uneven, and wave-like in appearance, seemingly “rolling” across the skin’s surface. Boxcar scars have a round or oval-shaped appearance, well-defined edges, and deep vertical sides. Depending on the types of scars, Dr. Green may recommend treatment options such as laser skin resurfacing, chemical peels, microneedling, dermal fillers with subcision, punch excision, or TCA cross. When you consult with Dr. Green at her private dermatology office in NYC, she will physically evaluate your skin condition, collect a thorough medical and family history, and review any previous scar treatments you’ve undergone in order to establish a personalized plan that leaves you with a smooth, clear, healthy complexion that lasts.

What is a Keloid Scar?

A keloid is a firm, raised, growth-like scar. Unlike normal hypertrophic scars, keloids can continue to grow after the skin trauma has healed to extend beyond the limits of the initial wound. The color of keloid scars can vary and may change over time as the scar develops. Keloids may be flesh-colored, erythematous, or hyperpigmented. Keloids are benign growths that may cause burning, itching, or pain in the affected area. Keloids do not resolve on their own or regress over time. They can be an especially challenging type of scar to treat, and successfully reducing them requires treatment by a board-certified dermatologist or plastic surgeon, like Dr. Michele Green in New York City.

How do Keloids form?

Keloids may develop in response to an injury, infection, inflammation, burn, piercing, tattoo, surgery, abrasion, laceration, insect bite, injection, or hair removal procedure. Collagen is a structural skin protein contributing to a firm foundation and an overall youthful appearance. A keloid can form when the body produces more collagen than is needed to heal a wound. A keloid scar typically extends beyond the limits of the initial injury and does not regress over time, unlike normal hypertrophic scars. Some individuals are more prone to developing keloid scars. Dark-skinned individuals have higher rates of keloid development, and a family history of keloids increases the risk for their development. Keloids may develop on any body part but are most commonly found on the chest, shoulders, cheeks, and earlobes.

How to remove hypertrophic scars and keloids

Some scar treatments can be found over-the-counter, such as ointments and creams, that can be used to reduce the appearance of mild hypertrophic scars. Over-the-counter topical products often contain such ingredients as Vitamin A and Vitamin E to revitalize the skin, increasing the rate of skin cell turnover and stimulating new collagen production. The American Academy of Dermatology recommends that patients speak with a board-certified dermatologist, such as Dr. Green, before purchasing over-the-counter products for scar revision. Dr. Green can provide more information about the type of product that will best address your specific needs.

Another standard topical treatment for scars is silicone gel sheets. These sheets are best used on a recent wound to prevent raised scars from forming and decrease the likelihood of redness, swelling, itching, or stiffness in new scars. Researchers have found that though silicone ointment is also available, silicone gel sheets are more effective at preventing scarring. These sheets should be applied to the wound after it closes daily for as many as three months.

A popular in-office treatment option for eliminating the appearance of scars is corticosteroid injections, more commonly known as steroid injections. These steroids, however, are very different from the kind of steroids you may hear about in the media regarding bodybuilders. Corticosteroids are synthetic drugs similar to hormones that appear naturally in the body. Steroid injections are injected directly into the treatment area to decrease the size of the scar, as in a hypertrophic scar or keloid scar, with no systemic side effects. Small amounts of corticosteroid injection help reduce the size and thickness of keloid scars and improve their appearance, making them smaller and flatter.

Surgical Scar Revision for Keloids

Surgical scar revision may be the best treatment option for patients with a more significant scar. Specifically, surgical scar revision can be effective for patients suffering from a significant keloid scar that is very large or has grown such that it limits movement. When choosing a surgical option for scar removal, it is essential to remember that surgery of any kind will also leave a scar, and you will be trading one spot for another. Ideally, surgical scar revision will result in a less prominent spot. However, any surgical procedure poses more significant side effects and infection risks.

How much is scar treatment?

When patients ask how much it costs to remove a scar, the answer is it depends. The cost of scar treatment depends upon various factors, including the size of the treatment area and the location, severity, and type of scar present. For example, patients with a vast keloid scar may require more extensive treatment to eliminate the scar, increasing the price. Additionally, most patients require a unique combination of treatment options to achieve optimal results, which can also affect the overall cost of the scar treatment. The best way to determine the approximate final cost of your scar treatment is by consulting an expert, such as Dr. Green. When you consult with Dr. Green regarding non-surgical scar revision, she will physically evaluate your skin condition, collect a thorough medical and family history, and review any previous scar treatments you may have had. She will then recommend the combination of treatments that are best suited to your particular needs and goals. At that time, the final cost of your scar treatment can be estimated.

25-34 year old man, VBeam and eMatrix for acne scars

How much is laser scar treatment?

The total cost of laser treatment for scar revision ultimately depends on both the size and scope of the treatment area, the number of laser treatments required to achieve your final desired results, the geographic location of the office where you have treatment, and the experience level of your provider. The type of laser treatment used for your scar revision can also impact the total cost. When you consult with Dr. Michele Green at her private office in Manhattan’s Upper East Side neighborhood, she will work with you to create a customized treatment plan that incorporates the laser treatment best suited to your particular needs and aesthetic goals. At that time, the final cost of your laser treatment can be estimated.

Does insurance cover scar treatment?

Typically, scar treatment is considered cosmetic and not covered by private insurance companies. Insurance may cover scar treatment. You may be insured if there is documented evidence of functional impairment related to the scar, such as in a severe burn, and the treatment can be expected to improve function. The best way to determine your coverage is by contacting your insurance provider.

How much is scar treatment abroad?

It is important that your scar treatment is performed in a medical setting by a certified healthcare professional to ensure that the treatment is safe and effective, produces ideal results, and avoids unwanted or dangerous side effects. Prices abroad can vary significantly depending on the country, the establishment in which you’re treated, and the experience level of your provider. Consider the potential risks of traveling abroad to have scar treatment before planning a trip.

When to start scar treatment

To achieve the best results in regard to scar revision, it is best to start treatments as soon as possible once the scar has fully healed. If you are considering post-surgical scar treatment, you should prioritize the full healing process of the wound first before navigating through the various scar treatments available. A consultation with a board-certified medical professional can be helpful at any stage in your scar treatment process since a dermatologist can advise regarding your healing and treatment timeline. Make sure to carefully follow post-operative instructions and wait until the wound has completely closed and healed before undergoing any scar reduction treatments or applying topicals to the scar. Before, during, and after your scar treatments, avoid sun exposure to the affected area by wearing protective clothing and SPF 50. The scarred skin area is highly susceptible to developing hyperpigmentation and skin cancer due to UV exposure.

To most effectively reduce acne scars’ appearance, whether atrophic, hypertrophic, or hyperpigmented, patients should no longer be experiencing active breakouts of acne lesions. Controlling acne breakouts is important in scar treatment since new acne lesions can create new scars. Patients who first undergo acne treatment to prevent future flare-ups enjoy long-lasting results when treated for their scars. If you are struggling with acne, Dr. Green can help. Depending on your medical and family history, skincare routine, lifestyle, and hormone levels, Dr. Green may recommend acne treatments such as Accutane, spironolactone, or oral/topical antibiotics to prevent breakouts. Once the acne has been effectively managed, acne scar treatments can be started so that patients can enjoy smooth, clear, healthy skin that lasts.

When to start scar treatment after surgery

Generally, it is best to wait at least three months after a surgical procedure before considering scar reduction treatments. Ensuring the wound is completely closed and healed before undergoing scar treatments is essential. Post-surgical instructions must be followed carefully to prevent scar formation. After the wound is fully healed, the scar can be assessed by Dr. Green to discuss the best treatment options. Because there are so many options available for treating scars, it is best to consult an experienced, board-certified dermatologist like Dr. Green, who can determine what type of scar you have, when to start treatments, and which treatments would be safest and most effective.

How long does it take for a scar to go away?

While the appearance of scars can be effectively reduced with a variety of treatment options, scar tissue is permanent. The amount of time required to reduce the appearance of your scars will ultimately depend on your skin condition and type, as well as the severity, location, and types of scars present. Most scar treatments need to be spaced several weeks apart to allow the skin to heal between sessions. The majority of scar treatments also produce the best results when they are performed in a series. Thus, it can take six months or more to produce optimal results. When you consult with Dr. Green, she will establish a personalized treatment plan for your scar revision and work with you to develop a timeline that best suits your needs.

Can scars be removed permanently? Can you permanently get rid of scar tissue?

Unfortunately, scar tissue is permanent. Scars form when there is irreparable damage to the skin’s underlying tissue. During the healing process, either an excess or insufficient amount of collagen is produced. Collagen is the skin’s most abundant protein, providing structural support and contributing to a smooth, firm skin texture. If too much collagen is produced, the result is a keloid or hypertrophic scar. When insufficient collagen is produced, the result is an atrophic scar. Various treatment options can be used to reduce different types of scars. The best way to reduce the appearance of scars successfully is by consulting an experienced board-certified dermatologist, such as Dr. Green in NYC. Dr. Green has over 25 years of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic procedures, including scar revision. When you consult with Dr. Green, she will work with you to achieve and maintain a healthy, clear, smooth complexion.

How do you break up deep scar tissue?

Deep scar tissue can often be addressed with a range of treatment options, such as dermabrasion, chemical peels, laser skin resurfacing, corticosteroid injections, subcision with fillers, or punch excision. If none of these treatment options are suitable for your skin condition and the types of scars you have, surgical scar revision may be recommended. Ultimately, the treatment option recommended for breaking up your scar tissue will depend on the severity, location, and type of scars present. An experienced healthcare professional, such as board-certified dermatologist Dr. Michele Green in NYC, can evaluate your skin condition and recommend the treatment options best suited to your needs and goals.

What is the best product to break down scar tissue and help scars heal better? How long should you wear silicone sheets?

Patients who are undergoing topical treatment to prevent scars may be prescribed silicone gel sheets. The silicone sheets effectively reduce the scar’s size and minimize potential discomfort, such as itchiness, during the healing process. However, patients must wear the silicone sheets as recommended for the treatment to be effective. Most patients will be asked to apply the sheets to the wound for 12 to 22 hours daily for up to three months.

What fades scars the fastest?

Hyperpigmented scars can develop when the skin cells responsible for making melanin, melanocytes, produce too much pigment during the skin’s healing process. Protecting the skin from sun exposure is important for fading scars as quickly as possible, as UV rays can trigger melanocytes to produce melanin and lead to worsening discoloration. Dr. Green recommends wearing sun-protective clothing or covering the scar and using a broad-spectrum sunscreen with a minimum SPF of 30. Broad-spectrum indicates that it offers protection against both UVA and UVB rays.

In addition, some targeted over-the-counter products can help accelerate the healing process, fade discoloration associated with post-inflammatory hyperpigmentation, and create a more even skin tone. Serums containing active ingredients like vitamin C, azelaic acid, or alpha hydroxy acids, such as glycolic acid and lactic acid, are great topicals for reducing post-inflammatory hyperpigmentation. Vitamin C increases cell turnover and has powerful antioxidant properties to slough off pigmented skin cells and provide a more even skin tone. Alpha hydroxy acids exfoliate discoloration to reveal healthy, even-toned skin cells. Azelaic acid inhibits the activity of enzymes involved with melanin production. When you consult with board-certified dermatologist Dr. Michele Green at her private dermatology office in NYC, she will work with you to develop a customized skincare routine that includes the products best suited to your particular needs and goals.

What are the best oils for scar treatment?

Many oils have anti-inflammatory and healing properties that can potentially benefit wound healing and scar treatment, though there is little clinical evidence. Topical Vitamin E and tea tree oil are two types of essential oils that have anecdotally helped prevent and treat scarring.

Creams to Treat Keloid Scars

Silicone creams can be used to reduce the size and color of keloid scars. Silicone creams are available over the counter and do not require a prescription. These products are also available as gels or as an adhesive sheet. Silicone products can be applied to old scars and those that are still healing, as long as the skin has healed over and the wound has closed. Silicone gel sheets are considered an optimal scar treatment for keloids. Silicone scar treatments should be used to cover the keloid for at least four months to attain the best results. Corticosteroid creams can negate the itching sensation that can often accompany keloid scars. Corticosteroid creams can also be purchased over the counter.

What is the best scar treatment for a tummy tuck?

Traditional tummy tuck scars extend from hip to hip and can take up to one year to heal completely. Many patients struggle with redness and irregular skin texture following a tummy tuck. Laser treatments such as V-Beam and Fraxel can work wonderfully to reduce the appearance of a tummy tuck scar. The V-Beam laser operates on a wavelength that targets the red pigment in the skin, leaving the surrounding tissue unharmed. The pigment absorbs the energy from the laser and is destroyed. Fraxel resurfacing laser treatment can improve the texture of a tummy tuck scar, smoothing the skin’s surface so that the scar is much less noticeable. Many patients choose to combine these laser treatments in their scar revision plans to optimize their results.

What is the best scar treatment for old scars?

Dr. Green may recommend combining treatment options such as dermal fillers and resurfacing laser treatments for old scars. The eMatrix sublative rejuvenation laser treatment and Fraxel laser are ideal for targeting old scars. The eMatrix laser relies on radiofrequency energy to create micro-injuries in the dermal layers of the skin, stimulating new collagen production in the treatment area. The eMatrix can be an excellent treatment for treating old, white-colored stretch marks. Dr. Green often refers to the Fraxel Dual laser treatment as the “magic eraser” for its unique ability to address a wide range of skin concerns, including the appearance of scars. Fraxel operates on two distinct wavelengths, the 1927 and 1550 nm. The 1550 nm stimulates new collagen production in the dermal layers of skin while leaving the outermost surface layers intact and is ideal for treating stretch marks, surgical scars, fine lines, and acne scars.

Collagen is a structural protein in the skin that provides a firm foundation and contributes to an overall youthful appearance. Minimal downtime is involved, with most patients experiencing side effects of temporary redness, dryness, and peeling in the treated area. It is essential to refrain from sun exposure in the treated area following each treatment session, as the laser treatment increases the skin’s photosensitivity, which makes one more susceptible to UV damage. Most patients require 4-6 laser treatments to achieve their desired results.

A dermal filler is a type of cosmetic injectable designed to give the skin a smoother texture by ‘filling’ in the gaps left by the collagen loss, which causes atrophic scarring. Dermal fillers are also a popular cosmetic treatment option for improving the appearance of fine lines, age-related volume loss, or enhancing certain facial features. Some of the most popular dermal fillers for improving the appearance of scars include Restylane, Juvederm, and Sculptra.

Sculptra is a unique dermal filler composed of poly-L-lactic acid that stimulates new collagen production in the treatment area. It is an excellent treatment option for targeting atrophic scars, including acne scars and depressed stretch marks. Over time, as collagen is produced, the skin texture becomes smoother, reducing the appearance of depressed scars. Most patients require an initial series of three treatment sessions to achieve ideal results, and the effects of this innovative filler treatment last for up to two years.

Dermal fillers such as Juvederm, Voluma, Belotero, and Restylane are composed of hyaluronic acid, a naturally occurring substance in the skin that contributes to hydration and an overall youthful appearance. Depending on the type of HA filler used and the patient’s metabolism, the filler lasts 6-18 months. Dr. Green often performs subcision in conjunction with dermal filler injections, a technique that stimulates new collagen production in the treatment area and provides a long-lasting, smoother skin texture. This treatment option is highly effective for atrophic scars due to the immediate volume restoration provided by the HA injectable filler and the long-term effect of producing new collagen provided by subcision.

Does scar treatment work?

Yes, Scar treatments reduce the appearance of scars, helping restore self-confidence. However, some scar tissue may be permanent, and it may be impossible to remove a scar completely. Dr. Green has over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive treatment options, including keloids, hypertrophic scars, and acne scars. When you consult with Dr. Green at her private dermatology office in NYC’s Upper East Side neighborhood, she will work with you to create a customized scar treatment plan that best suits your types of scars, skin type, and overall aesthetic goals.

How do I get started with scar treatments today?

Scar tissue develops as a natural part of the skin’s healing process. Still, the appearance of scars can negatively impact one’s confidence, mainly if located on a visible area like the face. Scars can also be a constant reminder of a negative or traumatic experience that can lead to depression and anxiety. Scars are permanent but gradually improve and fade over time, usually up to two years, depending on the scar’s severity and location. You may already have tried creams, gels, and lotions sold over the counter that claim to make the scar disappear, to no avail. Luckily, you can take steps to facilitate the healing process or undergo the various scar treatments available to diminish the appearance of scars. Because there are multiple types of scars and scar treatments, it is best to consult an experienced dermatologist like Dr. Green, who can determine the best and safest treatment options.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing some of the world’s most discerning individuals with the best non-invasive cosmetic procedures available, including scar treatments. She takes a holistic approach and embraces a less-is-more philosophy, consistently being identified as one of New York’s best dermatologists by Castle Connolly, New York Magazine, the New York Times, and Super Doctors for her dedication to her patients and expertise. When you consult with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood for scar revision, she will work with you to develop a customized scar treatment plan that best suits your needs and goals. To schedule a consultation with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood, please contact us online today or call 212-535-3088.