Effective Scar Treatments: Keloids and Skin Lightening Options - Plastic Surgery

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Scar


Hello Doctor: I have a scar from a fall I had previously.
I bought a scar treatment cream; is it effective? Is the scar I have raised and bumpy a keloid? The scar has some dark spots; is there a way to lighten them? Otherwise, wearing a skirt looks so ugly! Thank you for your help.

Xiao Xiao, 20~29 year old female. Ask Date: 2002/07/20

Dr. Jiang Baicong reply Plastic Surgery


Regarding Miss Xiao Xiao's wound from a fall, if it results in a prominent scar, it is usually due to a deeper injury, an infection in the wound care, or the wound being located in areas with greater tension, such as the knee, outer elbow, or ankle joints, which have a larger range of motion.
If the prominent scar is caused by the aforementioned reasons, it is typically referred to as "hypertrophic scarring" rather than "keloid." Once the underlying cause is addressed, the results are usually quite good.
Keloids, on the other hand, are often related to individual predisposition and present scars that extend beyond the original wound area, usually appearing more raised and are more challenging to treat.
I hope you have beautiful legs.
- Jiang Bai Cong, Qishan Hospital

Reply Date: 2002/07/20

More Info


When it comes to effective scar treatments, particularly for keloids and skin discoloration, it’s essential to understand the nature of the scars and the available treatment options. Keloids are a type of raised scar that occurs when the body produces too much collagen during the healing process. They can be itchy, painful, and often larger than the original wound. If your scar is raised and has a firm texture, it may indeed be a keloid.

For treating keloids, there are several options available:
1. Topical Treatments: Over-the-counter creams and gels designed for scar treatment can be helpful, but their effectiveness varies. Products containing silicone are often recommended for keloids, as they can help flatten the scar over time. However, it’s important to note that while these treatments can improve the appearance of scars, they may not completely eliminate them.

2. Injections: Corticosteroid injections are commonly used to reduce the size and itching of keloids. These injections can help flatten the scar and reduce inflammation. Multiple sessions may be required for optimal results.

3. Surgical Options: In some cases, surgical removal of the keloid may be an option. However, there is a risk that the keloid could return after surgery, sometimes even larger than before. To mitigate this risk, doctors often recommend combining surgery with corticosteroid injections or radiation therapy.

4. Laser Therapy: Laser treatments can also be effective in reducing the appearance of keloids. They work by targeting the blood vessels in the scar tissue, which can help flatten the keloid and improve skin texture.

5. Cryotherapy: This involves freezing the keloid with liquid nitrogen, which can help reduce its size. This treatment is often used in conjunction with other therapies.

Regarding the discoloration of the scar, if you notice dark spots on the scar, this could be due to post-inflammatory hyperpigmentation, which is common after an injury. Treatments for this include:
1. Topical Lightening Agents: Products containing ingredients like hydroquinone, kojic acid, or vitamin C can help lighten dark spots over time. However, these should be used with caution and ideally under the guidance of a dermatologist, as some ingredients can cause irritation or allergic reactions.

2. Chemical Peels: These can help exfoliate the top layer of skin and reduce pigmentation. They should be performed by a qualified professional to minimize risks.

3. Laser Treatments: Certain types of lasers can target pigmentation and help even out skin tone. Again, this should be done by a qualified dermatologist.

4. Sun Protection: It’s crucial to protect the scar from sun exposure, as UV rays can worsen pigmentation. Using a broad-spectrum sunscreen with an SPF of 30 or higher can help prevent further darkening of the scar.

In conclusion, while there are effective treatments available for keloids and skin discoloration, the best approach often involves a combination of therapies tailored to your specific situation. It’s advisable to consult with a dermatologist who can assess your scar and recommend the most appropriate treatment plan. They can provide guidance on the use of over-the-counter products and whether more advanced treatments are necessary. Remember, patience is key, as scar treatments can take time to show results.

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