International Academy of Cosmetic Dermatology

SCARS

A scar is a mark remaining on the skin after an injury.  It represents both a challenge to and an opportunity for the dermatologic surgeon.  Essential in any surgical intervention (cosmetic or otherwise) is careful postoperative scar management.  In a cosmetic surgical procedure the optimal healing and cosmesis are the raison-d’être and final reason for patient satisfaction.

Hypertrophic scars and/or keloids represent the biggest potential complication of elective surgical procedures.  Careful pre-operative evaluation of the patient (with evaluation of any previous surgical scars) is the biggest single means of avoiding such complications.

Treatment of scars has centered around three traditional modalities:
  • Steroids for their effect on collagen formation 
  • Radiation for their effect on fibroblasts
  • Various products that exert pressure or occlusion (including silicone gel sheets)
  • Surgical repair

Less common but problematic are atrophic (ice pick, cigarette paper, or stretch) scars that have no medical treatment but surgical revision is the most common approach at present.

The perfect/? Invisible scar is truly the calling card of the expert SCARS dermatologic surgeon!!

Larry E. Millikan, MD
Meridien, MS, USA

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