There are different options for scar revision which may depend on several factors:
- Length of time the scar has been present
- How the scar developed
- Scar appearance – for example, its depth, location, orientation, quality
- Factors relating to the patient’s skin thickness and pigmentation
Although it is not possible to remove a scar completely, its appearance may be improved through various techniques. Some scars may benefit from re-excision followed by meticulous wound closure. Surgically created scars are often more precise than ones caused by trauma. Elevated scars may benefit from dermabrasion, which is a surgical technique to resurface the scar by removing the outer layers of tissue. Depressed scars may sometimes be released surgically or injected with hyaluronic acid fillers.
If a scar has been present for less than a year, it is generally recommended to wait until final scar maturation before considering any revision techniques. In the interim, scar massage performed several times daily may help to flatten and soften the scar as well as desensitize the region. There are other non-surgical treatments for immature scars. If elevated, immature scars may benefit from either silicone gel (for the head and neck region) or silicone sheeting (for the body). The silicone may improve scar appearance through hydration and potentially by increasing scar temperature as it matures. Other types of elevated or thickened scars may benefit from steroid injection.