Wound Care and Scar Treatment

Overview

A scar cannot be erased, but many can be made flatter, paler, softer or better aligned. What is realistic depends on the type of scar, how long it has been there, its site, and skin type. The purpose of assessment is to say honestly which of the available approaches is likely to help a particular scar — and where the honest answer is that little will change, to say that too.

Common presentations

• Wound management — care of wounds that are slow to heal, including post-operative wound breakdown, chronic and pressure-related wounds, with dressing selection, debridement and surgical closure where appropriate.
• Keloid scar — raised scars that grow beyond the original wound, managed with intralesional steroid injection, pressure and silicone therapy, and surgical excision combined with adjuvant treatment where the scar warrants it.
• Burn scar — contracted or thickened scars after burns, addressed by release, grafting or flap reconstruction where movement is restricted, and by resurfacing where the concern is texture and colour.
• Surgical scar — revision of scars that are widened, depressed, tethered or poorly aligned, by re-excision and careful layered closure.
• Acne scar — atrophic and rolling acne scarring, treated by resurfacing, subcision or excision of individual scars according to the pattern present.

Consultation & planning

Assessment covers how the scar formed, how long ago, whether it is still changing, skin type and any history of keloid, and which features trouble the patient most — height, colour, texture, tightness or position. Scars are usually left to mature before revision is considered, since many improve substantially on their own over the first year. Treatment is often staged, and more than one modality may be combined.

Recovery

Injection treatments take minutes and are usually repeated at four- to six-week intervals. Surgical revision involves a fresh wound with its own healing period — sutures out at five to fourteen days depending on site, then several months of taping, silicone and sun protection while the new scar matures. Resurfacing involves redness and a period of careful skin care. Results are judged at twelve months, not at six weeks.

Risks & considerations

Scar treatment carries a real risk of an unchanged or worse result. Steroid injections can thin the surrounding skin, lighten it, and cause visible small vessels. Keloids recur after excision alone and must be treated with an adjuvant. Every surgical revision trades an old scar for a new one, which needs a year to settle and may end up no better. Darker skin types carry a higher risk of pigmentation change after resurfacing. These outcomes are discussed before any treatment is agreed.

This page provides general information only and does not constitute medical advice. Suitability, benefits, limitations and risks of any procedure can only be determined at a medical consultation.