Scar formation after even minor skin injuries is often inevitable. For patients with Asian skin types, cutaneous injuries have significant implications due to their genetic propensity for abnormal scar formation and hyperpigmentation. Therefore, preventing abnormal skin scarring is paramount in these patients. Additionally, they have a higher genetic susceptibility to hypertrophic and keloid scars in pigmented skin.
Interestingly, significant structural and physiological differences exist between Asian and Caucasian skin concerning the wound healing process and scar formation. Asian skin has a thicker dermis and a higher collagen density compared to Caucasian skin at the same anatomical sites, which can lead to an increased fibroproliferative response during healing. Furthermore, scars in Asian skin are more prone to becoming abnormal and developing into hypertrophic scars due to a prolonged inflammatory period, resulting in increased erythema during wound healing.
Asian skin also exhibits increased melanin production, sebum secretion, fibroblast proliferation, collagen formation, and fibroplasia compared to Caucasian skin. Studies have shown that scar maturation can take longer in Asian skin. Both excessive inflammation and increased mechanical tension adversely affect abnormal scar development, therefore, it is crucial to tailor treatment options to Asian patients, considering their specific skin type.
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What Are Hypertrophic Scars and Keloids?
Hypertrophic Scars:
Hypertrophic scars are raised, red scars that form within the boundaries of the original wound.
They occur when the body produces too much collagen during the healing process.
These scars can be itchy or painful but often improve over time, becoming less noticeable.
Keloids:
Keloids are more severe than hypertrophic scars, extending beyond the original wound site into surrounding skin.
They are raised, thick, and can grow over time.
Keloids can be itchy, painful, and may not improve without treatment.
They are more common in people with darker skin tones and can be triggered by minor injuries like piercings or acne.
Dream’s Aesthetic Treatments for Hypertrophic Scars and Keloids
Dream’s aesthetic treatments can help reduce the appearance of hypertrophic scars and keloids. The choice of treatment depends on the scar's size, location, and severity.
1. Steroid Injection
Intralesional steroid injections are a widely used and highly effective treatment for hypertrophic scars and keloids. This method involves injecting corticosteroids directly into the scar tissue, which helps to reduce inflammation and inhibit excessive collagen production. As a result, the scar gradually becomes flatter, softer, and less noticeable. The anti-inflammatory properties of steroids not only alleviate symptoms like itching and pain but also prevent further growth of the scar.
Typically administered in multiple sessions spaced several weeks apart, intralesional steroid injections can significantly improve the appearance and texture of hypertrophic scars and keloids. This treatment is often used in combination with other modalities, such as silicone gel sheets or laser therapy, to enhance results and provide a comprehensive approach to scar management. The precise delivery of steroids directly into the scar ensures that the treatment is localized and effective, making it a cornerstone in the aesthetic and therapeutic management of challenging scars.
The Fotona Er:YAG ablative laser is an advanced option for treating hypertrophic scars and keloids to provide an effective result. This laser works by vaporizing the outer layers of scar tissue, which helps to reduce the height and thickness of hypertrophic scars and keloids. By removing the excess tissue layer by layer, the Er:YAG laser stimulates the skin's natural healing process, promoting the regeneration of smoother, healthier skin.
Additionally, the thermal effect of the laser helps to remodel collagen within the scar, improving its texture and flexibility. The precision of the Fotona Er:YAG laser ensures minimal damage to surrounding healthy tissue, reducing the risk of adverse side effects and shortening recovery time. This makes it a superior option compared to traditional surgical methods. Often used in combination with other treatments such as steroid injections, Fotona Er:YAG laser is an integral part of a comprehensive approach to managing and improving the appearance of hypertrophic scars and keloids.
Preventing Hypertrophic Scars and Keloids
While not all scars can be prevented, certain measures can help minimize the risk of developing hypertrophic scars and keloids:
Proper wound care: Keeping wounds clean and moist can promote better healing.
Avoiding unnecessary skin trauma: Be cautious with piercings, tattoos, and other skin procedures.
Using silicone gel or sheets on healing wounds: These can help reduce the risk of excessive scarring.
Conclusion
Managing hypertrophic scars and keloids can be challenging, but with the right aesthetic treatments, significant improvements in their appearance are possible. If you have concerns about a scar, please schedule an appointment with us at Dream Clinic to explore available treatment options. By taking proactive steps, you can attain smoother, healthier-looking skin and regain confidence in your appearance.
Reference
1.Ledon, J. A., Savas, J., Franca, K., Chacon, A., & Nouri, K. (2013). Intralesional Treatment for keloids and Hypertrophic Scars: a review. Dermatologic Surgery, 39(12), 1745–1757. https://doi.org/10.1111/dsu.12346
2.Nast, A., Eming, S., Fluhr, J., Fritz, K., Gauglitz, G., Hohenleutner, S., Panizzon, R. G., Sebastian, G., Sporbeck, B., & Koller, J. (2012). German S2k guidelines for the therapy of pathological scars (hypertrophic scars and keloids). Journal Der Deutschen Dermatologischen Gesellschaft, 10(10), 747–760. https://doi.org/10.1111/j.1610-0387.2012.08012.x
3.Jung, K. E., Jung, K. H., Park, Y. M., Lee, J. Y., Kim, T. Y., Kim, H. O., & Kim, H. S. (2013). A Split-face comparison of ablative fractional lasers (CO2and Er:YAG) in Asian patients; postprocedure erythema, pain and patient’s satisfaction. Journal of Cosmetic and Laser Therapy, 15(2), 70–73. https://doi.org/10.3109/14764172.2012.75905
