Every skin injury leaves a scar after healing. The appearance of the scar depends on the type of injury and its extent, patient’s other diseases, and the patient’s healing ability. Scars differ in colour and height – hypertrophic or hypotrophic. Keloidal scars emerge in the individuals with inherited or acquired predisposition, or after strong exogenous intervention into the skin. Their occurrence is related to age, gender, and localisation of the injury. The patient is traumatised by the appearance of the scar or movement restriction. When planning the operation the surgeon has to consider the preceding factors to avoid re-operations. The surgeon will help the patient to decide, which method to use (after patient’s informed agreement):
Dermabrasion is used for acne scars on the face, posttraumatic or surgery scars. It is a method for smoothing scars elevated above surrounding skin by high speed milling machine.
Both dermabrasion and excision can be performed under a local or a general anaesthetic. It depends on the size of scarred area and its localisation.
The hyperpigmantation may a problem in the next few months after the surgery, especially after sunbathing. The patient thus has to use sunbathing creams with high sun protection factor for 6 months after the surgery.
The hypertrophic and keloidal scars cannot by accepted aesthetically. Sometimes they are accompanied by pain and itching. There is no universal method assuring perfect results of the treatment. The healing process depends on biochemical, genetic, metabolic, and immunological factors, which influence the origin of a scar. Considering the complexity of the problem the cooperation between the patient and the surgeon, who tries to choose the best treatment, is necessary.