Understanding and Treating Different Types of Scars

Types of Scars and Their Characteristics

1. Atrophic Scars:
These scars are indented and occur when there is a loss of tissue, common with acne. Treatments often include fillers like Sculptra or a dermal filler of choice, and fractional laser resurfacing (Profrac to build up volume in the tissue and encourage collagen production.
2. Ice Pick Scars:
These are deep, narrow scars that appear as small pits in the skin, often requiring a combination of excision or punch techniques to remove the scar tissue, followed by laser resurfacing smooth edges.
3. Rolling Scars:
These scars have a wave-like appearance, with a wider base and rounded edges. Treatment may involve subcision (manual separation of the scar tissue from the skin), followed by laser resurfacing, micro-coring, or injection with fillers to smooth the skin surface.
4. Boxcar Scars:
These scars have defined edges and a flat base, giving them a box-like appearance. Combination treatments often include Profractional Laser Resurfacing (LRS) to smooth the edges, fractional medicine delivery, and possibly RFMN (radiofrequency microneedling) to address deeper tissue.
5. Hypertrophic Scars:
These raised scars result from an overproduction of collagen. Treatment typically involves fractional laser resurfacing (Profrac) , followed by steroid injections with Kenalog to reduce the excess collagen. Additional lasers like BBL with a 560 filter or 1470nm wavelength (Halo) may help reduce redness.
6. Keloid Scars:
Like hypertrophic scars, keloids are raised but extend beyond the original wound. Keloid scars can be difficult to treat and may require a combination of steroid injections, laser treatment, and regular follow-up to monitor progress.
7. Hypopigmented Scars:
These scars lack pigmentation and appear lighter than the surrounding skin. Treatment might include Profrac delivery of topical treatments like Latisse to encourage pigmentation. Repeated sessions are often necessary, with realistic expectations set for gradual improvement.
8. Hyperpigmented Scars:
Scars that appear darker due to an excess of melanin in the healing process. Treatments often involve Moxi or anti-melanocytic agents, paired with cooling methods like ice and steroid applications to minimize inflammation and control melanin production.