Scar and Keloid

1. WHAT ARE THE DIFFERENT TYPES OF ACNE SCARS?

Acne can heal with red scars, brown scars, shallow and pitted scars and keloids. These scars can be prevented by treating acne early. Different treatment modalities are used depending on the type of scars. Combination treatments are often used; red scar are treated with the pulse dye laser: brown scars with prescription medication, chemical peels or pigment specific lasers like Fraxel or Picoway Lasers and deep scars with subcision and the Fraxel lasers.
 

2. WHAT CAN WE DO FOR INJURY SCARS OR POST SURGERY SCARS?

These scars are fresh and red. The pulse dye laser treatment is started as soon as possible to reduce the redness and to smoothen out the scars. This can be combined with LED phototherapy.

Scars become brown during the healing stage and usually disappear with time. However the pigment laser can be used to improve the brown colour.
 

3. WHAT IS THE TREATMENT FOR KELOIDS?

Keloids are difficult to treat. They can be itchy and painful and continue to grow. Treatment consists of repeated steroid injections and is often combined with the pulse dye laser or the fraxel laser.
 

4. WHAT IS SUBCISION?

Subcision is a minor surgical procedure to release the attachments of deep fixed scars from the skin below and make them movable. Dr Joyce Lim will “slice” the base of these scars. After subcision there will be a bruise at the base of the scar.
 

5. WHAT IS LASER RESURFACING?

Laser resurfacing is a procedure whereby a laser (usually a fraxel laser) is used to resurface or smooth out scars. Fractional lasers are the best lasers for improving scars. They work by removing tiny columns of old scars while keeping the adjacent skin intact. Thousands of these microscopic laser columns penetrate deep into the scars, to remove old and damaged cells and scar tissue. The adjacent skin between the lasered columns is kept intact – this allows for better healing, faster healing and minimal side-effects – and eventually this too is replaced with new skin.

Dr Joyce Lim uses the Fraxel Dual Restore and the Fraxel CO2 repair or the hybrid Youlaser to treat scars.
 

6. WHEN ARE DERMAL FILLERS USED TO TREAT SCARS?

Dermal fillers are injected into the base of scars to lift them up. They are useful for shallow scars and the filler effect lasts for a year. It is better to treat your scars with lasers rather than dermal fillers as the results from laser treatments are more effective and longer lasting. However there is a role for dermal filler – Dr Joyce Lim will inject dermal fillers when you want to see results immediately while waiting for the other procedures to work.
 

7. WHAT IS THE TCA CROSS TREATMENT?

A strong chemical (usually trichloroacetic acid) is applied to the apex of the scars. The chemical removes some scar tissue and stimulate new collagen below the scars. Several treatments at 6-8 weeks are done till the scars are flat.

The Scar Crossing treatment is effective, safe and relatively cheaper than other scar treatments. There is less downtime and you can resume normal activities immediately after the procedure.
 

8. WHAT IS THE TIXEL TREATMENT?

The Tixel is a novel thermal fractional skin rejuvenation treatment. It uses natural heat (at 400C) to rejuvenate skin and smooth out scars. A template with cones is heated and this is stamped onto the skin to create tiny microscopic columns keeping the adjacent skin intact. The treated skin generates collagen and smooths out wrinkles and scars. Effectiveness is similar to the fractional CO2 laser.

Treatment time is short and there is minimal pain or discomfort.