Dr. Michael Tirgan, MD - New York City

Skin Growth Removal / Skin Tumor Treatment; One Patient at a Time.

hypertrophic Scars

Healing at the site of prior skin injury is quite often associated with scar formation. A scar is excess growth of fibrous tissue which results in a bumpy or uneven  skin surface.  Some scars can be very thick and even grow out of control to cause Keloids. 

When scars appear on the face, they are noticeable to others. This can cause discomfort and self-consciousness, not only for the person with the scar, but also for  the viewer. Revisions of scars can be a tedious and time consuming process.  Patience, persistence and  the willingness to explore different modalities are required to achieve improvement in the appearance of the scar.

Treatments for scars:

Treatment of each scar depends on its location, size and thickness.  Knowing what caused the scar as well as its age, are two other important factors that help in planning for a revision.  The principals behind scar revision are to (1) destroy, or remove the scar tissue (2) and then allow the skin to repair itself and grow normally.  Various methods are used to destroy the scar tissue, among which are: Surgery, Laser, Dermabrasion, Mechanical Sand Papering the skin, etc.  

For large and bulky scars, which mimic keloids, I often use cryotherapy to destroy the scar tissue. For smaller,  typical hypertrophic scars,  I often start with steroid injections.  Minor scars can sometimes be removed with a simple dermabrasion.  Some scars are associated with skin atrophy, and deep groves and dimples.  For these scars, releasing the pulling pressure from under the scars may result in skin relaxation and return of the skin to its normal position. 

Fresh wounds in individuals with history of keloids are best with  ocal steroid injections to prevent formation of a full-blown new keloid. Below is a video of a 10 days old wound in a patient with history of two prior keloids.  I treated this wound with steroid injection.  Follow up will be needed to minimize the chance of keloid formation for this wound.

cosmetic tattoos for scars:

Medical Tattooing can cover up and  camouflage some scars. Best indication for medical cosmetic tattooing is for cuts and scars in eyebrows, especially in individuals who have dark or black hair. Some scars cause loss of pigment of the skin, also known as vitiligo.  Tattooing the skin to match its normal surrounding area can tremendously improve the appearance of the skin. 

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Copyright © 2011 Michael H. Tirgan, M.D., all rights reserved.