Starting about 2 weeks after skin repair, scar tissue starts to grow and thicken. This is a normal process of healing which can make the surgical area look worse. The thickening of the scar is also known as hypertrophic scarring. Keloid scarring, an extreme case of scar growth, is rare and is characterized by a ballooning scar lump in the repair area.
Scars can be surgically revised after at least 2 months of healing. The procedure can be performed under local anesthesia. The widened scar is excised and the normal skin edges are brought together. The main reason scar revision months after original surgical repair works better than the surgical repair is wound tension. The original wound tension has relaxed and the skin has stretched. Scar revision involves minimal tension of repair and results in narrower scar.
Laser treatment of scars diminishes the capillaries and veins in and around the scar. The laser (most commonly the KTP laser) seals the blood vessels without breaking the skin. The procedure is usually performed after 4 months of healing. Topical anesthesia with numbing ointment is usually sufficient to make the procedure tolerable. Local anesthetic injection can be used for additional numbing.
The area of the treatment will feel like a sunburn for 24-48 hours. It is treated with Aquaphor ointment for 5 days. Mild skin crusting can occur and resolves in less than a week. The procedure may need to be repeated 2 more times spaced 2 weeks apart. Insurance does not cover this procedure. Cost to the patient is $250-$500 for the entire course of laser treatment of the scar.
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