Skin on Forty-Five

Scar Management

Scars can tell a story or just be annoying and unsightly but thanks to modern medicine scars can be a thing of the past.


Scar formation is part of the last phase of the natural wound healing process. It occurs only when damage occurs to the basal layers of the skin and is different in every person. Through the application of a detailed understanding of the process by which scars form we can use some simple techniques to reduce scar formation following procedures or treat scars that have already developed.

How does a wound normally heal?

There are 4 classical phases to wound healing. Haemostasis stopping bleeding), inflammation, proliferation and remodelling. The first 3 phases occur over a period of days to weeks with the final remodelling phase continuing for up to years. Many factors such as irritation, infection and trauma and other medical conditions can delay healing and lead to larger and more unsightly scarring. 

What is a hypertrophic or keloid scar?

A hypertrophic scar occurs when the wound heals under a lot of tension resulting in a wide scar. Typically these occur in areas such as the back where the skin is constantly stretched and strained throughout the healing process. In a hypertrophic scar, the scarring is restricted to the area of damaged skin i.e. between to edges of a wound.

A keloid scar is a firm, smooth, hard growth due to spontaneous scar formation arising soon after an injury, or developing months later. Keloids may be uncomfortable or itchy and extend well beyond the original wound. They may form on any part of the body, although the upper chest and shoulders are especially prone to them.

What is scar management?

Scar management is where we use our detailed understanding of scar formation to prevent the formation of scars or improve the appearance or remove preexisting scars. This involves medical and surgical treatments tailored to individual patients, their scar and the aims of treatment.

What treatments are available for scar management?
  • Emollients: Creams and oils as moisturisers.
  • Silicone gel or sheets.
  • Oral or topical tranilast (an inhibitor of collagen synthesis)
  • Pressure dressings
  • Surgical excision: geometric broken line closure
  • Intralesional corticosteroid injection
  • Intralesional 5-fluorouracil
  • Cryotherapy
  • Pulsed dye laser
  • Dermabrasion or Skin needling
  • Subcision

Talk to your team at Skin on Forty-Five today to see how we can assist in reducing or improving the appearance of your scars.