Scars and Striae distensae, better known as stretch marks, are common skin conditions of a cosmetic concern.

What is A Scar?

A scar is an overgrowth of fibrous tissue and blood vessels that results from a cut, injury, or a burn.

There are many types of scars.

Hypertrophic scars: These scars look like a raised, reddish lump on the skin, but does not grow beyond the boundary of the injured site. Hypertrophic scars and keloids affect millions of people, with an overall incidence of 4.5% to 16% of the general population.

Acne scars: These scars are caused as a result of severe acne. They can leave significant pits, and depressions on the skin. Possible treatments will depend on the type and depth of scar formation.

Keloid scars: In contrast to hypertrophic scars, keloids proliferate beyond the boundaries of the initial skin injury and often continues to grow over time. Keloids are usually very thick and appear as red or purple lesions. Abnormal scarring responses are more common in certain locations (e.g., on the chest, shoulders, upper back, and ears) and in darker-skinned individuals. Keloids can be very difficult to treat and have a tendency to reappear even after scar removal. They can continue to grow and become large and tumorous (although benign). Smaller keloids can be removed by freezing with liquid nitrogen (cryotherapy). For larger keloids, optimally the treatments include intralesional steroid injections and/or surgical scar removal or treatment with a laser eg: Pulse Dye Laser/V-Beam, Tuneable Dye, KTP and others. It can be excised by CO2 or Erbium lasers.

Contracture scars: Contracture scars are formed where skin burns occur. Possible treatment depends on the extent of skin affected.

What is a stretch mark?

Striae or stretch marks commonly appear due to extensive skin contraction and/or increased glucocorticoid production during puberty, pregnancy, Cushing's syndrome, exogenous steroid use, and with excessive exercise. Striae are usually present on the abdomen, inner thighs, and around the knee and shoulder joints. Striae usually increases in length and width and acquires a darker reddish-purple appearance over time. The typical white, depressed appearance of older striae develops with continuation of skin tension.

Although complete disappearance of stretch marks have been observed, less visible appearance of the scar or stretch mark is a more realistic expectation and result.

Laser treatment for Scars & Stretch marks:

Many treatment options are available for scar and stretch mark removal. Factors to evaluate before treatment include: the individual's skin type, scar or stretch mark characteristics, the mechanism of injury, duration of lesion, and the extent of the scars or stretch marks themselves. After all this is considered, your dermatologist will choose which option is most appropriate for you.

There have been exciting and recent improvements in laser technology for scar and stretch mark removal. For some patients, a combination approach with laser treatments can offer a better outcome. There are specific lasers used to lighten and flatten scars. In general, lighter-skinned patients tend to heal better with laser treatments. Darker skin individuals may require more treatment sessions.

Candidates must know that complete scar / stretch mark eradication may not be possible in many cases. However, we have seen several good results and complete disappearance of scar/ stretch marks with our patients. In order to evaluate treatment progress, your dermatologist may suggest taking pre and post photographs after each session.