Last updated: 11/24/2009

There are a number of nonsurgical treatments that can be used before, after, or in place of scar revision surgery.

Drugs

Medications may be used during the initial inflammatory phase of scar formation, as well as therapy...

for such specific skin disorders as acne. Keloids are often treated by direct injections of corticosteroids to reduce itching, redness, and burning; steroid treatment may also cause the keloid to shrink. Corticosteroid injections, gels, or tapes impregnated with medication are also used after scar excisions and Z-plasty to prevent recurrence or formation of hypertrophic scars. Acne scars are treated with oral antibiotics or isotretinoin.

Massage, wraps, radiation, and nonablative treatments

The most conservative treatments of scar tissue include several techniques that help to minimize scar formation and improve the appearance of scars that existing already. The simplest approach is repeated massage of the scarred area with cocoa butter or vitamin E preparations. Burn scars are treated typically with the application of pressure dressings, which restrict movement of the affected area and provide insulation. Another technique that is often used is silicone gel sheeting. The sheeting is applied to the scarred area, and remains for a minimum of 12 hours a day over a period of three to six months. It is effective in improving the appearance of keloids in about 85% of cases.

Keloids that do not respond to any other form of treatment may be treated with low-dose radiation therapy.

Nonablative treatments, which do not remove the epidermal layer of skin, include microdermabrasion and superficial chemical peels. Microdermabrasion, the use of which has increased widely since 2000, is a technique for smoothing the skin. During this procedure, the physician uses a handheld instrument that buffs the skin with aluminum oxide crystals; skin flakes are removed through a vacuum tube. Microdermabrasion does not remove deep wrinkles or extensive scar tissue, but can make scars somewhat less noticeable without the risk of serious side effects. Mild chemical peels, such as those made with alpha-hydroxy acid (AHA), are used sometimes to treat acne scars or uneven skin pigmentation resulting from other types of scar revision treatment.

Camouflage

Scars on the face and legs can often be covered with specially formulated cosmetics that even out the color of the surrounding skin and help to make the scar less noticeable. Some of these preparations are available in waterproof formulations for use during swimming and other athletic activities during which one perspires.