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1 Scotts Road #04-15/16 Shaw Centre Singapore 228208
Scars and Keloids

Scars and Keloids

What are scars?

Scars are unique marks on the skin, each with its own story, emerging as a natural part of the body's healing journey.

In our practice, we understand that scars — whether from accidents, infections, burns, surgeries, acne, or other health conditions — carry physical and emotional weight.

Scars can manifest through changes in colour or texture, each with its unique characteristics:

Colour alterations in scars

  • Hypopigmented: these scars are lighter than the surrounding skin, indicating a loss of pigment during the healing process.
  • Hyperpigmented: darker than the surrounding area, these scars have an excess of pigment.
  • Erythematous: characterised by a pink to red hue, indicating inflammation or increased blood flow in the area.

Textural changes in scars

  • Atrophic scars: atrophic scars present as indentations, craters, or pits resulting from dermal tissue loss and insufficient collagen production during the healing phase.
  • Hypertrophic scars: these are thick, raised lesions that form due to an overproduction of collagen.
  • Keloidal scars: a form of hypertrophic scar that grows beyond the initial boundaries of the wound, keloids represent a unique and more complex challenge in scar management.

Understanding the nature of your scar is the first step towards effective treatment. Our clinic is dedicated to providing personalised care that addresses all aspects of scarring. We offer a range of treatments tailored to the specific type of scar, its location, and your skin type, ensuring the best possible outcomes for your skin and your confidence.

We value your journey towards healing and recovery. Explore our scar treatment options and schedule a consultation today to learn how we can help you embrace your skin confidently and comfortably.

Hypertrophic scarsKeloids
Remains within the confines of the original woundExtends beyond the confines of the original wound
Occurs soon after the wound healsCan develop a few months after a wound heals
May improve with timeGets worse with time if no intervention is started
More responsive to treatmentLess responsive to treatment, i.e. more treatment sessions often needed
Keliods

At Lumine Dermatology & Laser Clinic, we understand the complexity and emotional distress associated with keloids — a condition that goes beyond cosmetic concerns and affects patients deeply. Keloids, with their characteristic raised, reddish-purple appearance, most commonly manifest on the chest, shoulders, back, jawline, and earlobes. They mark areas where the skin's healing process has been dysregulated, leading to an overproduction of collagen. This condition, often influenced by genetic factors, requires a nuanced and empathetic approach.

A dermatologist must approach keloid treatment on a case-by-case basis. Encouraging early intervention and educating patients about the risks of keloid formation following skin trauma or inflammation are also key components of comprehensive dermatologic care for those susceptible to this condition. For example, if the keloids are due to acne or pityrosporum folliculitis, we must address the underlying causes to prevent new keloids from forming.

At Lumine Dermatology & Laser Clinic, we have programmes that treat various kinds of keloids, which include one or a combination of the following treatments:

  • Intralesional steroid injections: to reduce inflammation and flatten keloids, making them less noticeable.
  • Laser-assisted drug delivery: laser-assisted drug delivery enhances the effectiveness of topical treatments by facilitating deeper penetration.
  • Pulsed dye laser treatments: pulsed dye laser treatment targets and diminishes the redness of keloids, improving their appearance.
  • Neurotoxin injections: neurotoxin injections relieve discomfort and reduce the activity of keloids in select cases.
  • Surgical options: including debulking or removal of keloids for more severe cases, followed by personalised aftercare to minimise recurrence.
  • Silicone sheets or pressure earrings: non-invasive options for keloids on the earlobes or certain flat areas. They promote healing and reduce scar tissue formation.
Burn Scars: Diagnosis, Causes, and Treatments

At our clinic, we recognise the profound impact that burn scars can have on our patients' lives, not just aesthetically but also on their overall health and well-being. Our approach to managing burn scars begins with immediate and appropriate wound care. By applying the right dressings soon after the burn occurs, we aim to reduce the risk of severe scarring significantly.

Burn scars vary widely, with superficial and deep burns leaving distinctly different marks on the skin. Superficial burns may result in minimal texture changes but can lead to hypopigmentation, hyperpigmentation, or post-inflammatory erythema. In these instances, we may recommend specialised topical treatments to soothe inflammation and skin pigmentation. Additionally, advanced laser treatments, including picosecond lasers for hyperpigmentation, pulsed dye lasers for redness, and non-ablative fractional resurfacing lasers for hypo and hyperpigmentation, offer targeted solutions to address these concerns.

For deeper burns, a more holistic approach is necessary. Collaboration with occupational therapists and physiotherapists allows for the introduction of pressure garments and early mobilisation exercises, crucial steps in the healing process. To soften and improve the appearance of deeper scars, we suggest intralesional steroid injections or fractional carbon dioxide lasers, enhancing the treatment's effectiveness with laser-assisted topical delivery.

Our dedicated team is committed to providing personalised, comprehensive care. By combining immediate, appropriate post-burn treatments with advanced therapeutic options, we strive to improve the appearance of burn scars and support our patients' journey towards healing and recovery.

Post Herpes Scarring: Diagnosis, Causes, and Treatment

Scarring is a common aftermath of herpes simplex or herpes zoster infections. These infections often leave behind noticeable skin changes due to the intense inflammation they cause, including marked hypo or hyperpigmentation and atrophic scarring.

Recognising the importance of early intervention, our approach focuses on beginning treatment as soon as the wounds have fully healed. This proactive strategy is key to effectively restoring the skin’s appearance. We start by prescribing topical treatments to manage residual inflammation and pigmentary abnormalities.

Lasers, including picosecond lasers, pulsed dye lasers, and non-ablative and ablative fractional lasers, are chosen for their effectiveness in targeting specific pigmentation changes. For those dealing with atrophic scars, we offer treatments with fractional carbon dioxide lasers and polynucleotide injections to boost the skin’s healing machinery.

Traumatic and Post-Surgical Scars

Traumatic scars often manifest with discolouration, atrophy (depression of the scar), or hypertrophy (raised scar tissue), with specific areas of the body tending to heal differently. For instance, scars around the mouth and chin are prone to hypertrophy, while those around the eyebrows, forehead, temples, and shins typically heal with atrophy.

While scar discolouration may naturally fade over time, more persistent and unique issues, such as traumatic scars from materials like asphalt penetrating the skin during injury, may necessitate advanced treatments.

Picosecond lasers are particularly effective. They help break down and remove foreign material, significantly improving the appearance of the skin.

Hypertrophic scars, especially around the perioral region, pose a significant therapeutic challenge. Our approach often combines laser treatments and injectables to effectively reduce and soften these scars. Additionally, spread scars resulting from either surgery or trauma benefit from resurfacing lasers. These treatments help blend the scars with the surrounding skin and stimulate collagen formation, promoting a smoother and more uniform skin texture.

We thoroughly assess each scar or keloid to determine the most suitable treatment approach for optimal results. We have experience managing various scars and are equipped with the right tools to improve their appearance. If you are concerned about your scar condition, please schedule an appointment with Lumine Dermatology & Laser Clinic for a thorough diagnosis and an appropriate treatment plan.

Frequently asked questions

What can be done to minimise the risk of keloid formation if I am keloid-prone?

This is a common concern for those undergoing surgery who are prone to keloid formation or have a family history of keloids. Intraoperatively, meticulous fine-handling of the tissues and multi-layered wound closure is important. Post-op, minimise excessive tension over the wound with special dressings and delay return to vigorous physical activities. Finally, laser treatment (e.g., pulsed dye laser, fractional CO2 laser) can be initiated very early on to control the inflammatory wound healing process post-surgery.

Can scars and keloids be completely removed?

While completely removing scars and keloids is challenging, a personalised treatment plan developed by a dermatologist can significantly improve their appearance and texture and reduce their visibility.

Are scars and keloids permanent?

Scars and keloids are permanent but can be effectively managed, and their appearance minimised with appropriate treatment and care. Regular follow-ups and maintenance treatments may be needed to sustain results over time.

Can scars and keloids cause any complications besides aesthetic concerns?

In addition to aesthetic concerns, scars and keloids can sometimes lead to functional issues such as restricted movement or discomfort, especially if they are large or located over joints. Regular monitoring and timely intervention can help address potential complications.

Why is my scar still red after 6 months?

While most scars fade, some take longer than others to do so. This depends on the individual and the amount of tension and inflammation at the site of the scar. Pulsed dye lasers effectively address red scars. It will be beneficial to make an appointment for a consultation with us to diagnose your scar process.

Can lasers remove scars?

Laser treatment may not eliminate scars completely, but it can significantly reduce their appearance. These procedures stimulate the growth of new, healthy skin. This therapy is suitable for various scars, including surgical, acne, and injury scars, and is safe for use on the face.

Healthy skin, Happy mood.

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1 Scotts Road #04-15/16 Shaw Centre Singapore 228208





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