8/3/2023 0 Comments Scar revision surgery cost![]() ![]() If hyperpigmentation occurs secondary to laser therapy, topical bleaching and peeling agents may be used.Ītrophic scars are difficult to treat given texture abnormalities that occur. To prevent hyperpigmentation, intraoperative energy densities can be lowered with increased number of treatment sessions. However, lasers can still be used safely for scar revision in darker skinned individuals. Laser therapy in darker skinned individuals may be particularly challenging due to the increased risk of dyspigmentation and scarring.įitzpatrick skin types I–III tend to have better results with laser treatment because there is less risk of unintentional absorption of light by epidermal melanin. While other nonablative lasers may be used for hyperpigmentation, ablative lasers should be avoided, as these lasers may cause further hyperpigmentation as an adverse effect. This is similar to its common use in treatment of Mongolian spots, melasma, and solar lentigines. IPL utilizes infrared wavelengths to improve scar color. The IPL is best suited for treatment of scar hyperpigmentation. Lasers may be used in conjunction with topical therapies. Other topical agents, including silicone and tretinoin, have shown efficacy in reducing postinflammatory hyperpigmentation. Hydroquinone, though once banned by the FDA due to carcinogenic concerns, is now classified as a safe agent and can be used topically for hyperpigmentation. Tyrosinase is an enzyme involved in melanin production, and inhibitors of this enzyme are used clinically to target hyperpigmentation. Hyperpigmented scars may similarly be treated with topical and/or laser therapy. Pulsed dye laser (PDL) and intense pulsed light (IPL) laser are best suited for treatment of such scars. Laser therapy may be considered for erythematous scars unresponsive to conventional topical therapy. Silicone is hypothesized to improve scar color via occlusion and hydration of the stratum corneum, and has been validated across several studies. While onion extract shows efficacy in vitro, demonstration of clinical efficacy is lacking. ![]() Onion extract has an inhibitive mechanism of action and decreases fibroblast proliferation and histamine release. MEBO is a formulation that promotes maturation of keratinocytes, and has been shown to significantly improve the appearance of scars and increase healing times. Proposed topical treatments include moist exposed burn ointment (MEBO), onion extract (Mederma), and silicone sheeting/gel. Simple scar erythema may be targeted with topical therapy alone.
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