Wolf200's Guide To Improving Scars (Acne and Surgical)

[Wolf200]

(also stretch marks and post-inflammatory hyperpigmentation)

Seen a lot of threads lately about people with, especially acne, scars asking on what to use to improve them. Yes this is a long post, skip the next couple of paragraphs if you just want to see the treatments.


MY BACKGROUND

I have 3 surgical scars on my face and neck, one of which is a Keloid and one of which split open and is widened (both of these were re-cut and ended up exactly the same).

I have 6 Hypertrophic acne scars, 2 on my chest and 3 on my back. I used to have really bad chest and back acne, and did 9 months on Accutane which cleared it up, but unfortunately I was left with some unsightly scarring.

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Originally I tried Bio Oil on all of them. Used almost two bottles. Honestly, I don't think it did much for me. If I had "normal", thin flat scars I think it would help with the redness but personally I wouldn't recommend it, though some swear by it. It is probably the cheapest option, and may be better suited if you have a really small scar. Though there are a lot of mixed opinions on whether or not it does anything (again, some people will swear by this and it's cheap enough to try). Also 1 bonus is you can normally just buy it from your local pharmacy (at least here you can anyway) rather than needing to order online.

After that, I received some Cortisone Steroid injections in the worst scars from my Dermatologist. For the keloid on my neck (had about 3 or 4 shots over the course of a year) it helped with the raised part, but ended up giving small "indents" and spread the scar more. I had 1 shot in 2 of my acne scars (all raised), 1 of them almost completely disappeared and the other it didn't do much for.

Next I tried a gel called SCARprin, which is 100% silicone gel. This actually worked okay. Much more effective than Bio Oil was (for me). It seemed to reduce the redness, but didn't do much for reducing how raised the scars were.

Following that, I used Mederma, which is a gel based on onion extract. This was a lot different to SCARprin, as it seemed to "peel" the top layer of the scar off each time it was applied. This helped reduce the redness and "smooth" out the scars further.

Finally, I bought some Silicone Sheets. These are proven to be MUCH more effective than silicone gels. I used Cica Care Silicone Sheets. These by far have done more for my scars in the last 3 months (still have a month or longer on it) than any other treatment I have used in the past 2 years. I kid you not, I saw results after the first day of using these. They are the most expensive and the most time consuming (you need to clean daily and wear for 12 hours + (I put them on when I'm sleeping). These have reduced the redness, smoothed the scars, reduced how raised my scars were and even helped with the "indent" I have on my keloid. These are used by some plastic surgeons and are the most proven to work treatment for scars.

Other things I have tried over the years:

Petroleum jelly (Vaseline) - great for moisturizing
Vitamin E cream (See-No-Scars) - same as above, good if your scars have been in the sun
Cortisone cream (Viaderm) - this was prescribed to me for my keloid. Probably no use for most, although I used it with some success on some dark spots

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So overall, here is what I would recommend (will post other potential options at the bottom, but have not tried them so can't personally recommend them).

Best to worst (again, this is from personal experience on many different scars, but everyone is different.)



CREAMS, GELS AND PATCHES

#1

Silicone Sheets
by Cica Care

CICA-CARE◊ is a self-adhesive gel sheet that helps improve the appearance of the majority of red, dark or raised scars. It has already been widely used by the medical profession with over a million units sold.

CICA-CARE◊ is durable, comfortable and re-usable, ideal for day and night use. It may be used on children and adults making it suitable for the whole family. CICA-CARE◊ has been shown to be successful in improving older scars, however results are expected to be most effective in more recent scars.

Within 2-4 months, scars you thought were permanent can be reduced and their appearance improved.

http://global.smith-nephew.com/us/CICACARE_8966.htm

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#2

Mederma
by Merz Pharmaceuticals (NOTE: they also make a cream especially for stretch marks, if you have them)

Mederma® is the #1 doctor- and pharmacist-recommended brand for scars because it works. Mederma® is clinically proven to soften, smooth and reduce the appearance of scars. Accidents will happen, surgeries will be had, teenagers will get acne and Mederma® will be there to fade the scars that are left behind.

http://www.mederma.com/products/gel

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#3

SCARprin
by SCARprin

-Forms a protective, flexible silicone barrier over the scar area protecting it from natural elements.
-Allows the scar to retain moisture from the surrounding, healthy areas of the skin thus helping the scar heal more quickly.

Unlike some of its competitors, SCARprin uses only medical-grade silicone. This is because silicone has been proven time and time again in a variety of studies to be the singular most important and effective ingredient used to treat scars. Silicone has been proven effective to not only help treat minor scars such as accidental scars, but it has also been proven to treat more serious scars

http://www.scarprin.com/about-scarprin.php

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#4

Bio Oil
by Bio Oil (NOTE: also claims to be effective for stretch marks, if you have them)

Scars are an integral part of the healing process and result from an over-production of collagen at the wound site. Scars go through numerous changes as they mature, but they are permanent in nature. Bio‑Oil is formulated to help improve the appearance of scars, but it can never remove them.

http://www.bio-oil.com/en-us



SURGICAL OR CLINICAL OPTIONS

#1

Cortisone Injection
for raised Hypertrophic or Keloid scars

Using a very fine needle, cortisone is injected directly into the scar. Used with raised scars causing them to shrink and flatten.

See your doctor or dermatologist, or for more information go here:
http://www.aocd.org/skin/dermatologi...nd_hypert.html

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#2

Laser Treatment (NOT PERSONALLY TESTED)
for raised scars, especially good for acne scars. (NOTE: I was turned down by 3 different surgeons for laser treatment for my keloid, it will not work on certain scars)

Lasers can be used to smooth lumpy scars or to flatten raised scars. This is typically achieved with resurfacing techniques with CO2 lasers. In addition, lasers can be used to remove the abnormal coloring that develops in some scars, which is usually completed with pulse dye lasers. Sometimes, scar laser treatment is used in conjunction with other treatments, such as steroid injections, in order to fully remove the appearance of the scar.

See your doctor or dermatologist, or for more information go here:
http://www.laser-treatment.com/removing-scars.asp

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#3

Chemical Peel (NOT PERSONALLY TESTED)
for acne scars

The basic principles of an acne scar chemical peel is that you are burning off the superficial, or top layer of your skin, in order to allow the newer and healthier skin cells to develop in replace of the dead and damaged cells. As you can imagine this is a very delicate procedure and therefore you should research your dermatologist or cosmetician carefully to ensure they have a great deal of experience in this field.

See your doctor or dermatologist, or for more information go here:
http://www.healingacnescars.com/chem...acne-scars.php

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#4

Scar Revision (Would not recommend if you are prone to keloids as, like me, you are likely to form a keloid scar again)
for most scars, better suited for smaller or serious scars but run the risk of developing the same, or a worse scar

Scar revision surgery is meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture.

Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.

See your doctor, dermatologist or plastic surgeon, or for more information go here: (NOTE: ask your doctor/derm for recommended plastic surgeons in your area)
http://www.plasticsurgery.org/recons...-revision.html



OTHER

-There will be lots of other treatments available. Creams, gels and possibly other surgical treatments. I have recommended what's worked for me, or what is regarded as being "popular" or well known for treating scars. Use at your own risk.

Post Inflammatory Hyperpigmentation
For more information on PIH, click here (post #46 in this thread)



TIPS:

-The sooner after developing the scar that you treat it, the more effective the treatment will be. (unless specific treatments require you to wait so long)
-STAY OUT OF THE SUN. I see so many people recommend getting a tan. I do not recommend it. It might make it slightly less visible temporarily, but it will damage the scar, make it worse in the long run. Always wear sunscreen on new scars when going outside, and as often as possible on older scars (if they are exposed to the sun)
-Do plenty of research and ask your doctor/dermatologist before choosing a scar treatment. Some have some side effects and some (esp surgical treatments) can make them worse, or end up costing you a lot of money.
-Also note, scars take time to heal. Especially surgery scars. Some can take 6 months to 1 year before you start to see any real improvement and the redness disappearing. In saying that, I still recommend you use something to treat them as soon as possible if the scar bothers you, or it starts to become raised.

Tip for tanning:
-If you tan and want to keep your scar out of the sun to prevent damage to it, here's what I do. Get some tin foil, fold a small piece in half and tape it over your scar. Light will not penetrate this. Also make sure to wear sunscreen underneath in case it falls off. Moisturize your scar afterwards. I do this when tanning in private at home. If you tan it public or a tanning bed it may not be suitable.

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Hopefully this helps someone, and feel free to post what has worked for you.

WHAT OTHERS RECOMMEND
for scar treatment

Click here (Post #44 in this thread)

MY GUIDE TO THE SILICONE PATCHES
picture guide for the Cica Care silicone patches

Click here (Post #56 in this thread)

MY BEFORE AND AFTER PHOTOS
for 3 of my scars

Click here (Post #26 in this thread)

[Duolicus]

1rd

will have to acquire some BioOil myself
hopefully local pharmacy will have some

[Skirrel]

in.

[Aesacus]

What do I do about scratches that have left a mark?

[Wolf200]

What do I do about scratches that have left a mark?

Not sure if this is a serious post or not, but will answer it anyway.

Chances are, unless it was a serious scratch (did it require stitches?) then it won't scar, or won't scar bad enough to need treatment. If it does, if it bothers you, or if it is very visible, then I would start with some of the cheaper creams/gels. If you have the money, buy the silicone sheets.

Otherwise give it time and it may fade to become completely invisible.

[thelaxbro123]

Would any of this help fade the redness from my previous marks?

[40InchVert]

hmm this is just like my teeth whitening thread except for scars. gj on this. starting reps 391

[Wolf200]

Would any of this help fade the redness from my previous marks?

By marks, do you mean scars?

If so then yes - to an extent. Obviously I'm not a doctor and I can't see your scars, but a lot of what I posted claim to work on old scars. My scars are over 2 years old and I am still seeing improvment as of today from what I am currently using (Mederma during the day, and Cica Care Silicone patches at night)

Again, everything is more effective when used early on, but old scars can generally still be treated.

hmm this is just like my teeth whitening thread except for scars. gj on this. starting reps 391

Thanks Vert. Actually your thread inspired me to make this. Threads like yours and others on Misc have helped me with various things, and I wanted to give a little something back.

[Aesacus]

Not sure if this is a serious post or not, but will answer it anyway.

Chances are, unless it was a serious scratch (did it require stitches?) then it won't scar, or won't scar bad enough to need treatment. If it does, if it bothers you, or if it is very visible, then I would start with some of the cheaper creams/gels. If you have the money, buy the silicone sheets.

Otherwise give it time and it may fade to become completely invisible.

They have faded but It looks like slight forehead wrinkles...

Not really visible....but im a perfectionist.

Nothing I can do after they fade?


did not require stitch's but when I was younger I picked off the scab and was left with lines..

I want a flawless complexion

NO HOMO

[iPWNu]

Good post man, for real.

Definently something I need some advice on.

Thinking about Mederma before any surgical type things......

[AgRyan]

Good thread OP.

I was actually part of a test group testing out how lasers work on keloid scars, and that actually worked the best on my keloids out of everything (have done everything who have done as well, except I tried a different brand of gel). Got 5-6 keloids on my chest, 2 on my back, and a couple more longer ones on my face. Lasers ftw.

[Wolf200]

They have faded but It looks like slight forehead wrinkles...

Not really visible....but im a perfectionist.

Nothing I can do after they fade?

You can never completely remove scars, sorry brah. If you have a thin, skin coloured scar (ie not red, wide or raised) then consider yourself lucky. That is probably an "ideal" scar in my opinion. You could try some of the treatments, but you'd probably be wasting your money. Most just reduce redness or help reduce raised scars.

Good post man, for real.

Definently something I need some advice on.

Thinking about Mederma before any surgical type things......

Would definitely recommend to all to try the non surgical treatments first (unless of course a derm/doctor says otherwise).

Good thread OP.

I was actually part of a test group testing out how lasers work on keloid scars, and that actually worked the best on my keloids out of everything (have done everything who have done as well, except I tried a different brand of gel). Got 5-6 keloids on my chest, 2 on my back, and a couple more longer ones on my face. Lasers ftw.

Thanks. I have also heard lasers are one of the most effective. I was told they wouldn't do anything for my surgical scars (too big I think) but offered to do them for my acne scarring. But imo the cost wasn't worth it. Definitely a good option though if you have the right scars and can afford it

[Aesacus]

ok thanks man.

Currently on RC if I ever see your avi again and remember will rep.

[irollurmom]

Cortisone injections hurt a lot if your scar is sensitive. I'm gonna try those silicone gel pads for the uneven parts of my scar.

[Wolf200]

Cortisone injections hurt a lot if your scar is sensitive. I'm gonna try those silicone gel pads for the uneven parts of my scar.

I will agree to this. Hurt more in my neck than it did in my chest though. However, if you've ever had them in your joints (had bursitis in my shoulders a few months ago) the injection into a scar is no where near as bad as into your joints (same thing, Cortisone)

The patches should help with the unevenness of your scar. You don't need to use Cica Care (not sure who else make them) but would be the #1 thing I recommend. If you scar is not visible and you can wear them 24 hours a day you'll see even better results. (start off with 2 - 4 hours then gradually increase it). But just overnight still shows good results.

[zoida]

Some really good personal experience OP Subbed!
I've got some bad stretch marks on under my armpits traversing across to my bis, its a pinkish red colour and so really stands out. Tried bio-oil for 2 months and didn't see any improvements although most people say that it takes a long time with constant application for bio-oil to work.

The silicone sheets look pretty good... Wonder if they're available in aus and at what cost

[Wolf200]

Some really good personal experience OP Subbed!
I've got some bad stretch marks on under my armpits traversing across to my bis, its a pinkish red colour and so really stands out. Tried bio-oil for 2 months and didn't see any improvements although most people say that it takes a long time with constant application for bio-oil to work.

The silicone sheets look pretty good... Wonder if they're available in aus and at what cost

I'm not sure if silicone sheets will be the most effective thing for stretch marks, but will need to do some more research (never had stretch marks, so never had to use anything)

However, ironically I buy my silicone patches from Aussie. They don't seem to be sold here in NZ. Will PM you the link where I get them from.

[SLapCHop]

Know nething dealing with PIH (post inflammatory hyperpigmentation)? I dont got scars but i got brown spots where acne once was.. **** takes forever to fade

ive tried:
retin-a (using now)
mechanical exfoliants (using now)
chemical exfoliants - AHA, BHA (stopped using)

and ofc i use sunscreen

[Wolf200]

Know nething dealing with PIH (post inflammatory hyperpigmentation)? I dont got scars but i got brown spots where acne once was.. **** takes forever to fade

ive tried:
retin-a (using now)
mechanical exfoliants (using now)
chemical exfoliants - AHA, BHA (stopped using)

and ofc i use sunscreen

Hmm, don't know too much about that sorry. Have you tried using a cortisone cream? My derm gave me one and I used it for a few months (didn't include in OP as it's not really a "common" treatment) for my keloid and it helped with the inflammation from martial arts (would always get knocked). Also used it on a few "Dark spots" from old acne (not scars as they eventually faded) (not sure if this is similar to what you have or not) and it seemed to help.

You may need to get it from a doctor or dermatologist, but it could be worth trying. Used for quite a few things, and pretty sure it's an option for what you have. Otherwise what you are using may be the best.

Otherwise the silicone patches MAY help, but I couldn't guarantee anything.

[deadfingers]

in for later. Actually I used skin peels to help with some acne scarring. I use the ones by skin culture usa, they're pretty intense and definitely work. It pretty much burns the skin like a sun burn would do and the skin flakes off.

[deadfingers]

Know nething dealing with PIH (post inflammatory hyperpigmentation)? I dont got scars but i got brown spots where acne once was.. **** takes forever to fade

ive tried:
retin-a (using now)
mechanical exfoliants (using now)
chemical exfoliants - AHA, BHA (stopped using)

and ofc i use sunscreen

http://www.skinculture.com/

If you can afford it, get the 4000, it's the deepest peel and it'll definitely help you out. I'm going to try it again in the future, although my skin isn't really all that bad so I might wait a while.

[Devils212]

repped

[mario5890]

good info Op! I my self have a few acne scars and I have tried the chemical peel. Do you have any before/after pics?

[Wolf200]

http://www.skinculture.com/

If you can afford it, get the 4000, it's the deepest peel and it'll definitely help you out. I'm going to try it again in the future, although my skin isn't really all that bad so I might wait a while.

Did it work for you at all? I notice you said try it again. Did it give good results? May update OP with it as an option (assuming it's mainly for hyperpigmentation?), but can't seem to find too much info on it beyond what look to be obvious company reviews. (not doubting it, just because of the price of it, would like someone to vouch for it before recommending it)

[jujuB]

bio oil works.

won't fully heal your scars but it fukin works. been on it for a while now.

[Wolf200]

Off to bed now, will try and answer all questions in the morning.

[deadfingers]

Did it work for you at all? I notice you said try it again. Did it give good results? May update OP with it as an option (assuming it's mainly for hyperpigmentation?), but can't seem to find too much info on it beyond what look to be obvious company reviews. (not doubting it, just because of the price of it, would like someone to vouch for it before recommending it)

I did get good results with it, although I used the 3000. Basically you use it for 6 days for about an hour or a little more each day. You put this cream on your face that basically burns the outer layer, then on the last few days you add this cream (reminds me of Noxema) that basically cleans off the dead skin flaking off of your face. It doesn't look pretty after about 4 days or so, it looks like you had a pretty bad sunburn with all the skin flaking off, but it definitely works. Obviously you can only burn off so much, so deep scars won't go away so easily, but the smaller stuff and skin tone will definitely look much better. You can usually tell where the new skin is showing and where the old skin is at because the old skin looks darker and even dirtier. I highly recommend them, it's not cheap but you won't be disappointed. The pictures they show are definitely what I experienced, so I can definitely vouch for them.


Edit* by try again in the future, I mean it's something that can be done every 6 months. It's not like you do it once and your skin is perfect for life. Over time your skin gets damaged again, and I've had pretty bad acne growing up so it'll take a few more tries. My skin is fairly clean now and nearly acne free, but the remnants are still there. I did this about 3 years ago, so my skin needs to be "cleaned" again.

[diplodocus]

what do i do about a scar that is heavily indented from stitches?

[Wolf200]

what do i do about a scar that is heavily indented from stitches?

Is it a new scar? If so, there is a good chance the skin is still pretty tight around it and will loosen over time. However if they pulled the skin too tight and it is quite deep then there isn't much you can do about it (that I know of) other than getting it revised. But if the skin is already tight, it'll just become tighter.

It's quite funny being able to refer to myself for all different types of scars, but I just had my appendix out, so have 3 keyhole surgery scars in my stomach. 2 are hardly noticeable, but one is a line running down my belly button and is a little indented as well. The skin around is still quite firm (1 month later) but gets a little less firm each day. I can't say it's ever going to be back to how it was before but it doesn't worry me that much anyway because it is a nice scar (compared to my others)

Though if I was going to recommend something it would be the silicone patches. I have indents in my keloid from the cortisone shots, and the patches were the only thing to "pull" them up and even it out. This is probably slightly different to what you have, but is the best advice, other than giving it time, I can offer.

Although there is something called scar massaging (never tried myself, will update OP with info) that breaks up the scar tissue around it. No idea if it works or not, but something to look into maybe.


deadfingers - very helpful post, will update the OP with that as a potential option.

[Yoopwat]

Exoderm is supposed to be the best thing available for scars, but can remove your skin pigmentation.