What is it?

Scars can appear when skin heals from acne, injury, infection, or surgical excision with irregular color or texture. Scars can be red, white or brownish compared to normal skin tone. They can also be bumpy (hypertrophic) or pitted/depressed (atrophic), and some scars result from an abnormal healing pattern and are very severe and long-lasting (keloid). The goal for scar therapy is to help restore as close to normal skin color and smooth texture as possible, or to at least improve the harshness of a scar so it is not as noticeable.

Stretchmarks are similar to scars in that there is often color and/or texture change in the skin as a result of loss of collagen and elastin. Stretchmarks can appear pink or red, and have a depressed or crinkly texture.

Skincare Adjuncts

Topical retinoids are very helpful in stimulating collagen formation to help smooth any type of scar or depressed stretchmark, it also helps to normalize pigment. Scars that have darker pigment tend to get more brown in the sun, so sunscreen helps to prevent further hyperpigmentation. Most laser treatments require that the scar or stretchmark area is untanned at the time of treatment, and protected from sun exposure during recovery.

Treatment Options

Treatment Option	Key Benefit	Average Number of Treatments	Amount of Downtime	Comfort Measures
Pulsed Dye Laser	Reduces red or pink color in scar, spider veins around scar	1-3 sessions, done 2-3 months apart	Bruise for about one week	Topical anesthetic
Laser Genesis 1064 laser	Gentle therapy for gradual softening of mild scarring, safe for all skintypes	3-6 sessions, done 2 weeks apart	None	None
Fraxel Restore 1550 laser	Best suited for depressed acne scarring. Improves texture of scars that are bumpy or pitted. Gradually blends scar to surrounding skin	4 sessions, done 2-3 months apart	Swelling and redness for 2-3 days, exfoliation by day 5-7	Topical anesthetic, oral sedation and analgesic optional
Venus Viva (microneedling and radiofrequency)	Well suited for stretchmarks or mild depressed scar. Low risk of side effects	2-3 sessions, done monthly	Pink for 1 day. Can wear makeup next day	Topical anesthetic
Venus Viva (microneedling and radiofrequency) InMode Fractora (deep microneedling and radiofrequency)	Well suited for mild to moderate depressed scars, safe on all skintypes. Low risk of side effects	2-3 sessions, done 1-3 months apart	Mild redness and swelling 1-2 days. Exfoliation by day 5. Can wear makeup next day	Topical anesthetic, oral analgesic optional
Fractional CO2 or Erbium laser resurfacing	Improves texture of scar, tightens and smooths skin. Can be augmented with topical PRP, 5FU or kenalog	1-3 sessions, done 3 months apart	Oozing for 1-2 days, mild redness and swelling for 2-3 days, exfoliation by day 5-7	Topical anesthetic
Ablative CO2 resurfacing	Deep resurfacing for scars, dramatic tissue tightening	1 session. Can be repeated at 6-12 months if desired for further imrpovement	Oozing, redness and swelling for 5 days. Can camouflage with makeup in about one week	Topical anesthetic, nerveblock, oral sedation/ analgesic