Scars & Stretchmarks
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 |