Depressed scars look like holes or pits. They form when the skin’s collagen is destroyed by inflammation (as is the case with acne) or infection (for example, chicken pox). Pitted scars can also result from picking off scabs. Shallow scars can be improved with a series of microdermabrasion treatments or injectable fillers such as Juvéderm and Restylane. Large areas can be treated with a chemical peel or laser, which removes the damaged skin, allowing new, fresh skin to fill in more smoothly. For deeper scars, a surgeon can excise (cut out) the scar and stitch the skin back together. These more aggressive treatments often require a few weeks of strict sun avoidance, as well as preparation with prescription-strength creams, and the skin may need weeks to heal.
Raised, bumpy scars typically occur after surgery or an injury. If you have a new one, you can help soften it by gently massaging the scar for 10 to 15 minutes a day. Use almond oil or a bland moisturizer to prevent chafing. Be sure the skin is healed over (with no scabs) before you start, and if your scar is from surgery, check with your doctor first. Some of my patients also see improvement with Mederma Scar Gel, which contains onion extract. If your scar is lumpy, tender, or itchy, it may be a keloid. This type of scar is mostly found on the earlobes, chest, and upper back. Silicone gel sheets (such as Curad Scar Therapy pads) can help flatten them. If this doesn’t work, I often shrink them in the office with a laser or dilute cortisone injections.