Scar - Mole Removal

Normal scars are flat and in most cases become imperceptible with time. Objectionable scars come in two types: keloidal and hypertrophic vs. atrophic. Keloids and hypertrophic scars are confined to the original injury and increase in size by pushing outward rather by invading normal tissue. Keloids consist of scar tissue that extends beyond the confines of the original wound. Acne scars are examples of atrophic scars.

Keloids and Hypertrophic Scars

Keloids tend to occur in families and between the ages of 10 and 30 years. African Americans and Asians are affected more often than Caucasians. The tendency to form keloids is most pronounced on the chest, back, shoulder, and the back of the neck. In contrast, hypertrophic scars occur anywhere on the body with equal frequencies. Keloids persist over time and may worsen after surgery whereas hypertrophic scars tend to improve spontaneously and also with surgery.

Injections of corticosteroid are the number one treatment for these scars. Surgical excision is attempted next. Surgery is best avoided on certain types of keloid on the chest however. During surgery we generally try to reorient the scars with the skin tension lines to minimize tension on the wound. A variety of other modalities is used in conjunction with the surgery to improve the outcome: silicone gel application, radiation (especially for keloids), acid or TCA peel, and CO2 resurfacing/dermabrasion. Research is continuing in the use of lasers in scar management.

Before  Extremely uneven scar following car accident.	Before  Same patient, oblique view
After  Scar Revision and CO2 laser resurfacing	After  Same patient, oblique view

Just wanted to say thank you and let you know how grateful I am of the procedures that you did on my face after my accident. The whole office was extremely kind during those hard times for me.

Atrophic and Acne Scars

Atrophic scarring is the result of an inflammatory response that terminates in fibrosis and indentation. These are the three basic types of acne scars:
          a) boxcars
          b) ice pick
          c) rolling scars

The best treatment for acne scars is prevention. For this there is a range treatments from long term topical or systemic antibiotics, Retin-A cream, Benzoyl peroxide, oral contraceptives to Accutane. We have had good success with IPL combined with Levulan in terms of acne control

Essentially scars that improve with slight stretching respond to chemical peels, or C02 laser resurfacing. Deep boxcar scars do better with surgical excision followed by laser resurfacing.

BEFORE  Acne scars	Post Acne scars following Obagi Blue Peel

Call 559-434-9497 for an appointment or additional information

Moles and other facial lesion removal

Most elevated lesions such as moles on the face can be removed by shaving flat with the surrounding surface without leaving too much of a scar. Other lesions have to be removed as you would remove a large scar.