Scar Removal Creams Not Effective, Says Senior Dermatologist | Read More

In a recent interview with Republic Digital, Dr. Deepali Bhardwaj shared her thoughts, saying, “Recently, I saw the work of Cinta Tort Cartró, a Barcelona-based artist who has been on a mission to take natural skin changes such as pigmentation, scars, and stretch marks—things one must “fix"—and turn them into beauty pieces.” 

Dr. Deepali Bhardwaj commends the artist's work, highlighting its inspiring nature and its ability to shift the conversation towards reevaluating what actions we can take and what we should release to foster greater comfort within ourselves. 

She also said that this is why she tells all her patients that scar removal cream is not what it seems, and if they want to see results, there are better and more effective options to consider.  

What are scars?  

Scars are either an elevation or a depression of the skin. The elevation is due to the accumulation of extra tissue on the epidermis of the skin; the depression is formed because of certain collagen fibers, which pull the skin down. The physiology behind the formation of a scar explains why a topical cream, in my experience as a dermatologist, does not work. Other treatment options, such as chemical peels and derma rollers, will not help with scar removal. Derma rollers are often used for skin rejuvenation, but they're just a temporary fix. It may seem that the scars are gone, but they tend to come back a few weeks after derma rolling. At best, the scars will be lightened by 20%.  

If scar removal is something you’re researching, the best way forward is through surgical or invasive treatments.  

TCA Cross: TCA Cross is an abbreviation for chemical reconstruction of skin scars (CROSS) using trichloroacetic acid (TCA) and is one of the most effective treatment choices for scar removal. In fact, a paper I wrote in 2010 showed that 70% improvement was seen in 8 out of 10 patients, and a transient improvement (50–70% improvement) was seen in the remaining 2 patients when using TCA for treating ice pick acne scars.  
  
This concluded that the CROSS technique with 100% TCA is a safe, efficacious, cost-effective, and minimally invasive technique for the management of ice-pick acne scars that are otherwise generally difficult to treat.  

Lasers: Lasers are the go- to for dermatologists when trying to prevent a scar from forming after surgery, reducing scar pain and increasing the range of  movement if it is limited by the scar. Lasers make scars a lot less noticeable and help boost confidence.  
  
Within lasers, you have different options. CO2 lasers are fractional resurfacing laser systems that show significant improvement. The flipside is that the  downtime is increased, so if you’re a working professional or have a busy social life, this may not be the best option for you.  

Subcision: Subcision is a minor surgical procedure that involves inserting a needle into the skin to allow it to rise, in turn releasing the acne scar. I have perfected my own style of subcision: I re-stitch the scar by giving another scar, perpendicular to each other. Due to this particular style of re-stitching, the scar is not visible any longer, almost like a Tyndall effect.  

She added that, In addition to the more permanent methods of scar removal, there are some temporary methods such as fillers, punch grafting, excision, fat transfer, and filler injections. All of this depends on many factors regarding the scar.  

Age of the scar: A scar from 5 years ago will be much more treatable than a scar from 10 years ago. This is due to the collagen released and the deep extent of scarring.  

Overall collagen health: Anything that affects the collagen health of the body can affect scar healing. Smoking, a bad diet, and dehydration all have an adverse effect on the collagen production of the body.  

Type, shape, and size of scar: The different types of scars need different types of treatment and results.  

Fine line scars: seen after a cut or  surgery, these thin scars are due to raised skin. Over a period of two to three years, this fades into a very slight shadow of its  former self.  

Keloid scar: When there is excess collagen growing at the site of a wound, it results in a keloid scar. Notoriously itchy or painful, these scars are raised above the skin and have a tendency to come back often.  

Hypertrophic scars: similar to keloid scars, they are also due to increased collagen growth; that is where the commonality ends. Hypertrophic scars do not extend beyond the boundary of the wound. They tend to thicken up for 6 months before gradually improving over the next decade.  

Depressed scars: Ice pick scars or depressed scars are due to acne or an injury that leads to the loss of underlying fat.  

Box scars: These are oval-shaped scars that are left behind after acne heals.  

Rolling scars: Due to bands of tissue that form under the skin, these scars are 4-5 mm wide and look like a ‘M’ shape.  

In the end she concluded that while opting for scar treatment, it’s better to know the history and geography of your scar before choosing the correct treatment.