After a wound heals, scars form. Scars remain active for one year and during this time they will usually improve significantly. Only after a year can you definitively say what scars will look like. However, it can happen that a scar remains noticeably red or brown. Fortunately, there is something you can do about both problems and lasers in particular can help! With a red scar there are extra blood vessels under the skin surface that are open. With a brown scar, extra pigment has been produced after injury, which is called post-inflammatory hyperpigmentation.
How can I prevent a strikingly colored scar in the first place?
Prevention is better than cure, so from now on try to keep the development of strongly colored scars to a minimum. It actually all starts with wound care. You should clean the wound very carefully and, if you suspect an infection, apply an antibacterial fluid. Never close the wound during the first few days with greasy creams that make the wound completely soft (such as Vaseline), this prevents healing! Do not immerse the wound in water for extended periods of time. However, you can consider using a special wound dressing such as Tegaderm that keeps the wound moist (not soft).
If the wound is no longer open and has scabbed over, it is also important to keep the area moist. It works best to use a light serum that is full of skin-repairing substances (beta glucan, allantoin, panthenol, niacinamide, antioxidants). You can also consider using silicone products at this stage, which often provide the best results for scars. Silicone products come in the form of gels or patches (such as Dermatix). Patches are slightly more effective than gels at suppressing keloid scarring, but both can significantly improve the appearance of all kinds of scars! After about three months of use, you should start seeing results from these silicone products. For the rest, avoid the sun and irritating ingredients for the entire period. Regular use of serums and silicone also keeps the scar tissue supple, which in any case has a beneficial effect.
You could also use vitamin A acid cream. This is a medication (available only by prescription) that is also often used to reduce acne scars in acne patients. The drug stimulates healthy cell division, which can be beneficial for scar tissue.
Red scar
For scars that nevertheless remain bright red, laser treatments will be the most effective option. Always go to recognized clinics with a good reputation for laser treatments, because there are many inexperienced people with laser equipment who want to make money quickly. The intensity of the redness depends on the density, size and depth of the blood vessels under the scar. Lasers suitable for red scars include:
Pulsed Dye Lasers
Pulsed Dye Lasers are generally the most effective lasers for red scars. Pulsed Dye Lasers produce a concentrated beam of light that has a wavelength between 585-595 nanometers. Light of this wavelength is very well absorbed by blood vessels, where it is then converted into heat, which simply destroys the blood vessels. The light from the Pulsed Dye Laser is yellowish and should not harm surrounding tissues, provided the practitioner sets the correct settings. This depends, among other things, on the skin type of the patient. Most patients require between 1-3 treatments with a rest period of 4-6 weeks between each treatment.
IPL
IPL systems are not actually officially lasers, but can be used in the same way. It is used for all kinds of brown and red discolorations (such as age spots and rosacea). The practitioner determines how many treatments the patient needs, but for strong scars this will certainly be about 3, normally with intervals of 4-6 weeks. This device is also commonly found in all kinds of beauty salons, but if used incorrectly it can leave even more scars. So this device should certainly not be taken lightly!
KTP laser
The KTP laser emits a green light with a wavelength of 532 nanometers, which is also well absorbed by the blood vessels and destroyed. However, the effect of KTP lasers is limited to the papillary dermis (thin upper layer of the dermis) and is therefore not suitable for deeper blood vessels, but therefore entails fewer risks. It is not very suitable for bright red scars.
Q-Switched Nd:YAG Laser
In contrast to the KTP laser, the Nd:YAG laser has a deeper penetration depth and can target blood vessels deep into the dermis. The Nd:YAG laser also has a positive effect on collagen and can therefore improve the structure of scars. Nd:YAG lasers are considered less painful and less likely to cause side effects than Pulsed Dye Lasers, but for truly reducing a bright red color, the Pulsed Dye Laser remains generally the best.
Brown scar
Extra pigment produced after an injury that causes the scar to turn brown is called post-inflammatory hyperpigmentation (PIH). This pigmentation always disappears, but this sometimes takes a very long time (sometimes a few years) for tanned skin. Always protect it from the sun anyway! The clearing of the spots can be accelerated with creams (containing salicylic acid, tretinoin or hydroquinone) and mild glycolic acid peels. Care products containing substances such as Niacinamide, Vitamin C and Licorice Root are also known for the fact that they can significantly brighten pigmentation, without the harmful effects of aggressive bleaching agents such as lemon juice. In terms of lasers, Q-Switched Alexandrite or Nd:YAG lasers are suitable options. IPL is also suitable, but only for white skin.
If it has been there for several years, you probably do not suffer from post-inflammatory hyperpigmentation but from melasma. Applying the above types of creams and care products is actually the only thing you can do, because more aggressive treatments such as lasers always carry the risk of extra pigment enhancement for this skin condition.
