Facial Scarring: Opinions and Options

By Hillary Hoffman for Scars1

Some people wear their scars proudly as “badges of honor” or reminders of past experiences.  But scars in highly visible areas like the face and neck can be emotionally and socially burdensome.   Studies have shown that acne and acne scars are correlated with lowered confidence and self-esteem, social withdrawal, depression, and poor body image.  The same psychological issues can result from facial scarring that is the result of an accident, burn, skin disease, or surgical procedure. 

Just as no two scars are identical, the reactions of different people to facial scarring vary widely.  Some, perhaps most notably the celebrity singer Seal, grow to accept their scars.  Seal, whose scarred face is the result of childhood lupus, has remarked to journalists that he “really likes [his scars]” and that they serve as a kind of insignia.  Though he could surely afford it, he chooses not to investigate scar removal options.

Many people with facial scarring don’t share Seal’s viewpoint, however.  For them, visible scars are a source of embarrassment or shame.  One biomedical executive was horrified at the prospect of permanent scarring after a basketball accident left him with a forehead gash and split lip.  At the hospital, he refused to have a nurse stitch him up and insisted that a surgeon do the job.  The nurse teased him about his vanity, but in the end a plastic surgeon performed the procedure.  Today, the executive is scar-free, for which credits his insistence on getting a cosmetic professional to give him immediate treatment.

In many cases, facial scarring cannot be avoided, and some people are left with scars they’d rather not have.  Fortunately, a range of both invasive and non-invasive techniques exists to lessen the appearance of scars.   Topical creams and gels offer a low-cost and easy way to reduce the appearance of scars.  Ointments that contain vitamin A (retinoic acid) have been shown to render scars less irritated, less elevated, and softer.  Vitamin E-containing ointments, though popular in the past, have been shown in several scientific studies to have little to no effect on improving scar appearance. 

Other non-surgical means of intervention include injection, dermabrasion, and laser therapy.  Protruding scars (such as keloid or hypertrophic scars) can often be reduced by injection of corticosteroids, which act as an anti-inflammatory.  Pitted scars such as acne scars can be “filled-in” with collagen injections.  However, injections don’t offer a permanent solution and must be repeated several times a year to maintain results. 

Dermabrasion can be a useful technique for reducing the appearance of slightly raised scars.  The surrounding skin is frozen and then “sanded” with a special tool in order to make the scar less noticeable.  People considering dermabrasion should be sure to select a trusted physician to carry out the procedure, since improperly performed dermabrasion can lead to infection or greater scarring.   The field of laser therapy has advanced a great deal over the past decade, and laser treatment can be an effective way to make long-term changes to the appearance of scars.

For those interested in making lasting, dramatic changes to their scars, surgery is often the best option.  Since surgery should not be undertaken lightly, it’s important to consult with a surgeon to gain a realistic perspective on the types of surgeries that exist and which physical changes can be expected to occur as a result of the surgery.  More detailed information about the various invasive and non-invasive scar reduction options can be found in the Scars1 Education Center.

When deciding on a treatment, keep in mind that even surgical remedies usually minimize, but do not completely eliminate, scars.   Seek out emotional support and do not let unrealistic expectations weigh you down.  A 2008 study offers some good news for men with facial scars – many women associate male facial scarring with health and bravery.

Discuss scar treatment and acceptance in the forums.

Sources:

Personal interview
eMedicine
Seal’s biography
WebMD
Scars1 Education Center

photo credit: Jonf728