How to treat scar nodules

Many people suffer burns, scalds, accidental injuries, etc. in their childhood due to carelessness or ignorance. Some scars are not obvious and not exposed, while others affect the appearance. After adulthood, they will want to remove the scar nodules. Currently, the most advanced scar removal method is laser treatment, but it also depends on the scar. This article introduces several methods for treating scar nodules. Let’s take a look.

1. Non-surgical treatment

(1) Pressure therapy is suitable for patients with large scar area who are not suitable for radiotherapy and local drug treatment. The daily downtime should not exceed 30 minutes. This method is not effective for active keloids, but it can reduce the dose of postoperative radiotherapy and injection.

(2) Chemotherapy uses long-acting steroid preparations that are injected directly into the scar to inhibit the excess collagen in the scar and achieve the effect of scar degeneration. The main side effects include skin atrophy, depigmentation, capillary dilation, necrosis, ulcers and Cushing's syndrome, most of which are reversible. Other chemical drugs such as cytotoxins, immunosuppressants and other drug treatments have been reported, but serious systemic side effects limit their application.

(3) Radiotherapy: Early use of electron beam or X-ray irradiation (within 24 hours) after keloid removal can reduce postoperative recurrence of keloid and improve the cure rate.

(4) Laser treatment is suitable for flat scars without obvious functional impairment, and for scattered, uneven, depressed scars of varying sizes left after healing of smallpox, chickenpox, and acne.

(5) There are different reports on the efficacy of other treatments for hypertrophic scars and keloids, such as cryotherapy, wax therapy, iontophoresis, and ultrasound, and there is a lack of large-scale case controls and follow-up.

2. Surgery

(1) Scar excision followed by tension-reducing fine suture is a commonly used and increasingly sophisticated surgical method for scar treatment, and is mostly used for scars of smaller areas. During the operation, the tension of the incision is fully reduced, the operation is performed delicately, and secondary damage is reduced to reduce the degree of postoperative scar hyperplasia, and the clinical effect is definite and obvious.

(2) Dermabrasion is a surgical method that involves grinding the epidermis and superficial dermis of the skin to improve irregularities on the skin surface, making it smooth and flat and similar in color. It is suitable for superficial scars left over from acne, smallpox, chickenpox, shingles, eczema, trauma, burns or surgery. If necessary, it can be performed simultaneously with scar surgical excision, and the effect is better than simple grinding.

(3) Scar release and local reshaping: For smaller, tense, linear or webbed scars, the scar can be removed and then a skin flap formed with the surrounding normal skin tissue is used to repair the skin defect at the scar site through cross-replacement.

(4) Scar excision and free skin grafting Larger hypertrophic scars can be surgically removed, and then free skin grafts are cut from normal parts of the body and transplanted to the scar surface to repair the wound and restore skin function. However, the color of the transplanted skin is often quite different from that of the surrounding skin. In addition, contracture is prone to occur after surgery, which can cause deformation of surrounding tissues and organs or induce functional disorders.

(5) Scar excision flap transplantation: Since the flap contains a large amount of subcutaneous fat tissue, it can not only be used to repair skin defects after scar excision, but also has the function of protecting deep tissues. The commonly used expander technology currently also belongs to flap transplantation. By burying the expander under the normal skin around the scar, after several months of expansion, excess skin can be "grown" to repair the scar.