The appearance of a scar is the result of tissue repair of a cutaneous lesion. As soon as the dermis is damaged (burns, wounds, pimples), the skin activates a physiological healing mechanism. Starting immediately after a trauma, this process aims to repair skin tissue in depth and takes place in several stages. Depending on the extent of the injury, the overall healing process can take between 1 and 1.5 years.
The healing phases are as follows:
- The coagulation phase: a blood clot forms following haemorrhage and turns into a crust
- The inflammatory phase or detersion phase: white blood cells are activated to clean the injury and destroy any foreign bodies in the tissue. This phase results in an inflammatory reaction leading to redness and swelling (oedema) and a rise in temperature in the area concerned
- The proliferative phase: the dermis and epidermis begin to rebuild themselves. The remodelling phase: the structure and resistance of the scar improve, as does its visual appearance. The quality of scarring changes according to the size of the lesions, the quality of the skin and the individual's state of health. In fact, the skin's ability to regenerate depends on a number of factors (age, vascular pathologies, nutritional deficiencies, smoking).
When anomalies affect the healing process, visible and permanent scars form on the area concerned. There are several techniques in morphological and anti-ageing medicine to attenuate a scar.
Acne, surgery, burns or even an accident can leave marks on the skin of the face or body. The scars left by these events can be a source of psychological suffering. To reduce or eliminate a scar, surgery is not necessarily necessary.
There are medical techniques for removing a scar. These marks, which are sometimes difficult to accept, require tailor-made approaches to be corrected effectively. Treatments available include laser for scars, hyaluronic acid injections, and medium and deep peels.
Scars can appear in a number of situations:
- Severe acne: a common cause of dimpled scars.
- Surgery or medical procedures: incisions can leave visible marks.
- Accidents or injuries: cuts, burns or trauma.
- Stretch marks: the result of extreme stress on the skin (pregnancy, weight changes).
- Dermatological diseases: such as chickenpox or skin infections.
Each scar is unique, so treatments must be equally individual.
Scar healing is a complex process influenced by many internal and external factors. By understanding these factors, we can better anticipate the result and optimise treatments for less visible scars.
- Age: younger patients generally heal more quickly thanks to greater collagen production, whereas more mature skin may heal more slowly.
- Genetics: some people are predisposed to developing hypertrophic or keloid scars.<Skin type: darker skins are more prone to pigmented scars, while lighter skins may be more sensitive to prolonged redness.
- Location of the wound: areas that are subject to a lot of stress or strain (knees, elbows) tend to heal less well.
- General state of health: chronic illnesses (diabetes, vascular insufficiency) or deficiencies (zinc, vitamins A and C) can slow healing.<Infections: a local infection can aggravate the scar by disrupting the skin regeneration process.
- Post-injury care: appropriate care (cleansing, moisturising and protection) is necessary for optimal healing.
- Sun exposure: UV rays can cause hyperpigmentation of recent scars, making them more pronounced.
- Smoking: smoking reduces tissue oxygenation, delaying healing.
- Stress: chronic stress can disrupt the immune system and slow down the skin's repair process.
Adopting appropriate measures and consulting a professional can help minimise these impacts and optimise healing.
Scars are classified according to their nature.
<These are the most common scars. Due to a loss of dermal thickness at the site of the lesions, they appear as depressions in the skin surface. These scars do not regress naturally.
There are three types of atrophic scars, classified according to their shape, contour and depth: Icepick or V-Shaped scars, depressed scars with shallow edges called Boxcar or U-Shaped scars and depressed scars with pronounced edges called Rolling or M-shaped scars.
These lesions are raised (but less so than keloid scars) and red. Simple hypertrophic scars disappear naturally after 12 to 18 months.
Cheloid scarring does not disappear spontaneously and is often associated with pain and/or itching. It appears as a raised lesion, lightly coloured between white, red, brown and pink. Its specific form is due to an abnormal proliferation of skin tissue.
These marks are a way of healing superficial inflammatory lesions. While erythematous macules often disappear spontaneously in a few weeks without leaving any trace, pigmented macules regress more slowly, in a variable manner.
In medicine, a number of innovative techniques can be used to reduce or eliminate a scar by significantly improving the appearance of the skin. These targeted treatments are adapted to each type of scar and skin.
One of the most effective solutions is the medium chemical peel, which exfoliates the layers of skin, stimulating cell renewal and reducing scarring.
Ablative lasers, whether continuous or fractional, are powerful tools that deeply regenerate skin tissue, offering visible improvement to deep, old scars.
For depressed scars, hyaluronic acid injections fill in skin depressions for an immediate, albeit temporary, effect. Each technique is personalised according to skin type, the nature of the scar and the patient's expectations, guaranteeing natural, long-lasting results.
The fractional ablative laser reduces scarring by stimulating collagen synthesis.
The skin tissue is heated and 'chunks' of skin are removed, resulting in the reconstitution of a thicker dermis.
The number of sessions required varies between four and six.
The advantage of this technique is that the after-effects are relatively slight (a five-day period of social withdrawal is to be expected), but the improvement is less than that obtained by a medium or deep peel. <Dark marks, pigmented scars, are also faded.
The continuous ablative laser, ideal for old and deep scars, is used to perform a laser peel. The aim is to remove damaged layers of skin to stimulate collagen production. This treatment, which is particularly effective on deep scars, results in a spectacular improvement of up to 80 %-95%.
The after-effects are marked by redness and scabs for 10 to 14 days.
The medium peel works by exfoliating the superficial and middle layers of the skin using specific solutions.
The medium peel is a TCA (trichloroacetic acid) peel using 20-25 or 30 % concentration of TCA. Phenol is used for a deep peel.
By stimulating cell regeneration, this treatment improves superficial and moderately deep scars, with a reduction of up to 80 % depending on the type of skin and scar, and radiance and evenness of complexion. <This technique is ideal for acne or pigmented scars.
The after-effects are identical to those of a laser peel.
L'hyaluronic acid has two indications:
- The treatment of an isolated hollow scar, which sometimes (scars with significant fibrosis cannot benefit from this type of treatment) can be lifted thanks to the lifting properties of hyaluronic acid. In this indication, Dr Romano uses a medium cross-linked acid such as Restylane.
- Dermal densification: Dr Romano uses hyaluronic acid in this indication. SkinBooster. Scars are less visible on thicker, more toned skin.
During a preliminary information consultation, Dr Romano listens to your expectations, assesses your needs, analyses your skin and the type of scar and advises you on possible procedures: laser or peel for scar.
A session lasts approximately 20 minutes, and the eyes are protected by eye shields. The protocol involves 4 sessions, one month apart.
If you have a history of herpes labialis, an anti-herpetic treatment should be started the day before the session. One hour before the session, it is strongly recommended that you apply the prescribed anaesthetic cream to the area to be treated. After the session, a healing cream should be applied twice a day for at least 10 days.
Before the peel, a local anaesthetic is administered to make the procedure completely painless. The area concerned is disinfected. The number of times the peel is applied and the time it takes varies according to the type of skin and the objectives pursued. Immediately after application, the peel causes intense redness and whitening of the skin (frost). This is completely normal.
Skin preparation should begin 3 weeks before the peel, and Dr Romano will recommend the cream best suited to your skin. One month before the treatment, no self-tanning products, essential oils, scrubs or masks should be used. <On the day of the peel, make-up or even the application of a cream is forbidden.
After the session, a healing cream is applied to the treated area. Antibiotics and aciclovir are prescribed.
The normal after-effects of a peel are: redness, oedema for 48 hours, then the skin turns brown and peels off within 7 days. Certain complications may arise: oedema, persistent redness, desquamation, exfoliation, bacterial or viral superinfection, acne outbreak.<There are several contraindications to peeling:
- Diabetes or severe insufficiencies such as renal or cardiac insufficiency, etc.
- Pregnancy
- Wearing a pacemaker or cardiac defibrillator
- Isotretinoin treatment stopped less than a year ago or current anti-acne treatment
- Skin infection or herpes
- Recent cosmetic procedure such as surgery, laser, dermabrasion
- Darker phototypes
- Contact skin allergies
For laser treatment, the after-effects of the session and the side-effects depend on the technique used and vary from a simple sensation of heating to more significant swelling and the appearance of scabs.
The first results are visible approximately one month after the treatment, and are optimal between three and six months. This depends very much on the treatment carried out.
Dr. Romano informs you, during the consultation prior to the procedure, that this is only an improvement, the extent of which depends on the type of scar and the skin.
The foreseeable rate of improvement is also announced at the time of this consultation.
Scar treatments are aimed at people who want to :
- Reduce the visibility of acne, surgical or traumatic scars.
- Smoothes out uneven skin texture.
- Reduces pigmentation marks or persistent redness.
- Gain in confidence by regaining a more even skin tone.
- Significant improvement in the appearance of the skin.
- Non-invasive or minimally invasive techniques.
- Natural stimulation of collagen synthesis for long-lasting results.
- Protocols tailored to each patient.
| Type of consultation | General rates |
|---|---|
|
Laser peeling |
From CHF 700 per session, a single session is required |
|
Fractional ablative laser |
From CHF 500 per session |
|
Medium or deep peel |
From CHF 700 per session, a single session is required |
|
Hyaluronic acid |
CHF 600 per syringe |
The services described on this site are applicable to Switzerland; there are differences between countries.
Contact details
Dr Valeria Romano
Pl. du Molard 5, 1204 Geneva, Switzerland
Monday to Friday, 9.30am to 6pm
Dr Valeria Romano - All rights reserved.
