a Raised scar come in two varieties, Keloids and Hypertrophic scars.
We treat raised scars with injection of substances into the scar itself. Lasers can also be used, but the injectables cost less and work as well as laser therapy. We use Triamcinolone or 5-Fluorouracil as injectables.Triamcinolone is a type of cortisone. 5-Fluorouracil is an antimetabolite originally used to treat cancer.
Both options work well for treating raised scars, but Triamcinolone causes more medium to long-term localised side effects. Triamcinolone can result in hypopigmentation (whitening of the skin) or the formation tiny blood vessels (telangiectasia) in 20% of patients and skin thinning (atrophy) in 10% of patients.
None of the above problems occurs with 5-Fluorouracil, although the injection itself is more uncomfortable and can cause a burning sensation for 30 minutes to a few hours. Most patients tolerate the injection easily. If required, we apply a numbing gel to the scar for an hour before the injection.
Triamcinolone is safe to use for bigger raised scars and 5-Fluorouracil once the scar becomes flatter.
We do the injections every 1-4 weeks and space the injections 1cm apart along the scar. The more frequent the injections the faster the response.
We use either a very thin needle or a Dermojet for the injections. A Dermojet is an air pressurised device that can deliver the Triamcinolone or 5-Fluorouracil into the scar in a much quicker and less uncomfortable way. We use the Dermojet for bigger scars and once the scar become small and flatter we tend to switch to the standard injection technique.
Be ready for at least five to ten sessions, depending on the number and size of the scars.