Treatment of Hypertrofic scars with dermatography

Dermabrasia, a treatment of hypertrofic scars

Dermabrasia is a very rough treatment to equalize the surface of the skin, using salt or a grindstone. This treatment is used within the field of dermatology and plastic surgery. The results are not always very good, nor are the results with CO2 laser. When used in the wrong way, even more scar tissue can arise.

Edula® ointment as pre-treatment

The specific scar will be treated with Edula ® ointment, under occlusion, about a month before the real treatment starts. After each treatment the patient keeps using Edula® ointment, to prevent scars and to stimulate the healing process.

Go to the website of Edula® ointment
and see the leaflet.

Hypertrofic scars: treatment with dermatography

The last 15 years scientific studies showed that hypertrofic scars get smoother and more solid by treating them with dermatography. Every treatment a very thin piece of skin tissues will be removed. In that way it is a mild form of dermabrasia. It is called intracicatricial keloïdectomy. At the same time a pigment can be used, so we can spak of a combined treatment. After a few treatments the scar feels less tensed and more smooth (atrofic). Under a microscope we can clearly see that the collagen changes from unstructured to normal collagen (see also scars and collagen).

detail hypertrophic scar, one year after plastic surgery

detail result after 11 treatments with dermatography

hypertrophic scar, one year after plastic surgery

result after 11 treatments with dermatography

neck scar after surgery

end result after 9 treatments with dermatography

Hypertrophic scars: after reconstructive operations

Hemangioma (wine stain - nevus flammeus). 5-year-old patient from wine stain before surgery

Same patient after years of surgery. Very strong hypertrophic scars and discolouration. Malfunctioning of the eyelid and mouth

after 28 treatments with dermatography

final result after 54 one-hour-treatments with dermatography. You can clearly see that the hypertrophic scars are greatly reduced, and the differences in colour almost disappeared

Kenacort® A40

In dermatography we supply Kenacort on the skin. Research shows that Kenacort10 is not very effective and at least it is not reducing the scar.

Until now the best results are made with Kenacort40. The number of treatments depends on the size and thickness of the scar. After the treatments with Kenacort40 the scar will get pigment bij using dermatography. Surprisingly we see that the scar tissue comes up to the same level as the healthy skin around it (intracicatricial keloïdectomy).

KenacortA40: Dermatography

after plastic surgery, strong hypertrophic scar

after 5 treatments with Kenacort® A40

result after 5 treatments with Kenacort® A40 and 4 treatments with dermatography

1 year after trauma and surgery

after 10 treatments with Kenacort® A40 and dermatography

In case of severe forms of hypertrophy/formation of keloïd, the first 2-6 treatments we only supply Kenacort, using dermatography. Research has shown that the usual injection of Kenacort in the scar with a mantoux needle is not only very painful for the patient, but also shows that 75% of the injected substance does not reach the right place.

right forearm after surgery, after 1 year, untreated

detail: very strong and painful hypertrophic scar

after 5 treatments with Kenacort® A40

right forearm

after 5 treatments with Kenacort® A40 the hypertrophic scar is greatly reduced

after 5 treatments with Kenacort® A40 and 6 treatments with dermatography

You can see clearly that the scar became smooth and hypertrofic after using dermatography/Kenacort40. The above described treatment would not have been necessary when we had used Edula® Ointment under occlusion/Tegaderm/Fixomull. The results of using the last can be seen at the left forearm of the same patient..

Local anaesthesia

These patients don’t get injections, because they can be very painful. Instead of injections we give them 1 hour before treatment 10% Lidocaïne solved in Pro-Edula(R) under occlusion with Tegaderm. In this basic ointment we left the calendula out.

Go to the website of Edula® ointment
and see the leaflet.

Atrofic scars: Dermatography

Atrofic scars and hypertrofic scars have opposite features: atrofic scars are supple, elastic, thin and soft. But most of the time they glow and many patients see that as disturbing. And because there also often is a difference in color, the best treatment to solve those problems is with dermatography.

Treatment of keloïd

Of all scars, keloïd is the most difficult one to treat, both in people with colored as those with fair skin. The predisposition to keloid is often genetic, but it can also arise from other causes. One can try to reduce keloid in a number of surgery sessions. Very important is the accurate suturing of the wound, as well as an adequate treatment of wounds there after. The treatment requires a lot of creativity, knowledge and skill, while the patient must have a lot of patience. Sometimes combination therapies are very successful.

X-ray and laser-therapy, corticosteroid injections, silicone patches, scar plasters, liquid nitrogen, and the like are not to be recommended. In the medical literature there is a lot written about it, but in general the final results we see are disappointing.