Topical Silastic Sheeting

There are a variety of treatments available to improve scars. However, it is important to note that we can never totally remove scars; we can only improve them. The top layer of the skin, called the papillary dermis, does not scar. However, the lower layer, called the reticular dermis, does scar. If injuries penetrate into the deeper layer (those commonly requiring stitches do), there will always be a scar. In facial plastic surgery, we try to make that scar less noticeable by hiding it in skin lines, making it less wide, or breaking up the longer scar into smaller scars. In some cases, medical treatments such as topical silastic sheeting or injecting steroids into the wound can soften it and make it cosmetically more appealing. In other cases, dermabrasion or laser resurfacing can provide improvement. In still other cases, the old scar actually has to be excised or removed and a new scar created. Hopefully, this new scar is smaller, less prominent, and more “camouflaged” than the previous scar. It is important to remember that it takes 12-18 months for an area to completely heal. Scars often look their worst in the first 3-4 months and then oftentimes improve remarkably. For that reason, one usually needs to wait until a scar has fully matured or is approximately 12-18 months old before one considers scar revision surgery.