The scars can have different origins but the common denominator is the accumulation of fibrous tissue beyond where there has been some kind of assault on our skin. Therefore, if what you want is to improve a scar, what we have to do is remove this fibrosis that results in scarring.
When we value a scar, we should take into account its conformation or appearance and the origin of this. Equally important is knowing the expectations of the patient to be more or less aggressive with this injury and recommend a treatment or another.
There are areas in which it is important to note that there is an increased risk of widening of scar as it is the case of the back, the keloid and hypertrophic scar as it is the case of the supraclavicular area… All of this in order to individualize each case and decide for the best alternative.
If we want to improve and even eliminate practically scar, what we have to do is remove this scar in its entirety and assess the reclosing once it is eliminated. So not only we must take into account the scar, but the location of it to eliminate this along the lines of our skin so that subsequently the scar is less evident. Sometimes, in addition to eliminating the scar, we need changes in their orientation to avoid subsequent enlargements because exists tension in its closure. This type of complement it is called z-plasty, W-plasty…
If you want to reduce the scar, we have essentially two options, corticosteroid infiltration that will generate a small scar or skin atrophy, and the realization of a dermabrasion to regularize its surface.