Erasing scars

Some thirty years ago Dr. John Yarborough published a now famous paper in the dermatologic literature in which he described performing dermabrasion on the forehead of a patient whose head had gone through a windshield during an auto accident. The man had extensive scars on his forhead after having been sewn up and Dr. Yarborough performed the procedure 6 weeks after the accident. The scars virtually disappeared. This contrasts with the common advice doctors give to patients to let scars heal for about 1 year before attempting to revise them. This is in direct conflict with the actual evidence. Numerous clinical studies over the past 30 years demonstrate that scar revision is best performed between 6 and 12 weeks after an injury or surgery. This is the period of collagen remodeling and the time in which the body can revise a scar. Since the Yarborough paper numerous methods of intervention have been tried and proven successful when performed early. The most popular is silicone sheets which can be placed over the new scar daily for 6 weeks. Here the theory is the static electricity formed under the sheeting induces the body to remodel its newly formed scar. These products are now available over the counter. Another popular method is laser resurfacing in which a CO2 laser is used to vaporize the surface of the scar in much the same way as dermabrasion does. One of the newest methods involves low level laser therapy and low level LED therapy in which an intense light source at low levels of energy is directed at the scar. There are many studies of wound healing with these lights including those of NASA performed in outer space. Despite the antipathy of most physicians these methods do work and can produce very good results. Lastly, fractionated lasers which are a compromise between laser resurfacing and low level laser therapy have produced excellent results.
The message here is treat new scars early and often and the scars may disappear.