Scar Treatment
Houston, TX
A scar is the body’s natural response to an injury or surgical incision, but not every scar heals the same way. Some scars become raised, thick, wide, depressed, discolored, painful, or itchy. Others may simply remain more noticeable than expected.
At De La Cruz Plastic Surgery in Houston, Dr. Emmanuel De La Cruz, a double-board-certified plastic and reconstructive surgeon, offers several surgical and nonsurgical options for improving the appearance and symptoms of scars. Depending on the type of scar, treatment may include surgical scar excision and revision, Kenalog (corticosteroid) injections, laser skin resurfacing, Morpheus8 RF microneedling, Fractora, or a combination of treatments.
The goal of scar treatment is improvement, not complete elimination. Every patient heals differently, and no treatment can guarantee that a scar will disappear or become invisible.
There is no single treatment that is appropriate for every scar.
Scars differ in their depth, width, thickness, color, texture, location, orientation, symptoms, and underlying cause. A flat but discolored scar may require a very different approach from a thick hypertrophic scar, a keloid, a widened surgical scar, or a depressed acne scar.
During your consultation, Dr. De La Cruz evaluates factors such as:
Based on these findings, treatment may involve a single procedure or a combination of surgical and nonsurgical therapies.
Although “scar removal” is a commonly used term, a scar cannot be completely erased. Even when a scar is surgically removed, the incision must heal by forming a new scar.
Scar revision is therefore designed to replace or improve an unfavorable scar so that the resulting scar may become flatter, narrower, softer, better positioned, less discolored, or less noticeable.
Some treatments remodel existing scar tissue without removing it, while surgical scar revision removes the existing scar and carefully closes the resulting incision to create more favorable conditions for healing.
Results vary from patient to patient, and a completely invisible scar cannot be guaranteed.
Treatment may be considered for several types of scars, including:
These are raised, thick scars that generally remain within the boundaries of the original injury. Depending on the scar, treatment may include steroid injections, laser treatment, surgical revision, or combination therapy.
Keloids are excessive scars that can extend beyond the boundaries of the original wound. They have a significant tendency to recur.
Treatment may involve corticosteroid injections, surgical excision combined with adjunctive treatment, or other therapies. Because recurrence is possible even after appropriate treatment, expectations and long-term management are particularly important.
Scars that have widened after surgery or injury may sometimes benefit from surgical excision and revision with careful layered closure.
Scars that sit below the surrounding skin, including many acne scars, may benefit from resurfacing, RF microneedling, surgical techniques, or combination treatment.
A surgical scar may become wide, raised, depressed, irregular, discolored, or otherwise noticeable. Treatment depends on the reason the scar healed unfavorably.
Acne scars vary considerably in depth and shape. Depending on their characteristics, treatment may include laser resurfacing, Morpheus8, Fractora, or other techniques.
Scars caused by cuts, accidents, burns, or other injuries may sometimes be improved surgically or with energy-based treatments.
Selected stretch marks may demonstrate improvement with fractional resurfacing or RF microneedling, although they cannot be completely removed.
Dr. De La Cruz may recommend one or more treatments depending on the characteristics of your scar.
Some scars are better treated surgically.
During surgical scar revision, the existing scar is carefully excised. The resulting incision is then reconstructed and closed using plastic surgical techniques intended to reduce tension and create a more favorable scar.
Surgical scar revision may be considered for:
Depending on the scar, Dr. De La Cruz may use techniques such as layered closure, tissue rearrangement, geometric scar revision, Z-plasty, or other reconstructive methods.
It is important to understand that scar excision creates a new scar. The objective is to create a scar that heals more favorably than the original one.
Raised scars may sometimes respond to intralesional corticosteroid injections, commonly using triamcinolone (Kenalog).
The medication is injected directly into the scar tissue and may help decrease excessive scar activity. Over time, treatment may help:
More than one injection may be necessary, and treatments are generally spaced apart to allow the response to be evaluated.
Steroid injections are not appropriate for every scar. Potential adverse effects can include thinning or depression of the skin, changes in pigmentation, visible small blood vessels, and other local tissue changes.
For certain hypertrophic scars, keloids, or scars with a history of excessive scar formation, surgical excision may be combined with corticosteroid treatment.
The abnormal scar is surgically removed, and Kenalog or another corticosteroid may be administered at the time of treatment or during the postoperative healing period when clinically appropriate.
This combination may be considered when excision alone carries a significant concern for recurrent excessive scar formation.
However, hypertrophic scars and particularly keloids can recur even after treatment. In some patients, additional steroid injections or other therapies may be recommended after surgery.
Laser skin resurfacing may improve selected scars by resurfacing damaged skin and stimulating collagen remodeling.
Dr. De La Cruz offers CO2, Erbium:YAG, and fractional laser treatments, allowing treatment depth and intensity to be individualized.
Laser resurfacing may be considered for:
CO2 laser resurfacing can provide deeper treatment when more significant remodeling is desired. Erbium:YAG allows precise resurfacing with less thermal injury to surrounding tissue, while fractional treatments create microscopic treatment zones while leaving intervening skin intact.
Morpheus8 combines microneedling with radiofrequency energy to stimulate collagen remodeling below the skin's surface.
Morpheus8 may be considered for:
Treatment recommendations vary according to the scar. Some patients may benefit from a series of sessions rather than a single treatment.
Fractora delivers radiofrequency energy through small pins to create controlled treatment zones within the skin.
It may be used to improve selected:
As with other treatments, the appropriate depth and energy depend on the patient's skin and the characteristics of the scar.
Depending on the scar and treatment selected, scar treatment may help:
Improvement is the goal; complete disappearance of a scar cannot be guaranteed.
You may be a candidate if you have a healed scar that remains raised, wide, depressed, irregular, symptomatic, or cosmetically concerning.
In many circumstances, scars should be allowed sufficient time to mature before surgical revision is considered. However, treatment timing depends on the scar, symptoms, location, and underlying problem.
During your consultation, tell Dr. De La Cruz if you have:
These factors may affect the recommended treatment and expected outcome.
Recovery varies substantially depending on the procedure.
There is typically minimal downtime. Temporary tenderness, swelling, bruising, or changes in the treated tissue may occur.
Redness, mild swelling, tenderness, and small crusts may occur for several days. Patients should allow the treated areas to heal naturally and follow all aftercare instructions.
Recovery depends on the type and depth of laser treatment. Redness, swelling, sensitivity, peeling, or flaking may occur. Deeper resurfacing generally requires a longer recovery period.
Recovery depends on the size and location of the scar and the complexity of the reconstruction. Sutures may be required, and activity restrictions may be recommended to minimize tension on the new incision.
Scar maturation continues for many months after surgery. Additional treatments may sometimes be recommended as the new scar matures.
Every scar treatment has potential risks.
Depending on the procedure, risks may include:
Patients with darker skin tones may have an increased risk of post-inflammatory pigmentation changes following certain laser treatments. Treatment selection and energy settings therefore require careful consideration of skin type.
Most importantly, no scar treatment can guarantee complete removal, an invisible scar, or prevention of recurrent abnormal scar formation.
Dr. Emmanuel De La Cruz is certified by the American Board of Plastic Surgery and the American Board of Surgery. His training in plastic and reconstructive surgery, microsurgery, and aesthetic procedures provides a comprehensive approach to scar management.
Rather than relying on a single technology, De La Cruz Plastic Surgery offers multiple treatment options, including surgical scar revision, corticosteroid injections, laser resurfacing, Morpheus8, and Fractora.
This allows treatment to be selected according to the patient's scar anatomy, skin type, healing history, and goals.
The appropriate scar treatment cannot always be determined from photographs alone.
During an in-person consultation, Dr. De La Cruz can evaluate the scar's width, depth, thickness, texture, pigmentation, orientation, symptoms, and relationship to the surrounding tissues before discussing appropriate treatment options.
Contact De La Cruz Plastic Surgery to schedule a scar removal and scar revision consultation in Houston.
No. A scar cannot be completely erased. Even surgical excision creates a new incision that heals with another scar. The objective is to make the resulting scar less noticeable or otherwise improve its appearance or symptoms.
Yes, selected scars can be surgically excised and revised. The existing scar is removed and the incision is carefully reconstructed and closed. The new incision will still form a scar, and the final result depends on individual healing.
Kenalog (triamcinolone) injections may help flatten and soften selected hypertrophic scars and keloids. They may also reduce symptoms such as itching or tenderness. Multiple treatments may be necessary.
For selected hypertrophic scars or keloids, surgical excision may be combined with corticosteroid treatment when clinically appropriate. Steroid treatment may be performed at the time of treatment or during postoperative follow-up. Recurrence remains possible despite combination therapy.
Treatment depends on whether the scar represents a hypertrophic scar, keloid, or another condition. Options may include corticosteroid injections, laser therapy, surgical revision, or combination treatment.
Acne scars are not all the same. Treatment depends on their depth and morphology. Selected patients may benefit from CO2, Erbium:YAG or fractional laser resurfacing, Morpheus8, Fractora, or a combination approach.
Yes. Mature scars can often be treated. The treatment selected depends on the scar's characteristics, location, skin type, previous treatments, and the patient's healing history.
Yes. Keloids have a significant tendency to recur following excision. For this reason, surgical removal may be combined with corticosteroid injections or other adjunctive treatments when appropriate. Recurrence cannot be completely prevented or guaranteed against.
Scar treatment can be performed in patients with darker skin, but treatment must be selected carefully because some procedures carry a greater risk of pigmentation changes. RF microneedling and appropriately selected laser treatments may be considered after evaluation of the patient's skin type.
Treatment varies considerably. A surgical scar revision may involve one primary procedure followed by observation, while corticosteroid injections, Morpheus8, Fractora, or fractional laser treatments may require multiple sessions. Combination therapy may also be recommended.
Cost depends on the type and size of the scar, its location, the treatment selected, and whether multiple sessions or combination therapy are recommended. De La Cruz Plastic Surgery will provide an individualized treatment estimate following consultation.
