scars Blog
Please feel free to use the blog below to share information about the subject, or to ask Dr. Ringpfeil a question that might be of interest to others.
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Treatments: Surgical revision, pulsed dye laser (PDL), intense pulsed light (IPL), fillers, CO2 laser, silicone sheets, intralesional steroids.
Scars are permanent changes of the skin that result from trauma to the layer beneath the most superficial skin. They are caused by surgery, lacerations, severe inflammation of the skin with destruction of the vulnerable layer such as in severe acne or cyst formation or some blistering skin diseases. If scars leave indentations below skin level, resurfacing by CO2 laser or fillers can correct their appearance.
Red color change can be tackled by PDL or IPL; bulging or dehisced scars can be excised in various fashions. If a keloid forms in a scar, the presence of symptoms dictates treatment. Silicone sheets or injectable steroids help with pain and appearance by softening the keloid.
Excision of keloids is discouraged because of their high recurrence rate. If unavoidable, post-surgical intervention is customized and crucial to reduce chances of recurrence.
| Patient comments (source: Patient Satisfaction Report) | |
| 2010-04-08 10:18:24 | I was given ample time to ask questions and have them answered to my satisfaction. |
| 2010-03-31 11:40:03 | start to finish it was a perfect experience, i found the reception area very heplful and understanding, |
| 2010-03-25 13:03:07 | Dr Ringpfiel is clearly extremely knowledgable, and dhe took the time to listen completely to me about my condition. I really appreciated the time she took with me, and I am confident she is on the right path for treatment. |
Please feel free to use the blog below to share information about the subject, or to ask Dr. Ringpfeil a question that might be of interest to others.
I have burns on my arms and legs and acne on chest, back, and Face. My skin looks like it needs to be renewed. But, I don’t know what type of treatment I need that will be most effective.
The degree of burn often determines the final outcome of the scar ranging from dark discoloration to structural changes of skin with possible complete loss of pigment or even keloid formation. Each type of scar is treated differently. Darkening of skin may be managed with fading agents, retinoids, glycoloc acid peels or microdermabrasion. Structural changes often respond to CO2 laser resurfacing but may need surgical scar revision. Loss of pigment is most difficult to tackle and may necessitate skin grafting (transplanting a piece of your normally pigmented skin from a concealed area onto the burn scar). Keloids forming in burn scars are treated similarly to keloids from other causes. They are injected to reduce symptoms and swelling and subsequently can be revised by CO2 laser resurfacing or surgical intervention.
Dr. Ringpfeil,
I have scars on my forearm from an accident several years ago. I would like to diminish their size and appearance. What are my options?
Thank you!
Scars can now be treated in a number of different ways. If the skin texture is uneven, CO2 laser resurfacing using the Deep FX technology is the best treatment. Deep FX technology came to the market over 2 years ago and has revolutionized scar treatment. It will significantly reduce structural changes. If the scar is discolored, other laser treatments can reduce the color. Surgical revision of a scar is sometimes possible especially when a scar is small but may not give the best cosmetic results on the forearm.
I once had a genital piercing that has left me with what I believe is either a keloid or a hypertonic scar, which I would like removed. What are my options and how much are the costs? Any information would be greatly appreciated!
Hypertrophic scars and keloids are very different in their biologic behavior. Both cannot be removed without trace but both can often be injected with a steroid and will reduce significantly or may resolve to a flat scar. There are circumstances under which scar revision by excision for a hypertrophic scar may be preferred, especially when the expected scar is minimal. However, the chance of another keloid developing, when an existing keloid is excised, is about 90%, and therefore excision is usually not an alternative. If several steroid injections soften a keloid without flattening it, shave excision may be attempted with additional steroid injections at time of excision, as well 2 and 4 weeks after to minimize the risk of a returning keloid. In very rare instances, when a keloid does not respond to steroid injections or is so large that it cannot be injected, radiation may be necessary.
Cost of the procedure depends on the size of the lesion. We typically charge $50 per injection and anywhere between 1-3 may be needed for hypertrophic scars and between 2-10 treatments for keloids. Revision of hypertrophic scars by complete excision ranges between $150 (up to 5 mm) and $400 (over 4 cm). Shave removal of small keloids may range between $130 (up to 5 mm) and $230 (over 2 cm). There is a size limit to shave removal of keloids which is determined by anatomic site. Three steroid injections needed after shave removal are charged in addition to the shave removal as mentioned above.
Radiation is not a service that our office performs because it is rarely needed.
While the revision of hypertrophic scars is not always an insurance covered service, most insurances cover the treatment of keloids.
Hello, I have an age spot in the middle of my forehead, between both my eyebrows, it does not look pretty at all, most of the people I know always ask me what is that and I feel embarrass, It looks like a beautymark but it’s not, I have no insuarance, and I would like to know what are the price range, thank you for your time.
If it is an age spot it can be removed without any scarring. Treatments are indicated only with continued commitment to tan prevention/UVA sun protection. Laser treatment is most effective for removal. 1-3 treatments are usually needed 4-6 weeks apart. Skin must not be tan at time of treatment. Cryotherapy is an alternative. It typically requires 1-2 treatments 4-6 weeks apart but may leave a permanent lighter colored spot behind. Regardless of procedure used, we charge $105 for one spot per treatment. If more than one spot is desired to be removed, $20 is charged for each additional spot per treatment.
I have a white scar and some addiitonal white spots on my face. Can they be corrected and how?
Scar correction is often possible. A color description is insufficient to make treatment suggestions. Scars have to be evaluated in context of their exact location and texture in addition to color change. In person evaluation and physical examination is a must for appropriate recommendation.
Hi Dr. Ringpfeil
I have scaring on my face from pinching my pimples in my teen years..i have always wanted to to reduce the appearance of these scars but fear i would do more damage than good as my skin is somewhat sensitive. I am not looking to have perfect scar free skin. I am sure you would need to see me to make a though analysis but would you be kind enough and make me recommendation on what procedure may be best for me and also a general cost for the procedures? thank you for your time.
Indeed, making any recommendation about scar revision is impossible without evaluation. Pricing can range from several hundred to several thousand dollars depending on your needs. You may review the paragraph and table outlining several different modalities we use for “acne scar” revision on our website.