Table 1.

Treatment of scars

Treatment	Description	Advantages	Disadvantages
Pressure therapy	Application of elastic bandages or pressure garments to apply pressure to scar sites.	Noninvasive. Can be applied at home by the patient.	Often cause discomfort to the wearer which affects compliance. To achieve optimum results from pressure therapy require 6–12 months constant wear.
Silicone gel therapy	Application of silicone gel sheets or gel formulated in a tube.	Noninvasive. Can be applied at home by the patient.	To achieve optimum results from silicone gel therapy require 6–12 months constant wear.
Steroid injections	Injection of corticosteroids directly into the scar tissue which inhibits fibrosis and reduces the number of contractile myofibroblasts.	Can inhibit the formation of hypertrophic scarring.	Requires multiple injections over a period of time to be administered by a clinician.
Dermal fillers	Fillers such as collagen can be injected at the scar site.	Can be used to improve the contours of pitted scars.	Must be carried out by a cosmetic/healthcare professional. Results are temporary.
Dermabrasion	Controlled abrasion or planing of upper to mid skin layers. This technique has largely been replaced with advanced methods such as laser resurfacing.	Can smooth raised scars and reduce shallow/mid-depth acne scars.	Invasive procedure which usually requires an anesthetic. The resultant wounds also carry the risk of further scar formation.
Microdermabrasion	A cosmetic procedure involving the exfoliation of the skin epidermis.	Noninvasive, nonsurgical and usually pain-free technique.	Usually only effective on shallow scars such as those caused by acne.
Laser resurfacing	The use of intense pulsed light typically with an erbium or CO2 laser.	Can reduce the elevation of scars and also soften scar tissue.	Must be carried out by a cosmetic/healthcare professional. Depending on the laser used, results can be short or long term.
Skin grafts (punch grafts)	Small skin grafts are taken from unscarred skin and used to cover a scar.	Most commonly used for deeper acne scarring.	An invasive technique which requires additional wounds to be created to harvest skin tissue.
Surgical revision		Can be used to improve the appearance of prominent, irregular-shaped scars.	An invasive surgical technique that requires often deep wounds to be created and which will form a further scar.
Ablative fractional resurfacing	A series of patients who experienced rapid and sustained healing of long-standing erosions and ulcers associated with traumatic scars and split-thickness skin grafts after initiating a course of AFR.	Advantages include the novel concept of photomicrodebridement, including biofilm disruption and the stimulation of de novo growth factor secretion and collagen remodeling.

AFR, ablative fractional resurfacing.