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Chemical and Thermal Burn Scars

Chemical Peel Scars: 

The availability of chemical peels in commercial cosmetics has increased the number and severity of burn scars that we see in our office. Chemical peels are formulated with caustic acids that are carefully applied onto the skin to stimulate collagen production. In an ideal situation, chemical peels are administered by a licensed professional who understands the problems associated with the incorrect use of chemical peels. The most commonly employed chemical peels include glycolic acid, hydroxy acids, salicylic acid, and trichloroacetic acid (TCA). 

A common mistake associated with chemical peels is to keep the acid on the skin for an extended period of time. This incorrect approach stems from the unsafe assumption that if the directions recommend applying a chemical peel for twenty seconds, that increasing the time on the skin will yield better results. Leaving a chemical peel on the skin for an extended period of time will often lead to hyperpigmentation, skin injury, hypertrophic scar formation, and even keloid scar reaction. 

Most of our chemical peel scar patients require a combination of lasers, injections, and topical therapy for hypertrophic scar formation. If there is associated pigmentation of the skin, a combination of Melarase AM and Melarase PM is recommended to reduce the skin pigmentation and lighten dark skin tone. 

Tattoo Removal Scars: Tattoo removal is usually performed with lasers, but some older techniques use a combination of salabrasion, acid treatments, dermabrasion, and caustic solutions to remove tattoos. Our office performs tattoo removal with top of the line lasers, but we see many patients who have attempted lesser treatments for tattoo removal, only to find that their tattoos were not completely removed and that they were left with permanent scarring. Tattoo removal burns can lead to permanent changes in skin texture, color, and contour. In some patients, skin and soft tissue damage from tattoo removal can cause permanent deep scarring with or without keloid formation. Treatment of tattoo removal scars begins with an examination to determine the depth of the skin burn and the extent of skin injury. Some burn scars may be only pigmentary, whereas others may involve the deeper dermis and soft tissue. If the scar is caused by post-inflammatory hyperpigmentation, then application of Melarase creams twice daily, followed by exfoliative treatments may improve the dark discoloration associated with the burn scar. If deeper dermal injury has occured, then a combination of lasers, IIT, topical therapy, and texture therapy may be needed. 

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