Mary Lee Amerian

Treatment of Scars

Many people have scars that they find unattractive. In addition, the presence of the scar may continue to remind the person of an experience from the past that was upsetting such as a cancer treatment, a traumatic injury, or a medically required surgery. Scars like these can occur on any part of the body. Other times, the scars are simply the result of an earlier childhood or teenage ailment such as acne or chicken pox.

Thanks to modern medicine, there are now many ways that scars can be cosmetically improved. In this month's newsletter, we will review the different types of scars and the methods available to improve the appearance of unfavorable or unsightly scars.

Scars come in several different types.

• Hypertrophic scars: Hypertrophic scars are raised, firm, thick, and red.
• Atrophic scars: Atrophic scars are depressions in the skin that result from the loss of collagen.
• Keloid scars: Keloid scars are raised reddish nodular scars that are quite firm and relatively large. With a keloid scar, the size of the keloid is actually larger than the size of the original surgery.
• Acne scars: Acne scars are very common. Although they may occasionally be hypertrophic or keloidal, they are usually atrophic. The most common type of atrophic acne scar is referred to as an "ice-pick" scar. Ice-pick scars are narrow with sharply demarcated tracts that can reach deep into the skin.

Options for improving the appearance of scars include the following:

• Steroid Injection – Steroid injections are often used to treat hypertrophic scars and keloid scars. With a series of steroid injections, the inflamed raised scar should flatten out and become less inflamed and less irritated. Although steroid injections may be used alone, combining steroid injection with laser treatment enhances scar treatment.
• Vbeam Laser – The Vbeam laser is an excellent choice for hypertrophic scars and keloids. In research studies, there has been significant improvement in scar redness and in reduction of bulk following Vbeam laser treatment. Generally, after three or four treatments, the scars are flatter and less red. The Vbeam laser procedure is very well tolerated, with patients only feeling a mild snapping sensation. There is no downtime after a Vbeam laser treatment.
• Fraxel Lasers – The two Fraxel lasers will improve all types of scars and they are the most commonly used lasers to improve the appearance of scars. The most common scars treated with the Fraxel lasers are atrophic acne scars and surgical scars. However, even traumatic scars resulting from injury to the skin can be improved with the Fraxel lasers. Often, Fraxel laser treatment is combined with steroid injection to provide optimum improvement of the scar.
  
  Patients undergoing Fraxel laser treatment of scars may choose between traditional Fraxel laser treatment and Fraxel Repair laser treatment. With traditional Fraxel laser treatment, patients undergo a series of 4 or 5 Fraxel laser procedures at monthly intervals, with no downtime, to improve the scar. The improvement in the scar results from the new collagen that is formed as a result of the laser treatment. This procedure is FDA approved for the treatment of acne scars and surgical scars, and it will also improve all other types of scars as well.
  
  With Fraxel Repair laser treatment, patients generally need only one or two treatments; however, depending on the size of the treated area, there may be a few days of downtime with Fraxel Repair laser treatment. The improvement in the scars following treatment with the Fraxel Repair laser results from immediate shrinkage of the scar tissue followed by new collagen growth. Like the traditional Fraxel laser, the Fraxel Repair will improve all types of scars, including acne scars, surgical scars, keloid scars, and atrophic scars.
• Surgical Scar Revision – Occasionally, a scar that healed poorly needs to be surgically removed and stitched using very precise and careful surgical technique. In properly selected patients, this will result in a much-improved scar. However, surgical scar revision is only rarely necessary, and nearly all patients can have their scars improved without surgery, using lasers and steroid injections.

Any of our patients who have a scar that they do not like are invited to call our office (1-866-811-7986) and make an appointment with either Dr. Amerian or Dr. Anterasian.

Dr. Anterasian Selected to America's Top
Surgeons 2008

Dr. Anterasian is proud to announce that he has been honored by selection to "America's Top Surgeons" for the year 2008 by the Consumers Research Council of America. This selection was made based upon Dr. Anterasian's twenty three years of experience as a surgeon, his board certification, continuing medical education, membership in professional societies, and his consistently excellent work. Dr. Anterasian would personally like to thank all of his patients who have selected him to do their surgery, laser work, and cosmetic rejuvenation, and he looks forward to helping many more patients in the years to come.

Dr. Anterasian Demonstrates Fraxel Repair
Laser to Physicians

Reliant Technologies, the maker of the Fraxel Repair laser, invited Dr. Anterasian to participate in an educational conference on this laser last month. At the conference, Dr. Anterasian performed a Fraxel Repair laser treatment on an actual patient in front of the other physicians who were present. Approximately thirty physicians attended the conference and as a result of this demonstration, they were able to learn how to perform Fraxel Repair laser treatments. Dr. Anterasian is one of the few physicians in Southern California performing Fraxel Repair laser resurfacing, and he was happy to demonstrate his technique for performing this procedure to the other physicians who attended the conference.

Dr. Amerian to Film Fourth Year of Television Show
"10 Years Younger"

By now, nearly everyone has seen at least one episode of the television show "10 Years Younger." On the show, the patients undergo a series of non-surgical facial rejuvenations designed to make them look ten years younger. Dr. Amerian has been a consulting dermatologist for the show since its very beginning in 2005, and she has had a lot of fun working with the patients. During the more than 20 episodes she has filmed, Dr. Amerian has been able to demonstrate nearly all of the techniques of non-surgical facial rejuvenation.

Recently, the producers of the show asked Dr. Amerian if she would participate in filming the show's fourth season. Dr. Amerian was very happy to agree to their request. Look for her on The Learning Channel (TLC) beginning in the fall.