Q: Dr. Eppley, I am interested in getting revision of my numerous arm scars. I have attached two photos of the scars on my left arm. The first one on my upper arm is an 8 year old scar. It is the largest of my scars. The second photo is of self inflicted wounds that are about 10 years old. These are the ones I am more insecure about. Let me know what you think of these.
A: Thank you for sending your pictures. I have seen many such scars as you have either from accidental or self-inflicted injury. The reality of your arm scar revisions is as follows:
1) The very large scar with the suture track marks can definitely be improved. But it would need to be done in two stages due to its width. First excise the inner
scar portion, let it heal for six months and then go back in a second stage to include the area that has the suture track marks. This is the best way to get a much narrower scar. It is simply too wide the way it is now to get substantial narrowing in a complete one-stage excision. Staged serial scar excisions is the best approach in wide scars where the surrounding skin is not very lax. These are office procedures done under local anesthesia.
2) The ‘cutter’ scars are always problematic because there are so many and they go the whole way through the skin. That is why they appear white as they are a full-thickness skin jnjury/scar. This laser resurfacing will not simply ‘wipe’ them away. They really need to be cut out and reclosed which often does not make a real big improvement for what you are trying to achieve. (not to look like you cut yourself) I have done a few case of complete skin grafting but that is an extreme approach for those who seek another more palatable explanation for why they have a ‘patch’ of their arm.
Dr. Barry Eppley