What Type Of Scar Revision Can Be Done For Scarring From Self-Mutilation?
Q: I self harmed for many years as a young person, I haven’t done so in almost a decade and I am a different person to the one I was back then. I find it almost unbearable to see the constant reminders on my arms and stomach. They are quite bad. I never go out in short sleeves and this has lead me to detest the summer as I am always covered up, miserable and uncomfortable. I wish I was like everybody else. Is surgery a good option for me to think about? I’m desperate to live a ‘normal’ life.
A: Self-mutilation leads to many linear and cross-hatched scars, often on the patient’s arms. They usually appear as fine white lines. They are white because of the unpigmented scar that is created from the often superficial lacerations. In general, the concept of simply wiping them away by laser resurfacing is not possible because the scar depth is too deep. At best, all one can do is trade-off a different type of scar for the self-mutilation scars. I have done deeper laser resurfacing to create a burned appearance as well as have even skin-grafted arm areas. The intent of this scar trade-off is that it can be more easily explained as part of a more socially accepted injury (e.g., burn) and not look like it was from self-mutilation or from someone who is a ‘cutter’. If one can accept this scar trade-off, such a scar revision approach may be reasonable.
Dr. Barry Eppley