Pigmented scars

Healing ability after surgery is a somehow unpredictable biological phenomenon with extreme variability between ethnicities, individuals, skin quality of different anatomical areas, features of the surgical technique and multiple genetical and mechanical factors; there are well known factors leading to a unfavorable aesthetic outcomes, including but not limited to black skin, sebaceous or oily skin, certain areas like back, shoulders, chest, mandibular angle and earlobe, abdomen, etc, causes by mechanical stress and pull from the wound edges like hematoma, seroma, excessive postoperative swelling or inflammation, poor surgical planning, features inherent to the surgical technique, etc; notwithstanding some areas are prone to superb aesthetic quality of the scars, like the scalp, face, eyelids, ears, lips, nose, intraoral mucosa, areolas, etc.

A dark pigmented scar occurs when there is an excessive melanin deposit connected with cutaneous ethnicity or phototype, and a reddish pigmented scar when there is an underlying hyperactivity in the healing process which is pretty much connected with the hypertrophic scars.

Treatment is initially expectant, since most cases evolve favorably and spontaneously; cases of prolonged pigmentation or featuring bad prognosis should be treated with depigmenting ointments therapy; should the evolution be unfavorable other actions could be indicated like late and scheduled surgical revision.