Hello. I am Dr. Sang-Ju Lee, a dermatologist. According to statistics from the Ministry of Gender Equality and Family, intentional self-harm has been the leading cause of death among adolescents for 11 consecutive years. At our dermatology clinic, we frequently encounter cases where parents visit with their teenage children for self-harm scar treatment. Understanding the parents' desire for their children, who are still young, not to carry the marks of self-harm for a lifetime, today we will delve into how parents can respond to self-harm scars and effective treatment methods.
How should parents respond to their child's self-harm scars?
If your child has self-harmed, it is advisable to apply a moist dressing product to the affected area as soon as possible. This is because using a moist bandage after cleaning or disinfecting the wound can help it heal with less scarring. If the wound has healed and remains as a red scar, applying a moisturizer may help, but a more definitive method is to receive laser treatment at a dermatology clinic.
What treatment methods are available for self-harm scars?
Generally, methods for treating self-harm scars are broadly divided into three categories: surgical methods, laser methods, and tattooing methods. Among these, laser methods are currently considered the most effective alternative.
Is surgical treatment truly effective?
Surgical methods for treating self-harm scars can again be divided into two types.
Limitations of Z-plasty
Z-plasty can be considered to change the direction of a linear scar to make it less noticeable. However, self-harm scars typically occur on the arms, and creating a Z-shape in this area can make the scars more numerous and more noticeable, so plastic surgeons often do not recommend it.
Problems with skin grafting
Skin grafting is sometimes considered good because it can cover self-harm scars. However, in reality, scars can remain on both the grafted area and the recipient area, and they may appear different from the surrounding skin, making it difficult to be an alternative for self-harm scar treatment.
Surgery involves excising the scar area and re-suturing it, but there is a limit to how much the skin can stretch. Therefore, if the self-harm scar is wide, it can cause problems during suturing.
"Self-harm scars may not be visible, but there are larger surgical marks, so general plastic surgeons usually do not recommend them."
Why is laser treatment effective?
Importance of early treatment
For red self-harm scars, it is important to treat them as early as possible to prevent the scar from becoming fixed. While it might be thought that there is little difference between adolescence and adulthood for scars that have turned white, in my experience, the earlier the treatment in adolescence, the more natural and effective the treatment results tended to be.
Principle of Pinhole Technique
We primarily use the Pinhole Technique for laser treatment.
- Visual Improvement: Our eyes visually perceive linear scars faster than punctate ones. The Pinhole Technique transforms linear scars into punctate forms, dispersing the scar and making it less noticeable.
- Skin Regeneration: Through Pinhole Technique, new cells grow in from the normal skin surrounding the scar. This leads to the scar tissue being replaced by cells closer to normal skin, resulting in the scar appearing lighter.
Can cover-up tattoos be an alternative for self-harm scars?
Many people think that cover-up tattoos on scar areas will make the scars invisible. However, our skin subtly changes color with the seasons. Tattoos do not change to match skin color changes, so the scar eventually becomes visible.
A bigger problem arises when trying to remove cover-up tattoos. Skin-colored tattoos are much more difficult to treat compared to commonly seen blue or black tattoos. Therefore, while treatment is not impossible with cover-up tattoos, it may require significantly more time and effort. If possible, it is advisable to consider laser treatment or other surgical treatments rather than tattoos for self-harm scars or other scars. Fundamentally, if the scar is not treated, efforts to cover it will continue, so fundamental treatment is recommended.
Important considerations alongside scar treatment
Self-harm scars often require perfect treatment and must not create new scars, so the treatment process can be very meticulous and lengthy. To prevent self-harm from recurring during scar treatment, it is essential to concurrently treat underlying depression or stress. If self-harm is repeated during treatment, the treatment period will be extended, so parents' continuous attention and care are crucial. Please remember that good treatment results can only be achieved with consistent parental attention and love for the child, and psychiatric counseling if necessary. Self-harm scars can definitely be improved with treatment.