Self-harm scars: Instead of hiding them, treat them this way! It will definitely make a difference.

Hello, I am Kang Jin-moon, a dermatologist. Many people visit our dermatology clinic with self-harm scars on their wrists, forearms, or thighs due to depression. Self-harm scars, especially long, linear lacerations on specific areas like the wrist, are easily noticeable to others and can cause discomfort in social life. Therefore, it is important to treat them well. Today, I will explain in detail the characteristics of self-harm scars and effective treatment methods.

Self-harm scars exhibit several characteristics that differ from typical scars.

• Various forms and depths: There are often not just one, but multiple long, linear lacerations arranged horizontally. The most common are slightly raised, long, linear white scars, and recent scars may appear reddish. Depending on the individual's constitution, they may appear as keloid scars or be accompanied by brown pigmentation in the injured area.
• Diversity in depth: The depth varies from scars that only damage the shallow layers of the skin to those that are deep enough to cause the skin to gape open.
• Accumulated scars: It is rare for self-harm to occur only once, and unlike other scars, self-harm scars are often accumulated, which is another characteristic.

Recently, with a significant increase in adolescents experiencing depression due to various reasons such as academic stress, school violence, and peer relationship concerns, the largest group of patients visiting our dermatology clinic with their parents for self-harm scar treatment are young students.

There are two main methods for treating self-harm scars: surgical treatment and laser treatment.

Limitations of surgical treatment

Surgical methods include skin grafting or suturing. However, surgery can create new scars or cause the sutured area to open up, leading to an undesirable appearance. Unless ligaments or muscles are damaged, surgical methods are usually not very helpful.

Why laser treatment is fundamental

Therefore, laser treatment can be considered the fundamental treatment for self-harm scars. Laser treatment works by creating microscopic injuries in the scar area with a laser, inducing the skin to regenerate. Representative lasers used for this include powerful regenerative lasers such as StarLux and Ultrapulse Encore. Repeated treatment with these regenerative lasers can gradually fade the scars, and with sufficient time, they may improve to a level where they are barely visible.

The duration required for scar treatment varies greatly among individuals, ranging from a few months to several years. Depending on the shape and condition of the self-harm scar, combining various treatment methods such as PicoWay Laser, V-beam Laser, or Subcision can yield much better treatment results than laser treatment alone.

Looking at the principle of scar treatment alone, it might seem simple. This is why doctors with little experience in scar treatment sometimes venture into this field. However, just as what seems simple is often more difficult in reality, scar treatment is also a field where experience and know-how are very important. Of course, even with treatment by a dermatologist experienced in scar treatment using excellent laser equipment, it can take a long time for noticeable improvement due to the nature of the skin.

Therefore, the most important aspects of self-harm scar treatment are patience and perseverance. Usually, if there are only one or two self-harm scars, it might seem like treatment will be quick, but even this typically takes 1 to 2 years.

Another important point is that some individuals undergoing self-harm scar treatment may self-harm again during the treatment process. If this happens, the treatment received so far may become meaningless. Therefore, we recommend combining psychiatric treatment with dermatological scar treatment to prevent further self-harm.

So far, we have discussed the characteristics of self-harm scars and effective treatment methods. If you have any questions, please feel free to ask in the comments or via the Yonsei Star Dermatology KakaoTalk channel.

This was dermatologist Kang Jin-moon. Thank you.