Self Injury Scars
Self injury, or self harm, is a distressing condition for both patient and family members of the patient.
We recognise that the distress of living with self injury scars can last much longer than the condition itself.
Self injury scars can often be successfully treated using lasers, depending on the type and cause of the scar.
Laser treatment can reduce the appearance of scars, fade their colour, improve skin texture and generally make them much less visible.
Types of self harm scars
There are a number of self harm scar types that can be treated with lasers. They include:
- red scars, usually resulting from cuts or stabs
- white scars,
- hypertrophic & keloid scars,
- tattoos or ink-based marking.
- scarring within tattoos.
- unsightly skin grafts from attempts to cover scarring.
Treatment for self injury scars
Treatment for self injury, or self harm, scars begins with an appointment with our dermatologist, Dr Terence Poon. If you have a referral from your GP you will be eligible for the medicare rebate for your appointment fee.
Dr Poon will review the scarring, and determine the best treatment pathway, given the scars, your skin type and tone, and other factors. He will also ensure that no underlying skin conditions are present that may affect or be affected by laser treatment.
Dr Poon will give you all the information you’ll need to make an informed decision about whether scar treatment with laser is right for you or your child. In many cases, if you decide to proceed with treatment, you will be able to begin after your appointment with Dr Poon. However, legally, patients under the age of 18 must wait at least one week after the initial consultation before treatment can commence.
You will be given an opportunity to read through all materials in a private waiting room and discuss any questions you have with one of our registered nurses or skin laser doctors.
You’ll be asked to sign the consent form, or parents will sign on behalf of children under the age of 18.
It is likely you will require multiple (3-5) treatments, spaced 1-2 months apart, to achieve a good result with Fraxel lasers. So total length of treatment can be 5-6 months, but will depend how well your scars respond to the treatments.
Fraxel lasers make tiny holes in the skin causing fibroblast cells in the dermis to be triggered to produce new collagen, which will help minimise the appearance of scarring. Fraxel lasers are often used on other forms of scarring, such as acne scars or surgical scars, and they’re also effective at treating signs of aging such as wrinkles and crepey skin.
On the day of treatment
TREATMENT WITH A FRAXEL LASER:
On each day of treatment you’ll be asked to arrive 2 hours prior to your scheduled procedure time. On your arrival you will sign a consent form and be photographed, so we have a record of what your scars looked like when we began, and what they look like at intervals through the treatment process. This helps both you and your treating practitioners determine how well the treatment is working.
You will be given the opportunity to ask any questions you may have. We ask you to avoid fake tan or spray tans for 2 weeks prior to treatment, as well as avoiding natural sun tan on the areas to be treated.
Depending on the area to be treated, we may ask you to wear a hospital gown, but most areas will not require this. We recommend wearing loose clothing that can be pulled up to reveal the area to be treated, as this will help avoid the need for a hospital gown. We also recommend old clothing as items may be stained by numbing cream. Flat shoes are also recommended, as it helps keep you steady after treatment, when some drowsiness from pain killers may still be present.
For most treatments, anaesthetic cream is applied to the area to be treated and then wrapped with glad wrap to increase absorption of the cream. This will numb the area in preparation for treatment. Numbing cream is left on the skin for 2 hours.
We seat you in a private waiting space, in a comfortable chair, during this time, with magazines, though we do recommend bringing a book or your headphones to listen to podcasts or audiobooks on your phone.
If regular clothing can be worn over the numbing cream without affecting it, patients can choose to spend their first hour in a local cafe or browsing local shops.
One hour before treatment, you will be asked to take some strong oral painkillers. These tablets can make you very drowsy, so once this medication has been taken, we request you do not leave the clinic.
Patients who have been given this medication will not be able to drive for the rest of the day. If avoiding driving is not possible, we can give different painkillers but they will not be as effective, so treatment will not be as comfortable.
If someone is able to drive you home after treatment, we also have the option of giving you Pentrhox, an anaesthetic gas administered via hand held device, allowing you to breathe as much or little as you like. We will insist you have a responsible adult escorting you home after being given Penthrox.
In some cases, if the area to be treated in very small, a local anaesthetic injection can be given to the area, which avoids the need for all other painkillers we’ve mentioned, as well as the long wait time. However, this is not suitable for larger areas and requires that you are happy to receive an injection.
Your fraxel treatment will take anywhere from a few minutes for a small area to an hour for larger areas. A treating clinician and a registered nurse will be present during the treatment.
A stream of cool air will be blown onto the skin, further reducing the sensation of the laser.
After your treatment you’ll be given an ice pack to hold against the treated area to help relieve the sunburn sensation that usually follows a laser treatment.
Vaseline may also be applied to your skin to help assist healing. Some pinpoint bleeding may occur, and a gauze dressing may be applied in this case.
You will be given all the information you need to ensure you care for your treated skin appropriately.
You are welcome to stay in a private clinic waiting area again until you feel comfortable leaving, though many patients who have not received the Penthrox gas feel able to leave immediately.
If you have taken Penthrox, we request you stay in the clinic for an hour after treatment, to allow the gas to wear off.
TREATMENT WITH A VASCULAR LASER
Treatment with vascular laser feels like a small elastic band flicking against the skin, and is far more easily tolerated than Fraxel laser treatment.
For this reason, treatment is often able to be performed without any numbing cream. Often Panadol taken an hour before treatment reduces sensation enough to make treatment comfortable.
Most patients experience some redness or swelling after treatment with vascular laser. This laser does not break the skin, so both make up and sunscreen can be applied directly after treatment.
Patients can leave the clinic directly after treatment with vascular laser.
TREATMENT OF THICKENED OR KELOID SCARS
These scars often require intralesional injection with cortisone, in addition to laser treatments. These injections work to minimise inflammation in the thickened areas and make the scar flatter.
It may also reduce itchiness and pain.
Patients with these types of scars will also be given either vascular or fraxel laser treatment also.
TREATMENT OF SELF INJURY TATTOOS AND SCARRING WITHIN TATTOOS
Tattoos can be removed with pigmented lasers, which fade down the colour.
Most tattoo removal patients can manage the treatment without painkillers or with Panadol taken an hour before. For those who find the treatment too painful, numbing cream or local anaesthetic (depending on the size of the treatment site) can be used.
Please remember, if you are pregnant or unsure if you may be pregnant, you cannot receive treatment.
Sensitivity to the needs of self harm scar patients
Our staff are highly compassionate and have experience working with patients with sensitive issues, including histories of self cutting, burning, picking and more.
Our private consult rooms and medical experience makes the process of treating the scars from such a traumatic experience more comfortable and less distressing.
And we understand that sometimes it can feel like you’ll never really get past the struggles you’ve been through, when you wear the scars on your skin. We want to help you move on.
To book your initial self injury scar treatment consult
To book your initial assessment appointment with our dermatologist, Dr Terence Poon, please call our receptionists on (02) 9953 9522.
IF YOU ARE WORRIED ABOUT SELF HARMING OR SOMEONE YOU KNOW MIGHT BE SELF HARMING
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