Scarring is a common skin concern affecting people of all ages and skin types. While most often associated with acne, scars can also develop following injury, surgery, inflammation, or trauma to the skin, and frequently cause lasting disruption to confidence and self-esteem.
Skin scarring occurs when the body’s natural healing process becomes altered. Instead of smooth tissue regeneration, collagen fibres form unevenly within the dermis. This creates areas of tethering, indentation, or thickened texture. Over time, this abnormal collagen architecture becomes more established, making scars increasingly resistant to skincare alone.
The underlying reason for scar formation can be complex and multifactorial, influenced by genetics, depth of injury, inflammatory response, wound healing patterns, and skin type.
Understanding Scarring
Understanding scarring is crucial, not only for effective treatment but also to set realistic expectations and dispel common misconceptions. Scar revision requires medical assessment, anatomical understanding, and tailored intervention.
At Dr Ed Robinson Aesthetics, we take a consultation-led, medically driven approach to scar management. We consider both the physical structure of the scar and the emotional impact it can have, creating personalised treatment plans that address skin quality, collagen integrity, and long-term regeneration rather than surface improvement alone.
Scar treatment is rarely a single-modality process. Different scar types require different strategies. Tethered, depressed scars behave very differently to raised, hypertrophic, or inflamed scars, and therefore demand a more nuanced, anatomical approach.
Advanced Erbium laser technology, particularly ProFractional resurfacing, allows us to treat even moderate to severe scarring by stimulating deep collagen remodelling and controlled skin renewal. By creating precise micro-channels within the skin, the Erbium laser triggers regeneration while preserving surrounding tissue, improving texture, softening scar edges, and restoring smoother skin architecture over time.
For deeper or more extensive scarring, treatment can be uncomfortable. Unlike many clinics, Dr Ed is able to offer medical nerve blocks to significantly improve patient comfort. Drawing on his anaesthetic background, targeted local anaesthesia can be safely administered, allowing more effective laser settings where clinically appropriate and supporting better overall outcomes.
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MECHANICAL RELEASE FROM TEETHERED SCARS
For scars that are visibly anchored down into deeper tissue, scar subcision is often an essential component of treatment. Subcision involves carefully releasing the fibrous bands that tether the scar to underlying structures. Once released, the skin can elevate naturally, and the controlled trauma stimulates new collagen formation in the area. This technique is particularly effective for rolling or atrophic acne scars that do not respond adequately to resurfacing alone -
MANAGING RAISED OR HYPERTROPHIC SCARS
When scars are raised, thickened, or hypertrophic, the approach differs. In selected cases, intralesional steroid injections can be used to reduce inflammation and suppress excessive collagen production within the scar tissue. This helps flatten and soften raised scars over time, improving texture and comfort.