It is good to start of knowing that a strip scar once created cannot be made to disappear. The best solution is to avoid it all together.
The following approaches are all available options and they all have pros and cons:
Revision. If the scalp is lax enough and for scars wider than 1cm in the average, this is an option to consider. The scar is excised and closed again. Measures to take in improving the odds of a better scar includes the following
- i. Adopting a trichophytic closure technique if possible
- ii. Avoid revising a scar that is closer to the nape than the nuchal crest
- iii. Avoid scalp stretching positions and actions for a prolonged period of time after surgery
- iv. Adopting better closure techniques. Double layer closure is preferable
- iv. Avoiding revisions in cases of markedly reduce scalp laxity
THE PROS OF SCAR REVISION include the possibility of retrieving some grafts for transplantation in the process. THE CONS OF SCAR REVISION include:
- the higher likelihood of stretch back which may even be worse than the original scar
- the higher likelihood of Damage to neighboring follicles in the process of scar excision
- the higher likelihood of nerve damage with pain, numbness or abnormal sensations resulting
- the higher likelihood of further distortion of the anatomical landscape of the scalp
- A more involved recovery period.
2. Grafting the scar with hair follicles: This approach avoids all the drawbacks/cons listed above for scar revision. I have found beard hair to be especially well suited for scar camouflage by hair grafting purposes.
The following case report illustrates results of adopting this approach in my previous patients:Bad Hair Transplant Scars Repair and Severe Baldness Restoration by UGraft- BHT
3. Tattooing of scar: This is useful in instances where the scar visibility is mainly due to the whiteness in color which stands out. In this event, the scar might still be visible after adding hair to it. In this instances, adding a pigment to the scar by trichopigmentation would be complementary and contribute towards making the scar less visible. Here is an example of a patient in whom this approach was adopted successfully by Dr Umar: https://www.dermhairclinic.com/body-hair-transplant-tricopigmentation-patient-results/