Removal of Self-inflicted Razor Blade Incision Scars
Self-mutilation by sharp instruments such as razor etc. may leave life lasting scars, which are easy to notice and difficult to hide. Treatment of Self-Inflicted Razor Blade Incision Scars as well as their change into a form acceptable for the society is possible, by means of the Laser-Aided Skin Peeling and Thin Skin Patch Technique developed by Prof. Dr. Cengiz Açıkel et al.
Self-harming with cutters such as razor blade or glass is a behavior that has a basis, on which cultural, social and psychological factors play a role. The behavior of self-cutting with a razor blade is not a psychiatric disorder in itself. Usually, it is considered to be a symptom accompanying some psychological problems. This behavioral pattern can be corrected in the course of time with the recovery of the underlying psychological problem or its spontaneous remission. In our country, it is observed especially in adolescent and young adult males. This behavioral pattern can be seen in individuals from street children to university students at all types of socio-economic and socio-cultural levels in the society. This problem is not specific to our country. In also western societies, it is observed especially in adolescent girls and boys equally and in the same way. For example, the incidence rate of Razor Blade Incision Scar in the United States has been reported to be 4%, as a percentage increasing with each passing day.
Self-harm scars observed especially in the arms and chest wall as a result of self-cutting with a razor blade are permanent for life and difficult to hide. Scars have a specific appearance that can easily be identified by the society. Even if these people are now psychologically stabilized and have already left this behavioral pattern behind, they may feel a lifelong shame, guilt, and regret due to such scars that they bear on their bodies. Moreover, they are stigmatized and excluded by the society. In addition, an individual who has made such a thing in the past but now is living a normal life as a completely recovered individual has difficulty in explaining these scars, which suggest negative characteristics in his/her both business and social lives. In the periods when such people make friends, get married, get a new job, and enter a new social environment, they encounter these scars as a nightmare. A person who has gotten married and become a mother or father is worried about how to explain the scars on his/her arms to his/her children.
Features of Self-Inflicted Razor Blade Incision Scars
The most important feature of socially unaccepted razor blade incision scars, which makes them different from socially accepted other scars such as surgical scars and burn scars, is that they form a group of scars located side by side. In the treatment of a single scar, it is possible to completely remove it and suture it in a more aesthetic way; however, it is not possible to treat more than one scar in the same way because of their abnormal quantity and their colors different from the normal skin color. Sometimes a tattoo is applied to the scars as a camouflage, but such an attempt usually leads to an even more tragic result. Just rubbing these scars leads to just more noticeable scars.
Patients who consult a cosmetic surgeon request the scars to be completely eliminated if possible, or at least, turned into less noticeable scars that do not look like razor blade incision scars.
Surgical Removal of Self-Inflicted Razor Blade Incision Scars
In this regard, a surgical procedure developed by Dr. Cengiz Açıkel et al. was published in the American Journal of Plastic and Reconstructive Surgery in 2005, under the title ‘Camouflage of self-inflicted razor blade incision scars with carbon dioxide laser resurfacing and thin skin grafting’, and consequently took place in the international medical literature. The principle of this treatment procedure is to remove the 50-150 micron top skin layer of the area of the scars, in such a way as to include the normal skin between the scars, by means of laser or dermabrasion devices, and to cover the application area with very thin skin patches of 0.2-0.3 mm taken from thighs or other conceivable areas. Since the skin patch covers camouflages the color difference between the underlying razor blade incision scar and the normal skin, the razor blade incision scars do not be seen as separate scars, and that area looks in only one color, which is a little bit different from the surrounding normal skin. The difference of color tone between the surgical site and the normal skin is more noticeable in the first months, but as from the 6th month, it gradually decreases, and after a year, it looks almost normal that it can be noticed only when viewed carefully. The most important advantage of this procedure is the ability to eliminate the typical appearance of razor blade incision scars that are unique and easily noticeable; and/or the ability to transform them into socially acceptable, less noticeable and more innocent scars such as burn scars.
The surgery is performed under local or general anesthesia, depending on the size of the area to be treated, and the patient can go home the next day. The surgical site should remain dressed for a period of 10-14 days. Afterwards, the surgical site should be protected from mechanical traumas and direct sunlight for a period of 1 year. And the area, from where the skin patch has been taken, is dressed. It heals spontaneously one week after the operation. This area is also pink colored at the beginning, and averagely one year after the operation, it gains a less noticeable appearance. A scar remains to a certain extent varying depending on the skin colors and healing properties of patients.
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