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What causes scars to form?

Scars are caused by skin injuries. These can be triggered by minor or major accidents, burns or operations. Healing processes are triggered in the body that are supposed to close the wounds that have appeared. Complex wound healing processes are necessary for wound closure, especially with deeper injuries. Starting from the edges of the wound, the body forms new, but initially not very stable tissue. This tissue is then gradually filled with collagen.

Scar tissue is usually harder, less elastic, and slightly different in color than the surrounding, healthy skin tissue. In addition, scars sometimes cause a feeling of tension, pain, itching and even restricted mobility. In addition, aesthetic appearance can be affected, particularly in exposed areas such as the face and hands and can become a constant memory of the traumatic experience connected to an accident.

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Why do some people get worse scars than others?

Some people tend to develop significantly worse scars than others. In some cases, clearly visible scars form even after the smallest injury. Individual disposition plays a central role here.


What types of scars exist?

Scars can be divided into different types, although mixed forms are also possible.


Fibrous (physiological) scars: Fibrous scars are soft and smooth. They are as elastic as the surrounding healthy tissue that surrounds the scar. Often this type of scar is a little lighter in color. These scars do not cause any discomfort and are largely inconspicuous.

Sclerotic scars: Sclerotic scars are caused by increased collagen formation under the surface of the skin. As a result, the scar contracts and the tissue on the surface hardens. These scars appear wrinkled and are also known as shrunken scars. If these scars are on the joints, a feeling of tension and even pain can occur. Sclerotic scars are caused by burns, inflammation, and deeper soft tissue injuries.

Hypertrophic scars: Hypertrophic or protruding scars are caused by the excessive formation of connective tissue during the healing process. This type of scar is mostly red, raised and bulges on the surface of the skin. Hypertrophic scars are caused by mechanical irritation of the wound, wound infections, or an allergic reaction to sutures / bandages. Often these scars itch and tenderness remains.

Keloids: Keloids are extreme overgrowths of the skin in the wound area. The basic structure of the scar corresponds to hypertrophic scars. Treatment must start on the original wound so that further scarring can be stopped. Nodular growths appear, the affected tissue is reddish in color. The wound is itchy and tender. But more importantly, the steady growth of the wound is an increasingly aesthetic problem for those affected.

Atrophic scars: Atrophic or sunken scars are characterized by a dent within the surrounding tissue. These are caused by insufficient connective tissue during the healing process and are therefore the opposite of scarring phenomena like hypertrophic scars. Atrophic scars are often caused by acne, chickenpox, and minor lacerations. Stretch marks because of weight loss also fall into this category of scars.


Does a scar need treatment?

This question cannot be answered generally. First, it must be clarified whether the scar causes symptoms such as painful tension, tenderness, itching and even restricted mobility. Second, does the scar affect the patient aesthetically. In addition to the type of scar, this often also depends on where the scar is. In particular, scars on exposed areas like the face, neck and hands can be perceived as particularly bothersome or stressful. Third, are there any changes over time to the scar (keloids).

Sometimes people have become accustomed to scars that may have existed since childhood. These are simply tolerated, sometimes out of the lack of knowledge that they can often be easily removed or reduced. But once the scar is treated, no patient has ever missed their scar.


What treatment options are available for scars?

Depending on the type of scar and skin, different treatments are possible:

Laser treatment: Laser treatment of scars is a particularly effective and proven method and is a special focus in our practice. Treatment is painless. The laser beam, which is electromagnetic waves or amplified light, is aimed at the scar in question. The jet penetrates the top layer of the scar and is absorbed by the water in the skin. The water evaporates immediately, and tissue particles are removed at supersonic speed. In this way, the tissue is removed delicately and precisely in layers.

The ultra-modern equipment in our practice center enables differentiated settings of intensity. Scars in sensitive areas such as the face, neck and décolleté as well as scars on the arms, chest, stomach, back and legs can be treated. The laser pulses are also tailored to the thickness and degree of hardening of the scar. Laser treatments are extremely precise and safe for the patient. Satisfying results can be achieved in just a few sessions.

Injection of cortisone crystals: This treatment is particularly suitable for hypertrophic scars and keloids. This can reduce the collagen production that originally caused the scar. Hard scars become softer.

Chemical peelings: This treatment, which is also known because of cosmetic / aesthetic medicine, is particularly suitable for atrophic scars. Acids that match your skin type are selected and applied to the affected skin. This removes the superficial layers of the skin. During the healing process, the removed layers of skin are replaced by new, fresh skin, which reduces the scar, and the overall appearance of the skin becomes plumper and more even.

Microneedling: This treatment approach is also known in cosmetic / aesthetic medicine and is particularly suitable for atrophic scars. Tiny punctures are created in the skin that stimulate the body's own elastin and collagen synthesis. The blood flow to the skin increases, which means that the skin is better supplied with nutrients. The skin becomes thicker, scars are reduced, pore size decreases, and the end result is a more even and overall firmer surface of the skin.


How is the best possible treatment option determined for me?

During the first medical history consultation, we analyze your scar and skin type. We then select the optimal treatment variant adapted to this scenario. Depending on the size of the scar, treatment can be carried out immediately after the consultation, or a separate appointment will be made for you.

Our own cosmetic team is also available in our practice in Vienna. They can carry out comprehensive cosmetic treatments.

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What should I be aware of after treatment?

On the day of the treatment, we ask you to refrain from sport and sauna. In the case of laser treatment, it is important to ensure that the treated area is not exposed to any friction from clothing. We will also give you a recommendation for an effective and fast wound healing ointment. In addition, we strongly recommended you take particular care to consistently use sun protection.


What costs can I expect?

The initial consultation is estimated to be around EUR 145. Additional costs depend on the treatment option chosen. A chemical peeling costs from EUR 80. For laser treatment, cost will be from EUR 70 additional to the initial consultation.

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review review
  • Thank you Dr Bisschoff. The medicine you prescribed worked like a bom! I appreciate the time you took to descibe my illness in simple terms and the lifestyle changes I need to make to manage my condition. Many thanks! 
    Yelp: Christiaan B.
  • I traveled from London to see Dr. Johannes Bisschof for wrinkle treatment. I was extremely impressed with my wrinkle treatments. He has a very 'natural look' approach and after everyone asked me why I look younger and more relaxed I will definitely have it done again. I have also asked him advice on my skin texture and he suggested 2 creams and my skin has never looked this good. I feel 10 years younger. I can highly recommend him! 
    Yelp: Liezel M.
  • Dr Bisschoff used a laser to treat my skin scars. I was happy with the package that he offered. He is knowledgeable, friendly and I loved the end result.
    Google: Cecile du Toit
  • Dr. Bisschoff was absolutely wonderful and a great help. He took time to make sure I was comfortable, spoke incredible English, and explained everything in a careful and detailed manner. Thanks to his help, my skin condition was solved! I would recommend him to anyone.
  • Best dermatologist in Vienna. Really cares about his patient. He is a very good listener. He spent as much time as its needed and he doesn't rush patient. His aim is actually to help people not only earn money (like some of doctors tend to do). On the top of all of that he is really positive person and he explains everything in the proper manner.



  • Excellent doctor, extremely attentive! One of the best medical experiences I had.
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Scar treatment in Vienna Average rating: 3.43 - of 70 visitors

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