An early diagnosis and specific treatment is important to prevent the disfiguring scars caused by monkeypox

Dr Vikas Sharma

WHO has issued warning about the latest viral disorder – monkeypox. The most significant manifestations of monkey pox are on the largest organ system- skin.

One thing that everyone dreads is a cosmetically disfiguring facial scar. They can cause pain, inconvenience, and self-consciousness to a person thus affecting his/her quality of life.

In monkeypox, the skin lesions are in the form of vesicular lesions which later on lead to crust formation and then scars. Many other disorders like nodulocystic acne, trauma, surgical procedures, sports injuries and viral infections such as Varicella (chicken pox), herpes along with monkeypox can lead to skin scarring.

In severe cases, skin scars can even limit a person’s mobility. The extent of scarring is based on the severity of the original skin lesions, the delay in treating the skin disorder and also on interplay of hormones and genes.

An early diagnosis and specific treatment is of paramount importance to prevent the disfiguring scars. Your goal should always be to calm inflammation and avoid doing anything that will further irritate your skin.

Some people are more prone to scarring while others come through a case of severe facial skin disorder without a scar in sight. A proper knowledge of skin care during and post infection is thus of paramount importance.

Types of scars

Scars are areas of fibrous tissue that replace normal skin after an inflammatory insult. There are two broad classifications of facial scarring: atrophic and hypertrophic.

An atrophic scar takes the form of a sunken recess in the skin, which has a pitted appearance. These are caused when underlying structures supporting the skin, such as fat or muscle, are lost. This type of scarring is often associated with acne, chicken pox, monkeypox, surgery or accidents.

Atrophic facial scarring is divided into four main types: ice-pick, boxcar, shallow/atrophic and valley/rolling scars. Valley scars (rolling scars) are deeper and have an undulating appearance that is best appreciated in indirect lighting. Because acne, monkeypox and chicken pox scars are dermal defects, they require a treatment modality that reaches the dermis in order to achieve clinical improvement. Hypertrophic scars occur when the skin overproduces collagen, which causes the scar to be raised above the skin. Keloid scars are a serious form of scarring.

Erasing the marks

Fortunately, most scars are treatable. After analyzing the type of skin scar, the treatment option for facial scars is planned. The various treatment options include surgical scar revision, laser scar reduction, micro-dermabrasion, intralesional injections, pressure therapy, injectable collagen, fat transplant, multi-needle radiofrequency, fillers and silicone gel are among the many choices for facial scar management. Laser scar reduction offers a non-invasive solution that uses fractional laser technology to deliver rapid, reliable scar reduction with less risk, less pain and minimal downtime. Raised and reddened scars can be treated using a pulsed dye laser, while atrophic/angular scars are best treated using fractional laser skin resurfacing.

(Dr Sharma is a Chandigarh-based dermatologist)

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