Depending upon the nature of the scars on your abdomen, scar revision surgery may be an option for you. Generally this involves excision of the scar and careful reclosure of the wound and may be done under local or general anesthesia, depending upon the size of the scars. Scar revision is an attempt to improve the appearance or decrease the visibility of the scar, but cannot completely remove a scar, as a new scar forms at the location of the revision surgery. To see if you are a candidate for this type of procedure, a plastic surgeon would need to examine the scar and then discuss your treatment options and the likelihood of improvement.

There is no easy answer to your question. The plastic surgeon would need to see the scars, their size, quality and location prior to telling you what to do. Many options are available - too numerous to list without seeing the patient in person. The best thing to do is to set up an appointment with a plastic surgeon so that he/she can assess the quality of the scars and suggest what to do. Scars can often be improved, but they are not totally erased.

This is an example of why it is not a good idea to “pick at” scabs on the face. What has occurred is that the wound had penetrated to the deep dermal layer of the skin, which is the layer forming scar tissue and hence the depression. The cells forming the skin’s pigmentation have also been destroyed. There are now two problems to address: 1) depressed skin and 2) hypopigmentation (loss of skin color). There is a laser at 290-320nm called the “Relume” by Lumenis (Lumenis.com) which can restore pigment in an area. A simpler approach, of course, is just to use make-up. The depression can be raised with a filler such as Restylane, or one could attempt to build up collagen in the area with a laser called the “Titan” by Cutera.

There have been some promising advances in the laser treatment of leg veins. I personally use the laser to treat vessels up to 3mm in size and then use a combination of injections and laser for larger vessels. Either way I tell patients they may need at least 2 sessions to eliminate the vessels of concern. Presently the 1064nm laser is the most exciting technology; doctors are seeing nice improvement in elimination of the vessels. You must remember that the treatment for leg veins may vary from physician to physician with regard to lasers versus injections. The important thing is that you go to a board-certified plastic surgeon who has experience in treating leg telangectasias.

Plastic surgeons use many different lasers that utilize light energy in different ways. Some resurface the outer layers of the skin and some are designed to penetrate deeper to work on blood vessels or pigment below the skin surface. An evaluation by a surgeon is necessary to determine the exact nature of your problem. Generally, resurfacing is not recommended on the extremities. Certain vascular lesions are often treated. Pigmentation problems will probably not be amenable to treatment with lasers. I am concerned about your diabetes. An individual's response to injury can be affected by diabetes, since the lasers create a controlled wound. An individual's inability to heal properly may lead to unacceptable results from a procedure that was used successfully in others. Lactinol is generally prescribed for the treatment of very dry skin. It is not likely to lighten pigmented areas.

Laser resurfacing may be helpful in reducing increased pigmentation around the eyes. In addition, it may improve or eliminate fine wrinkles. People with light complexions are usually better candidates. Recovery time is about a week before cover-up makeup can be applied.