Scars can be trophies or triggers depending almost entirely on how you got them. I’ve been mostly proud of the scars I’ve achieved in my life—the one near my knee from a life-affirming play-offs game in middle school, the long thin, scratch-like one my pet bunny gave me in the fourth grade, and especially the bikini-line c-section scars from my first four children. It was the last c-section scar with baby number five, that turned to a trigger though.
Baby number five is a superhero in her own right—the living trophy I’ll be forever grateful for—but my battle with a near-deadly placenta accreta and previa left me with an enormously uneven vertical c-section scar that even months after my daughter was born would give me pretty traumatic flashbacks just from feeling it rub against the seam of my leggings, the top of my skirt, or the rigid fly of my denim.
That labor came on fast, furious, and with a slim chance of me making it out—so neat incisions and careful stitches were a luxury I couldn’t access at the time. I was sewn back together in a sort of Franken-mom kind of way, half-hacked, part stapled, and very much unevenly. It really didn’t matter much at the time—I was alive, my baby was alive, and I beat the odds. What’s a little scar tissue? Until you can’t really push it to the back of your head when you’re standing in line at the post office, shopping for diapers at the supermarket, or just going about your day. That’s when your trophy becomes a trigger.
I’m a lucky girl though, because after hearing my story, a top New York dermatologist, Doris Day MD, said she’d try just about every magic trick up her sleeve to smooth, flatten, and reduce the appearance of my uneven scar tissue. I hadn’t read her book, Beyond Beautiful, before she started treating me—but I soon learned that making the connection between aesthetics and emotional well-being is the crux of her entire practice after dealing with the loss of her sister at a young age to cancer.
I expected Dr. Day to whip out an arsenal of lasers and IPL, maybe some serums, creams, and lotions loaded with buzz-worthy growth factors—but her use of off-label topical Sculptra on my bumpy, uneven scar tissue was enough to shock a veteran beauty writer like myself. The first time she brought out her little syringe of Sculptra to treat my eight inches-long abdominal scar, I wondered where the needle was. How would she be able to get the syringe full of gooey collagen-helping Sculptra into my scar tissue?
Dr. Day, as it turns out, isn’t just a Clinical Associate Professor of Dermatology at NYU Langone Health and book author—she’s the kind of creative mad scientist every forlorn and emotionally exhausted patient is searching for. To her, there are no bounds on ideas and inventive ways to use tried-and-true products like Sculptra, which is mostly famous for distributing plump, peach emoji-esque Kardashian-like butt cheeks to those born without quite enough junk in their beloved and trendy trunks.
She explained to me that, “Sculptra is made of poly-l lactic acid, which is in the sugar gamily is also found in absorbable stitches. When it makes its way into tissue it goes to work stimulating your body’s own collagen, which is how you’d get the plumping effect.”
Using topical Sculptra is still very-much off-label though, and Dr. Day cautions against using her pioneering idea on its own because scars like mine are also discolored, offering a smattering of reddish, purplish, and brownish pigments, as well as atrophic and hypertrophic segments. In regular people speak, that means crazy discoloration and nooks and crannies need a combination of lasers and Sculptra—not necessarily one or the other.
“Using a combination of IPL to decrease the scar’s redness and to modify the blood supply that’s feeding the scar tissue, fractional CO2 laser treatment to stimulate proper collagen production and to decrease scar tissue production, and topical Sculptra application has helped reduce the bright red post-surgery color and most obvious textural issues,” she shared at my last visit. “Biostimulants such as topical Sculptra may help normalize skin cell production, which in turn can help erase the scar. Sometimes I also do microneedling with topical Sculptra instead, or alternating with the laser, depending on the skin type and the specific scar I’m treating.”
If you’ve never had a CO2 laser treatment which is typically referred to by the brand name Fraxel (although there are lots of other great CO2 laser machines out there), the treatment itself leaves the affected skin mildly wounded in an effort to give it a chance to spruce itself up and make some better-than-ever new collagen. The open, nearly raw-feeling top layer of skin then becomes a perfect channel to soak up collagen-boosting Sculptra.
Is using Sculptra absolutely necessary to treat a scar? Probably not, but the difference is seen in the time spent waiting for a scar to feel more like pre-trauma tissue. “Laser treatments alone may work, but by combining the treatments I’m able to get faster results with the treatments and to optimize the outcome,” says Dr. Day.
Dr. Day uses this combined method on stretch marks, acne scarring, rejuvenation, and a variety of other concerns in her New York office. The results have been significant on my own scar, and faster than I expected. I noticed the nooks and crannies on the long, vertical scar were less pronounced a few days post-treatment.
I’d be lying to you if I said I noticed immediate results—I didn’t. The CO2 laser left my scar tissue speckled with post-treatment dots, redness, and tiny scabs, but by the time those subsided I noticed the newly healed skin was softer, more even, and more similar in tone to the skin around it. By the second treatment, I noticed the little hollows where the first batch of Sculptra gathered into pools on my scar were nearly gone. The age-old it’ll get worse before it gets better saying rings true with treating scars in this abrasive, disruptive way, but if you can weather the weird-looking skin storm for a few days, by the end of a week you’ll be happy took the chance.
“The outcomes and number of treatments vary depending on the type of scar I’m treating as well as other factors such as the depth of the scar, its location, and patient genetics. Each patient and each scar requires a personalized unique approach,” contends Dr. Day.
I still have a few more treatments to go, but in the meantime, I’ll be spreading the topical Sculptra gospel until Dr. Day finds yet another way to reinvent sliced bread.