Deliberate self-harm scars treatment methods systemization:  a literature overview

Gratas Šepetys1, Nerijus Jakutis1,2

1Faculty of Medicine, Vilnius University, Vilnius, Lithuania

2Clinic of Rheumatology, Orthopedics, Traumatology and Reconstructive Surgery, Vilnius University, Vilnius, Lithuania


Introduction. Self-harm is a deliberate injury to oneself with no intention of suicide. Self-induced sharp cut injuries is one of the most prevalent forms of self-harm. Consequent scars hinder social integration and reduce the quality of life. Aim. Systematize possible treatment modalities for deliberate self-harm scars and evaluation methods of consequent results. Material and methods. Publications were discovered via specialized search engine Google Scholar. Keywords used: deliberate self-harm, scars, treatment. Inclusion criteria employed: article was published during the period of 2009 – 2022, it is written in English, treatment modalities were applied to patients with self-harm scars. Articles that did not fall into the aforementioned time period, conference abstracts and identical publications were excluded. Ultimately, 14 scientific articles were included in this literature review. Results. Treatment of deliberate self-harm scars consists of 8 non-invasive or mildly invasive methods and 5 different surgical techniques. Cosmetics, medical camouflage, elastic bandages, long sleeve tops are temporary and inconvenient. Silicone gel, steroid injection, microneedling are typically futile due to the specific physiology of self-harm scars. Nevertheless, erbium glass 1565 nm laser therapy is effective in achieving less conspicuous marks. Skin graft surgery is the sole strategy for concealing self-inflicted scars and their mechanism of origin entirely. Excision of the scar is inadequate since a new virtually identical scar will replace the former one. Various combinations of non-invasive or mildly invasive and surgical procedures are possible. Treatment results can be assessed by 6 subjective and 1 objective methods. Patient’s psychological state ought to be assessed initially. Conclusion. Multiple treatment modalities are available, however, none of them is exceptionally successful. Every clinical case has to be evaluated individually to achieve the best possible outcome. Subjective, objective assessment of the results is paramount in determining the most effective treatment modality. 

Keywords. Deliberate self-harm, scars, treatment.