The skin consists of three main layers: the epiderms (E), the dermis (D), and the subcutaneous (F).
Asian skin texture and thickness vary widely, but the dermis tends to be noticeably thicker and more fibrous, especially in those people with darker pigmentation. However, even Asian people with lighter milky skin tones tend to have greater collagen density than comparably pale non-Asians.
This higher collagen density in the dermis is associated with a more vigorous response to healing after injury or surgical incisions. Prolonged redness and scar thickness (hypertrophic scarring) are thus more common than in the Occidental population, even in Asians with light natural pigmentation.
Keloid formation may sometimes occur in thicker skin under prolonged tension after surgery, but it is rare in thin skin such as on the eyelids.
Traditional skin resurfacing with ablative (disruptive to the epidermis and sometimes dermis skin layers) lasers like the carbon dioxide laser or deeper chemical peels has generally been avoided due to unacceptably long healing times, more redness, uneven pigmentation, temporary overpigmentation, permanent underpigmentation, and scarring.
Newer non-ablative lasers and other energy sources such as pulsed light appear to be safer choices for less noticeable skin disorders.
Strict avoidance of direct sunlight, use of sunscreens, and use of bleaching agents may help to lessen the chance of irregular pigmentary outcomes after surgical skin incisions.
Careful wound cleaning, early removal of sutures, later moisturization, and, if indicated, injection of a weak steroid medication into the healing wound may help to lessen scarring. The effectiveness of over-the-counter commercial scar reducing products is not truly proven.