Every three to five years, NHS Lancashire and South Cumbria ICB review its clinical policies to ensure they reflect the latest evidence-based guidance and best practice. We are currently reviewing the following policies and would welcome your views on the proposed changes.
Please share your feedback by completing the short questionnaire.
This policy covers surgery to improve the appearance of scars, making them less noticeable.
Following National Institute for Health and Care Excellence (NICE) guidance the amended policy adds a minimum waiting time, the requirement that conservative therapies are tried before surgery, the requirement for therapy to be delivered via an existing NHS pathway, the requirement for patient counselling, particularly in relation to keloid scars and the addition of exclusions.
The revised policy wording is proposed as follows:
1. Surgical revision of scarring is commissioned when:
a. The scar is causing functional disability, recurrent bleeding or significant pain resulting in functional limitations.
b. 2 years have elapsed to allow full healing of the scar.
c. Less invasive treatments have been tried or are unsuitable.
d. The patient has been fully counselled in relation to the risks and benefits, particularly where there are keloid scars.
e. Revision is delivered through an existing NHS plastic surgery or dermatology pathway.
Exclusions:
· Malignancy investigation and treatment pathways.
· Congenital deformity or trauma reconstruction pathways.
· Management of contractures.
· Management of chronic wound infection.
Removal methods included in this policy section include:
· Surgical excision
· Cauterisation
· Cryosurgery
· Cryotherapy
· Electrodessication and curettage
· Chemical peeling
· Laser destruction
· Dermabrasion
The ICB has noted the recommendation in NICE NG198 that clinicians should ‘consider’ offering CO2 laser or glycolic peel for severe acne scarring. It has also noted the NICE committee statement this is a weak recommendation due to lack of evidence. The ICB has decided not to commission surgical treatment of acne scarring on the basis of the NICE finding that the evidence is limited.
Please note this survey closes at midnight on Saturday, 10 January 2026.