It’s almost Halloween and our minds are conjuring up images of witches, warlocks, ghosts, goblins, and childhood frights. In my own adolescence, my first knowledge of such scariness was when the older kids embellished stories about a man named Freddy Kreuger. After an earful of frightening tales of this fellow whom kids said lived in our neighborhood, I had many a sleepless night. It wasn’t till a few years later that I discovered the movies Nightmare on Elm Street, and realized Freddy was not my neighbor, but rather, a fictitious Hollywood boogey-man (Thank Goodness!). But his scarred hairless face is one that penetrates the realm of fear convincingly and leaves memorable marks.
Interestingly enough, skin plagued by scarring is a common physical feature of many horror movie characters. However, in real life, scars can leave a lasting impression not only in physical appearance but also self-esteem. Not to fret though….nowadays there are many advanced procedures, surgeries, and medications to improve the appearance of scars. Although skin may never appear perfect after an injury, it can be decreased through time, patience, and the right treatments as you can explore below.
Proper Wound Care to Minimize Scarring
Scars can arise from cuts, burns, injuries, poor wound healing, or disease processes. The appearance of such is dependent on the type of injury and its depth, age, ethnicity, genetics, and care of the wound.
Proper wound care can be a great foundation to prevent scarring. Current research advises that keeping a wound moist and scab free serves to accommodate new skin cell growth easily across the surface barrier. After a week of Polysporin and daily cleaning with soap and water, wounds can be switched to Vaseline with a bandage until healed.
Don’t forget to keep healing skin protected from UVB injury through use of an SPF 30 or higher sunscreen. Wounds may take 2-4 weeks to mend in most healthy people. However, for the elderly, especially with lower leg sores, it may take 6-8 weeks for a mild to moderate injury to recover, and months if thick in nature.
After a 2-3 week healing period, massage of the area to break up scar tissue is optimal. A topical anti-scarring agent may then be used to accommodate this.
There are a lot of scar products out there, but only a few research proven ingredients that work. Topicals with silicone, alkanolamines (dimethylaminoethanol, isopropanolamine, ethylethanolamine, etc), onion extract, pentoxyfylline, and dimethicone are the work horses of the OTC market. Silicone is often impregnated in gel sheets like the brand Rejuveskin Scar Heal Therapy, which also serves to create a moist wound environment. This brand comes in multiple sizes to fit post-surgical wounds (even breast augmentation/nipple bandages and tummy-tuck patch sizes available) or small abrasions. ScarAway gel sheets are also a good option carrying a reusable product with skin tone manufacturing. Mederma employs onion bulb extract, which has shown significance in reducing scar tissue with anti-bacterial, anti-inflammatory, and anti-histamine properties. ScarRid gel proposes a different active ingredient with Cyclopentasiloxane, Dimethicone, Dimethiconol, Aloe, and Sunflower oil to promote a protective barrier, sooth inflammation, and generate moisture.
Medical grade Manuka Honey is the newest player on the block. It is considered antibacterial and has been found to help wounds/burns/ulcers to heal significantly faster.
Although widely popular, Vitamin E oil does not have significant research to back its claims as an anti-scar therapy. In fact, there have been some research studies that advise it may worsen scars or cause and allergic rash, thus alternatives would be advisable.
Various prescription medications are used to treat scarring, ranging from pharmaceutical standards to compounded topicals. A few popular brands are silicone gel treatments like Recedo, Celacyn, which has a dimethicone and hypochlorous acid base, and Bionect a hyaluronic acid which is used often off label for wound healing. Compounded medications offer prescription grade ingredients mixed with unique chemicals like Tranilast, hydrocortisone, pentoxyfylline, or pracasil; all identified as having unique wound healing properties.
Make a visit with your local esthetician or Dermatology provider to explore modalities which target destruction of scar tissue and regeneration of new skin. Procedures like the skin resurfacing of microdermabrasion or chemical peels promote exfoliation of old tissue and regrowth of new. Yet, the hot new procedure that’s wowing patients now, is Micro-needling. This method is used to cause microscopic damage in order to rejuvenate new skin. Pulsed-dye lasers are also an efficient medium in correcting new and even some old scar tissue by catalyzing collagen formation. For a more comprehensive approach to scarring, non-ablative lasers can smooth surfaces without marring the skin surface, but can be a little more intense and invasive. Maximized efforts can be obtained with ablative lasers like CO2 and erbium which vaporize scar tissue and smooth skin surface, but expect a much more concentrated response with longer necessitated healing time.
Cortisone injections of scar tissue, like keloids, is also utilized for its effect of tissue thinning, but multiple injections are needed over several months.
Skin grafts or surgical removal would be options for extensive scarring or burns. This is a more extreme treatment modality used for injury of large surfaces or for body areas that have impaired functioning due to injury. Consult with a plastic surgeon for such procedures.
*The information provided above or in any blogs on this site is for educational purposes only. It does not replace advice or necessary examination and diagnosis from your healthcare clinician. Please see your healthcare provider for any and all concerns with changes in your health or treatment of disease.*