Exodontia.Info
Scars & Their Treatment
What are scars?

Scars are produced as part of the body's normal healing
process.

No matter how careful or meticulous the repair after an
accident or operation, there is always a permanent and
visible mark.

The quality of the
scar varies from one individual to another
and from one part of the body to another.  It is impossible to
be sure how a
scar will eventually look.  The scar may be
very stretched or may at first be irregular and become
smoother with the passage of time.

The
scar may become redder, harder and more raised (up to
4 months post-injury) but will hopefully settle over a period of
12 - 18 months, when it becomes more supple, flat and pale
(it has ‘matured’).


Looking after your scar

Massage can help to heal scars.  It reduces the tendency for
the skin to stick to any underlying structures and is thought to
speed up the healing process, reducing the redness and
irregularity.

Massage should involve moving the
scar on the underlying
structures rather than rubbing the surface of the
scar itself.  
For best results this should be repeated for 5-10 minutes,
several times a day, perhaps after washing and bathing.  
Lanolin, Vitamin E oil or a neutral moisturiser can help to
lubricate the wound during the massage.

You will need to wait until the
scar is strong enough before
you begin massaging.  It is wise to ask the doctor or nurse
after the stitches are removed when the best time to start
massaging the scar is.

Protecting your scar from sunlight

Scars are more prone than normal skin to injury from sunlight.

It is best to avoid exposing a
scar to strong, direct sunlight
for the first 12 - 18 months following injury.  A sun-block
cream with a high
SPF (Sun Protection Factor > 30) and a
wide-brimmed hat for scars on the face will help if you
cannot avoid going out in the sun.

If scars are allowed to tan, they may fade to leave a mottled,
patchy appearance.  Scars often itch in the heat so staying
out of direct sunlight may increase comfort.


Treatment For New Scars

Steroids

Giving steroids by injection is one of the oldest and most-
established approaches to treating scars.

The drawbacks of this treatment are the number of side
effects brought about by repeated injections (
pain; infection;
localised skin death; dilated superficial blood vessels and
the
depressing of the scar) and the frequent occurrence of
de-pigmentation (white patches on the skin).

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

Although NSAIDS have been used to prevent internal scarring
in arthritis for many years, they have only recently been used
for treating
hypertrophic and keloid scars.

Research has found that
salicylate compounds (as used in
acne) applied directly is very effective on new scars.  Using
salicylate this way should be done under a doctor's guidance
since some patients, particularly asthmatics, may develop
sensitivity to the drug.

Anti-Histamines

These are commonly used to control the itching caused by
new scars but they do have other anti-scar properties.

Anti-histamines subdue the inflammatory response resulting
in a smaller and more comfortable scar.  Patients taking
anti-
histamines
are less likely to scratch their scars which
reduces the scar growth rate and high-dose
anti-histamines
can slow down the production of
collagen in the skin (which
is responsible for scar formation).

Elastic Wraps

Elastic support and clothing are commonly used in scar
prevention
.  The drawbacks are that they retain heat and
restrict movement.

Gel dressing

Sheets of hydrogel and silicone dressings are sometimes
used to prevent excessive scarring.  They increase the
moisture in the skin over the
scar and affect the scar
temperature
.

They can be used in conjunction with
anti-inflammatory
creams
and ointments to lessen scarring, and are available
in some chemists.


Treatment for Old Scars

Mechanical tension blockers

Several drugs commonly used to treat high blood pressure
can be used to cause the breakdown of older 'settled'
scars.  
Calcium channel blockers’ injected into the scar can
encourage the
scar to break down.

Surgical Removal / Scar Revision

Surgical removal is usually only used for big scars that are
unlikely to fade using any of the methods listed above over a
reasonable time period.  Surgery can also help
scars that
harbour infection and
scars that hamper movement.

This kind of precise surgery has to be supported by
additional measures to reduce swelling, ease skin tension
and other factors in order that further scarring doesn't occur.

Use of lasers and other burning methods

Laser use and other burning techniques have been used for
scar removal but as yet there is not enough evidence to
support them as a reliable method for treatment and their
use is still considered controversial.


Useful Websites:

British Association of Plastic Surgeons

American Society of Plastic Surgeons

European Tissue Repair Society

UK Wound Care Society

Dermatix

Kelo-Care
Last Updated 2nd March 2011