Managing Your Scar
Written by Jackie Leyrer, PA-C
“Will I have a scar?” A common question we hear from patients in response to a necessary biopsy or surgery, out of concern for a good cosmetic outcome. The simple answer is most wounds, except for small or minor wounds, will result in some degree of scarring.
What is a scar?
A scar forms in response to an injury. It is the skin’s natural way of repairing itself. When skin is injured, the body creates new tissue made of a protein known as collagen to help re-heal itself. Scars tend to have different texture and quality than the surrounding tissue due to the buildup of collagen. Its appearance and its treatment depend on multiple factors.
What causes a scar?
Scars can be the result of infection, injury, surgery, inflammation or skin conditions such as acne.
Types:
· Hypertrophic – raised scars that flatten over time and stay within the area of the wound
· Keloid – raised scars that spread beyond the area of the wound
· Contracture – scars over joints/muscles that inhibit movement (burn injury)
· Depressed (Atrophic) – sunken scars that worsen over time (acne, chicken pox)
· Stretch Marks – result from expanded skin (pregnancy, growth spurts)
Scars can be raised, flat, depressed or pigmented. A scars appearance depends on several factors, including:
· Injury or event that caused the scar.
· Size, severity and location of the wound.
· Treatment you received for the wound, such as stitches.
· Your age, genes (your inherited tendency to scar), ethnicity and overall health.
Prevention
· Keep wounds moist: wash with warm soapy water or hydrogen peroxide and apply plain petroleum to avoid scabbing in the early days of wound healing.
· Avoid stretching/tension on the wound such as overexerting yourself days after a procedure. If the wound required stitches, remove the sutures in a timely manner, as advised by your healthcare provider.
· Apply sunscreen after the wound has healed to prevent discoloration.
Treatment
Although there is no cure for scars, with time, scars fade and there are some treatments that can help improve the appearance of scars or provide symptomatic relief.
Massage – decreases the buildup of scar tissue
o Vertical, circular, horizontal motions 2-3 times daily for 5-10 minutes each
o Note: massage is not effective on scars more than 2 years old
Topicals (avoid on open wounds)
o Silicone Sheets/Gel
To be effective, use 12 to 24 hours per day for two to three months
Ex: Scar Away
o Vitamin E Oil
o Onion Extract Products (Mederma)
Intralesional Steroid Injections
Pulsed Dye Laser
Microneedling
Dermabrasion
Surgical Scar Revision
In my opinion, the best thing you can do for your scar is give it time, massage it daily, and apply silicone sheets found at your local retailer. These three things are cheap and effective in improving the appearance of scars!