all worry about whether a scar is going to heal into a fine - white line.
There are some major key factors to remember about a scar healing:
Good surgical skill by your surgeon with
closure of the incision
Minimal tension or movement of the surgical
Keeping the incision clean - showing no signs
of a infection
No sunlight or UV light
By maintaining constant
pressure on the wound with special bandages/tape or silicone sheeting pads.
According to several studies, coverings like these help to flatten
scars-including keloids - which are scars with ropy tissue that grows
uncontrollably over their natural boundaries.
Hypertrophic scars occur due to an abnormal response to trauma or injury.
After a wound or an incision from surgery has occurred to the epidermis, both
skin cells and connective tissue cells called fibroblasts begin multiplying to
repair the damage. All scars are made up of “connective tissue” and fibroblasts
to help close the wound.
The hypertrophic scar is one that is widened, but yet
does not extend beyond the original boundaries of the wound or incision. Hypertrophic scars
tend to reach a certain size in which they eventually stabilize or revert and
eventually they might fade with time. Hypertrophic scars normally do not get as
big as keloids either, and can be present in all
racial groups. Treatments for hypertrophic scars include
Silicone Sheetingand creams that seem
to help with the appearance of the scar, and it usually takes 3 months or more
to see an improvement.
Keloids on the other hand are not as common as
hypertrophic scarsand only affect 10% of the people are considered benign tumors.
keloids appearance is raised
red growths above the surface of the epidermis and form large mounds of scar
are nothing more than abnormal scar tissue that grows beyond the boundaries of
the original site of the skin injury the fibroblasts continue to multiply even
after the wound is filled in. The upper chest area, shoulders, and upper back
are all areas where keloids tend to form.
The main trigger for a keloid scar is
inflammation. Anytime the skin is injured in some way - either from a cut,
surgical incision or infection, the healing process begins. When the
healing process starts, it involves a complex array of cells. These mast
cells produce and release "histamine" early in the healing process. It is
the histamine that attracts the fibroblasts. Fibroblasts are cells within
our body that is responsible for the production of collagen. And collagen
is the body's building block for scar formation.
between a person that has normal scar formation and a person that is proned to
keloid scars is that the process where there histamine release occurs from the
mast cells is finished within six weeks. But in a person that has a
tendency for keloids, the histamine signal never stops. This is the
reasoning on why a keloid will itch, because the histamine production is never
turned off completely.
Various symptoms of
Hypertrophic and Keloid Scarring
associated with Keloids and Hypertrophic scars include:
pigmentation of the skin
dome shape shiny scars
the scar can range from pink, red or purple
Treatment of Keloid and Hypertrophic scars include:
Areas of the body
that are involved with high movement, such as the knees and shoulders - are more
likely to develop keloids than other parts of the body. The upper portion
of the chest area (décolleté) is also another area that has a predilection for
keloid production. If keloids develop in these prone areas the chances are
that you developing keloids in the facial and neck area are probably much less.
Hypertrophic scars normally do not get as big as keloids, and can be present in all
racial groups. Keloids however tend to target
racial groups which have a lot of melatonin in their skin, such as African
American, Asian or Pacific Islander.
Dr. Lam talks about the difference of Hypertrophic Scarring and Keloids
The best and first line treatment of a Keloid is to inject long-acting cortisone.
Kenalog and Celestron Soluspan
are steroids that are injectedonce a month. After several injections with
cortisone, the keloid usually becomes less noticeable and flattens out within
three to six months time.
5-FU injections can
also be used alone or in combination with corticosteroid injections into keloid
scars. This treatment stops fibroblasts from making new scar tissue. 5-FU is
also used as a chemotherapy agent normally.
can be risky with a patient that is prone to keloids. If surgery with a scar
revision is considered, some surgeons like to inject steroids or apply a
pressure dressing to the wound site after cutting away the affected keloid.
Radiation is also considered after the excision of the affected area, so the
keloid will not grow back.
Nitrogen is used to destroy tissue of both benign and malignant lesions by the
freezing and re-thawing process. Applying liquid nitrogen does flatten out the
keloid scar and is effective, but the side effect of this treatment is
hyper-pigmentation after the fact.
being used with some success with keloid scars. Interferon has been evaluated
for efficacy in managing many diseases that involve the immune system.
Injections of interferon into the actual keloid have shown promise in reducing
the size of keloids, though it's not yet certain whether that effect will be a
Pulse-dye lasers are also another method of reducing the sign of the keloid scar. These lasers tend to soften up the excessive scar tissue with
making the scar flattened and less red. This treatment is very safe and not
very painful; however it might take several treatments to see an improvement.
Silicone sheeting has helped many patients with their keloid
scarring, however this method of treatment takes several months of wearing a
sheet of silicone gel. Some doctors prefer “compression bandages” which have
helped some see a positive end result. Both methods require a lot of time and
patience on the part of the patient.
Silicone Sheeting has been around since
the early 1980’s, and some patients have seen a remarkable difference in the
appearance of keloid or hypertrophic scarring. Silicone sheeting is soft and
pliable and will mold to any part of the body.
ReJuveness Silicone Sheets
can also last up to 6 months or has been proven effective on old raised red
scars (up to 20 years old) as well as newly formed scars.
ReJuveness silicone sheets are made of
USP medical grade six-silicone which can be cut to any size and shape.
ReJuveness is soft and pliable and easily conforms to any body part. ReJuveness
is proven effective at healing and preventing hypertrophic and keloid scars
resulting from burns, plastic surgery procedures, surgeries, acne, cuts and
Oleeva Clear Transparent Silicone
Sheeting is a silicone
sheeting offering transparency and remarkable stretch and conforming
Oleeva Fabric Silicone Sheeting with Fabric Backing
is a silicone sheeting with a fabric backing. The silky fabric backing makes it
easy to wear under clothing, it also reduces shear force and edge roll-up when
used under pressure garments.
Oleeva Scar Shapes Precut Shapes for Scar
Management Following Surgery
are made from Oleeva Fabric and shaped specifically to treat scarring from
breast, abdominal and other surgical procedures. The designs of these products
ensure proper placement and coverage.
scar treatment sheet is the most cost effective scar care product available when
compared to other scar management methods. Made in the USA of pure medical grade
silicone, 0.6mm thick (the thickness of a credit card), soft and flexible.
Soft, reinforced silicone gel shapes that have been developed to soften and
lighten hypertrophic and keloid scars. The GelShapes are specifically designed
for the treatment of scars resulting from breast lifts,breast reduction,
flap and C-section procedures.
ScarEase Sheets and
ScarEase Gel are indicated for use in the
management of hypertrophic and keloid scars. When used following surgical
procedures, ScarEase may prevent hypertrophic and keloid scarring. ScarEase
Sheets may work better in certain cases, but have use limitations. Since
ScarEase Sheeting is self adhering, it supplies gentle mechanical pressure on
the skin surface. This is a benefit!
Reduces raised, colored and keloid scars. Virtually invisible. Curad Scar
Therapy Clear Pads are virtually invisible. They are perfect for any skin color
as they blend with your natural skin tone.
Scar Guard offers four different treatments for the management of scars
(old and new) – and is the most powerful and effective treatment developed.
It is a clear liquid that forms a fine flexible film within
a few seconds after painting it onto the scar. This film helps to protect the
scar from irritation while delivering silicone cortisone and vitamin E
throughout the day.
BiioCorneum is the
only 100% Silicone Scar Treatment with an SPF providing UVA/UVB Protection.
It minimizes the appearance of scars while protecting them from harmful rays
from the sun. This product is only sold in physician offices and medspas,
and comes in different product sizes 10g, 20g and 50g gel. BioCorneum
dries within minutes forming an invisible silicone sheet over the affected area.
This breathable, flexible, waterproof layer binds with the stratum corneum (the
outer layer of dead skin cells) - providing hydration and protection to
underlying tissue allowing the scar to mature through normal collagen synthesis
efficacy in both prevention and treatment, with over 1,800 patients in published
ScarEase Gel can be used to manage both old
and new scars resulting from burns, surgical procedures and traumatic events.
Most people like ScarEase Gel better than ScarEase Sheets because it is "easier
works to help flatten, even, and fade dark or discolored skin while providing
healing qualities for scars - old or
new, caused by acne, surgery or trauma to the skin and stretch marks.
Results are permanent and may be seen in as little as 4-6 weeks with full
results in 3-9 months.
is a combination of recent advancements in lipid and trans-dermal technology.
Post surgical patients and clinicians are reporting accelerated healing and in
many a near scar-less appearance at the lesion site.
as a silicone gel and also a new cream, which has a SPF-30 in it to protect the
scar from the sun. The main ingredient is Cepalin, which is a proprietary
botanical extract which comes from onions.
Image courtesy of Mederma
According to a small pilot study
evaluating topical onion extract as treatment for post-surgical scars –
PubMed – August 25, 1999, authors B.A. Jackson and A.J.
Shelton, found that this main ingredient in Mederma concluded the following:
“Topical onion gel extract was ineffective in improving scar erythema and
pruritus in our patients.” Most patients who have tried Mederma have suffered
some sort of allergic reaction to it because of the onion extract, making the
scars more angry looking than before treatment.”
helps by working on the
collagen fibers and makes a scar softer and more pliable. However, in a double
blind study, found that Vitamin E was indeed ineffective in reducing the
symptoms of a hypertrophic scar or keloid.
is a specialist skin care product that is recommended for scars, stretch marks,
uneven skin tone, aging, and dehydrated skin. It is formulated for use on both
the face and body. product
has improved the appearance of regular scars tremendously; however has very
little effect on hypertrophic scars or keloids.
Acid or Tretinoin is derived from Vitamin A. Retinol, which is a less potent
form of Retin-A also has some very strong medical studies backing the
effectiveness of this type of topical cream to help with scar formation.
There is also the less
potent over the counter products called Retinol. After your surgical wound has
closed up completely, applying Retin-A to the scar fades out the redness it
might have and helps with exfoliating the area.
At first, Retin-A can
actually make the area look worse with redness, flakiness and peeling, for up to
eight weeks. But by 24 weeks, patients will see dramatic marked
along with the application of steri-strips helps with keeping tension off of the
incision site, so a thin scar will form.