Scar Care Guide

What are scars?

When your skin gets injured, it goes through a healing process. Sometimes, this healing can lead to scars, which are areas of thicker tissue. 

The two main types of scars are hypertrophic scars and keloids.

Both types of scars are caused by the skin healing in a way that produces too much collagen (a protein that helps in healing). This can happen after injuries, surgeries, or even acne.

Similarities

Raised and firm: Both hypertrophic scars and keloids are raised and feel firm to the touch.

Differences
  • Hypertrophic Scars: These stay within the area of the injury and can shrink over time.
  • Keloids: These extend beyond the original injury site and do not shrink. They are more likely to run in families and are more common in people with darker skin.

Symptoms

They can be itchy, painful, and may limit movement.

  • Hypertrophic Scars: Usually develop soon after an injury and may get bigger before gradually getting smaller.
  • Keloids: Can take years to form and are less likely to go away on their own and can return after treatment.

Treatment Options
  1. RNA Scar Patch: A new treatment that uses RNA technology to target scar formation. Sometimes combined with other treatments. 
  2. Compression Therapy: Wearing special dressings can help reduce scar formation. They work best right after an injury. 
  3. Steroid Injections: These help reduce collagen production and inflammation. Repeated injections are needed and the doctor will monitor for side effects of thin skin and prominent blood vessels. 
  4. Surgery: Removing the scar can work, but keloids often recur. Combining surgery with other treatments may help. 
  5. Cryotherapy: Freezing the scar with liquid nitrogen may reduce its size, especially for smaller scars. 
  6. Laser: Pulse dye laser can be used to reduce redness and inflammation. Fractional carbon dioxide laser has been used to create micro-injuries to stimulate collagen remodelling.

Doctors often use a combination of the above treatments to optimize managment. Always consult a healthcare professional to get a diagnosis and medical treatments.

Scar Management Tips

All wounds and surgeries result in scars as part of the body’s natural healing process. The maturation of scars can take up to 2 years. Once the wound has healed, specific treatments can improve the appearance of the scar and prevent it from adhering to underlying structures.

General Scar Care
  1. Wound Hygiene: Keep your wound clean to prevent infections, which can exacerbate scarring. Proper wound care reduces infection risks and supports optimal healing conditions.
  2. Healthy Lifestyle: Maintain a healthy diet and avoid smoking to promote better wound healing and scar formation. Nutritional support and avoiding harmful habits like smoking enhance tissue repair and reduce complications.
  3. Monitor Scars: Watch for signs of problem scars, such as redness, enlargement or being raised, itching, or pain, especially in the first three months. Early identification of exuberant/excessive scarring can facilitate timely intervention.

Moisturizing
  1. Regular Application: Scar tissue loses moisture faster than normal skin. Regularly moisturizing reduces itching and prevents cracking. Keeping the scar hydrated is useful for maintaining skin elasticity and barrier function.
  2. Recommended Products: Use unperfumed thicker creams or ointments. These products provide effective hydration without irritating the scar tissue.

Sun Protection
  1. Avoid Sun Exposure: Newly healed scars should be protected from the sun to prevent pigmentation changes. UV radiation can darken scars, making them more noticeable.
  2. Use Sunscreen: Apply a high SPF (50+) sunscreen on the scar whenever exposed to the sun. Sunscreen helps shield the scar from harmful UV rays, minimizing discoloration.
  3. Protective Clothing: Wear protective clothing, hats, or other accessories to cover scars. Physical barriers provide additional protection against UV exposure.

Exercise and Stretching
  1. Exercise and stretch the area of wounding/scarring only after the wound has healed and closed completely.
  2. In the first month, avoid stretching the new scar.
  3. Maintain Movement at joints: For scars at the joints, regular exercise and stretching helps maintain joint movement. Physical activity supports flexibility and prevents contractures around joints.

Problem Scars
  1. Identification: A scar may be problematic if it is red, raised, itchy, painful, or restricts movement. Hypertrophic and keloid scars are most common types of excessive scarring. Recognizing these signs early is important for instituting early intervention.
  2. Risk Factors: Higher risk includes having certain skin types (e.g., Mediterranean, Asian, African), delayed wound healing, or a history of problematic scars. Preventive strategies can be instituted especially for people at risk of problematic scarring.
  3. Prevention: Application of the BioRNA Micro-Tips antiscar patch in new scars (after stitches were removed) has been shown to result in flatter scars. If unavailable, silicone gel sheets may be applied.
  4. Early Intervention: Contact your doctor or occupational therapist when signs of a problem scar occur. Treatment may be instituted, such as injection of steroids into keloids.

Always consult with healthcare professionals before starting any new treatments to ensure they are appropriate for your specific situation.

Source:  The Scar Care Alliance and Research (SCAR)