MEDICAL SUPERVISION

It is important to realise that no scar can ever be removed completely. All scars are permanent, though they may improve naturally over a period of time. Sometimes it is possible to improve the appearance of a scar by surgical removal or other scar therapies. Listed below are the main recognised scar therapies that are used by the medical profession to improve the appearance of scars. More information is available from your doctor or dermatologist.

SURGERY

Any surgical removal will always leave a new scar that will take up to two years to mature. Surgery will never remove a scar but can be used to alter its position, alignment or shape. Sometimes, surgery will actually make the scar longer; although its appearance is improved overall. This is particularly important to bear in mind when the scar is in a visible location (e.g. face). Surgery may be necessary to release a tight scar near a joint that is restricting movement. In the case of hypertrophic and keloid scars, there is a very high risk of recurrence of excessive scarring following surgery.

LASER SURGERY & RESURFACING

Like surgery, the role of laser surgery in the management of scars is limited. The colour of a red scar may be improved by management with a vascular laser. It has also been suggested that removing the surface layers of the skin with a carbon dioxide laser may help to flatten scars. However, there are very few long-term studies to prove the effectiveness and safety of this therapy. It is important to establish that a fully trained medical practitioner carries out any laser therapy with experience in improving scars.

STEROID INJECTIONS

A course of steroid injections will help to soften and flatten a hypertrophic or keloid scar. The steroid is injected into the scar itself and very little is absorbed into the blood stream, so side effects are minimal. Injections are repeated at 4 to 6 week intervals and are given under medical supervision.

PRESSURE GARMENTS

Pressure garments are only used under supervision by a medical professional. They are most often used for burn scars that cover a large area and are only effective on recent scars. Pressure garments are tight fitting and are usually custom-made from an elastic material. They work best when worn 24 hours a day for 6 to 12 months. How they work is not understood, though it may be that continuous pressure on the surface blood vessels plays a part. Over a period of months, the scars soften, flatten and become paler.

RADIOTHERAPY

Low-dose, superficial radiotherapy may reduce the recurrence rate of hypertrophic and keloid scars after surgery. It is effective in about 70% of cases but is reserved for the most serious cases because of the possibility of long-term side effects.

CRYOTHERAPY

Cryotherapy is a technique that uses specialist equipment to freeze the scar tissue using liquid Nitrogen. Research suggests that this technique is only effective in around 30% of cases and it is mainly used to improve scars on the shoulders or back.

DERMABRASION

Dermabrasion can be used to reduce irregularities in the skin surface associated with scarring. This involves the removal of the surface of the skin with specialist equipment and usually involves a general anaesthetic. It may be helpful where the scar is raised above the level of the surrounding skin but is less useful when the scar is sunken or pitted.

LIPOSUCTION

Liposuction involves the removal of normal fat from beneath the skin. This has a limited role in evening out the contour around a sunken scar

COLLAGEN INJECTIONS

Collagen can be injected beneath a sunken scar in order to build up the level of the skin. However, the effect is temporary and injections need to be repeated at regular intervals. There is also a risk of allergic reactions.

SILICONE GEL SHEETS

Widely used in the therapies of red and raised scars by occupational therapists, dermatologists, physiotherapists, plastic surgeons and other medical professionals. See under Therapies for Self Use for more information.

SCAR THERAPIES for SELF USE

Listed below are the main therapies which you can use yourself to improve the appearance of scars.

SILICONE GEL SHEETS

Silicone gel sheeting was developed in the 1980's and has been used by over 1 million people throughout the world. Both waterproof and flexible, silicone gel sheets look and feel like transparent gelatine and work by flattening, softening and fading red and raised scars. Being flexible, they are comfortable to wear and easy to apply, even on awkward areas such as joints. The sheet is easily cut to fit the scar.

Current research indicates that silicone gel sheeting works by moisturising and covering the scar area. This helps to reduce the size and improve the colour of a scar and can improve elasticity of the tissue. Research also indicates that improvements in the appearance of scars are permanent.

Cica-Care is an advanced form of silicone in an adhesive gel sheet which is used by the medical profession to reduce red or dark and raised scars. It has recently been made available in pharmacies for people to buy and use themselves. Cica-Care reduces both new and old scars, red and raised scars and is safe for use by all members of the family. Tests indicate that the average improvement time should be between 2 - 4 months.

VITAMIN E CREAM

Although Vitamin E Cream is sometimes recommended for the self-management of scars, there is no medical evidence to suggest that it has an effect.

COSMETIC CAMOUFLAGE

Cosmetic camouflage is not a scar therapy as such but it can be a very effective way of disguising a scar, birth mark, 'port wine' mark or vitiligo (a condition which destroys pigment in the skin causing white patches). It is important to remember that scars are quite different from the other conditions mentioned above, though they can also benefit from cosmetic camouflage.


A Scar Clinic will be held every Monday Morning at the Valparaiso Indiana location with Dr. Hartley Thomas MD. and Dr. David Robinson MD. Call for Appointment and further information TEL: (219)462-8883 or Toll-Free: 866-462-8883.