What is a scar?
A scar develops as part of the normal wound healing process. Within 2 to 3 days of the skin’s surface being injured, scar tissue fills in the injured area to close the wound. Scar tissue can continue to develop over many weeks or months.
How does a scar mature?
Immediately following wound healing, a scar is usually red in appearance and is referred to as an ‘immature’ scar. Between 3 months and 2 years the scar should become paler, flatter, and softer and can then be referred to as a ‘mature’ scar. To help your scar mature it is recommended that you massage and moisturise your scar. All scars should be monitored carefully and if your scar becomes a problem contact your doctor or occupational therapist.
What is a problem scar?
A scar is a problem if it is:
- purple or red
- raised
- feels hard or itchy
- restricts movement
Problem scars can sometimes be known as hypertrophic or keloid scars. Those at risk of developing a problem scar include people with: skin types known to scar easily, such as Mediterranean, Asian, African, and indigenous Australians. If you have experienced problems with scarring in the past, or if your wound’s healing is delayed please consult a doctor.
What to do if your scar becomes a problem?
Most scars do not produce poor cosmetic or functional results, however if a delicate balance is not achieved during the healing process a scar may display abnormalities resulting in more noticeable scars (called keloid or hypertrophic scars) that can be itchy and painful as well as unsightly.
Many factors influencing the quality of a scar include; the nature of the injury or surgery causing the scar, the location of the scar, the person’s innate wound healing properties, racial background, disease status, smoking, the technique of wound repair, and any complications during the wound healing phase.
Scar appearance can be improved with both nonsurgical treatments and surgery.
Non-surgical treatments:
- Use Silicone: Silicone Gel or sheeting is universally considered to be the gold standard and first line of defence and treatment for hypertrophic and keloid scars. These gels and sheets can help with itching as well as reduce the size of scars through occlusion and hydration. We would recommend using these products as soon as the suture is healed
- Take Vitamin E: Vitamin E is believed to reduce the amount of reactive oxygen available during the inflammatory stage of healing.
- Massage: massage therapy can disrupt fibrotic tissue and increase the pliability of the scar. It can also improve swelling, thickening, and hardening of the scar tissue
- Wear clothing that covers your scar – for example,wear a long sleeve t-shirt or hat
- Use sunscreen (SPF 30 +) or zinc cream and stay in the shade when outdoors.
Rather than waiting until a scar becomes either hypertrophic or keloid, early treatment aimed at prevention is key.
Surgery:
There are several techniques for scar revision surgery depending on the type and size of the scar.
Options include:
- Completely removing the scar and then mending the wound again
- Taking skin from other areas to cover up the areas of the scar (also known as skin “flaps” or “grafts”)
- Making the scar less noticeable by changing the direction of the scar
The technique selected is highly dependant on the site and the specific type of scar problem.
Meticulous technique, both in removal of the existing scar and also the repair (suturing) of the wounds is paramount.
A common technique is z-plasty, where the orientation of the scar is changed to make it less visible.
The post operative care of the wound and removal of sutures is also very important.
If you have any concerns about scarring or your scars please contact our practice