Scar Secrets

"Will there be a scar, doc?"

Dermatologists all over the nation hear this question on a daily basis.  Scars can occur from any injury to the skin, such as: burns, scrapes, cuts, bites, biopsies, surgeries, and more.  The deeper the injury, the more of a risk of developing scar tissue.  The location of injury also plays a role: the more movement in an area, the more of a chance a thicker or wider scar will develop.  Chests, shoulders, and backs are areas more likely to scar.  And although it's impossible to completely prevent a scar, there are ways to minimize the appearance of them.

Clean
Wounds should be cleaned with a mild cleanser and water daily.  Hydrogen peroxide, alcohol, and iodine can be irritating and may actually slow healing.

Cover
Dry or wet?  The old school of thought was to let wounds "dry out and form a scab."  But research has shown that keeping a wound moist and covered with a band-aid actually greatly improves healing.  Aquaphor or petroleum jelly is the best emollient to use.  There is no proven advantage to using an antibacterial ointment like neosporin - in fact, many people are allergic to it and develop itchy reactions.  Vitamin E oils and herbal oils may also result in allergic reaction, and may in fact slow wound healing. 

Protect
Keeping it covered also imparts another advantage: sun protection.  Exposing healing wounds to sun may cause them to pigment and appear dark.  Once they've healed and are no longer covered, sunscreen can be used.

Take It Easy
Limiting movement can help.  Tension causes scars to "spread" or widen.  Avoiding lifting heavy objects or twisting motions will improve the appearance. 

Fine Details
Scars are composed of collagen.  Pressure and massage may prevent, as well as treat, raised or thickened scars.  Injections with cortisone, performed in the dermatologist's office, can help to flatten a raised scar (called a keloid).  Silicone gels such as biocorneum or mederma (contains onion extract) may further improve the appearance of the scar. 

Zap
Finally, laser treatments, such as the intense pulsed light, can be used to lighten the color of the scar.  Acne scars or thickened scars may respond well to fractional CO2 lasers, like the Active FX, or fractionated erbium lasers, like the Fraxel Re:Store 1550.

The bottom line?  Anytime the skin is cut or injured, there can be a scar.  What it ultimately looks like depends on: the depth of the injury, how the person heals, and how it's taken care of.