Body Wise
Scar Power
New over-the-counter remedies make skin wounds fade.

by Loriann Hoff Oberlin

Everyone gets scars, whether from falls, chickenpox, acne or a cesarean section. When you or your child develops a scar, is there anything you can do about it short of plastic surgery?

Scar management used to be limited to steroid injections, surgical revision and silicone sheeting by prescription. Today, you can purchase cosmetic scar products over the counter if you know the type of scar, a little about its formation and what your child’s or your doctor advises beforehand.

Scar Factors

• Too much sun causes the pigmentation cells to come closer to the skin surface. Use sunblock of at least 25 SPF.

• Adolescents and pregnant women with higher levels of hormones scar more easily.

• Scars that form on the chest, arms, trunk and joint areas are more difficult to heal.

Healthy skin is the body’s first line of defense against germs, harmful radiation and water loss. By definition, at least one of the skin’s three layers is involved in skin injuries. Bleeding is the first step toward healing, followed by clot formation (scabbing over) as well as swollen and sore tissue. Small tissue fibers called collagen form, and an excess of collagen at the wound site can result in a scar.

Scars can be not only unsightly, but render us self-conscious. Some dermatologists suggest that there is a genetic disposition toward scarring. The location of the scar, poor nutrition, skin coloration and age, and sun exposure factor into how pronounced a scar appears.

Treating Scars
When you or your child have a skin wound, treat it with antibiotic ointments and see a doctor if you suspect infection. You might want to see a plastic surgeon in the emergency room to stitch the wound properly, lessening any resulting scar.

Once the wound heals, begin rubbing cocoa butter and Vitamin E oil on the site, several times a day. Massaging and pressure helps the scar to stop growing; the moisture merely keeps the tissues supple and less irritated. There are two main types of scars.

A hypertrophic scar is raised and darker in color than normal skin, but confined to the site of the actual wound. This type of scar can regress and even lighten on its own, but it takes a long period of time, usually several years.

A keloid scar does not flatten or lighten without intervention. While similar to the hypertrophic scar, a keloid extends beyond the boundaries of the original wound. Those with a genetic disposition toward scarring tend to develop keloids fairly often.

Over-the Counter Choices
While the act of massaging any ointment benefits your skin, if you wish to remedy your scar, stick with preparations designed for that purpose.

Mederma is a botanical-based product first introduced in 1997. Derived from allium cepa (onion extract), it’s sold as a topical gel and applied three to four times per day, also after healing. Since it’s a gel, it might be messier to use on areas that are typically covered with clothing until the gel has a chance to dry or be absorbed.

Curad Scar Therapy Cosmetic Pads are a new over-the-counter remedy. These clear, silicone-free, polyurethane pads are breathable, flexible and self-adhesive. If you use them on recent or older keloid scars, you should see some flattening and lightening of the scar within eight weeks. The Curad pads are worn only 12 hours a day. They can be cut to size for smaller scars or used side-by-side for larger ones.

Rejuveness silicone sheeting once was available only by prescription, but now is sold over the counter. After healing, you tape a patch you’ve cut to size and wear the sheeting on your skin from eight weeks to several months. The patch can be removed, washed and reused. While the manufacturer markets tape to go with the patch, any first-aid tape will hold it in place.

Does one method work best? One theory behind the silicone sheeting is that its electrostatic pull reduces and lightens the scar, smoothing the skin. Another thought is that the heat generated between the skin’s surface and the silicone sheet helps. Some plastic surgeons feel that the collagen fibers, after having exposure to this silicone product, are more oriented. None of the over- the-counter products promises complete erasure of scars. Traces or a faint outline will remain.

Before more invasive options (such as a steroid injection), wait at least six months after the scar forms. Too many steroid injections can have a thinning effect on the skin. Surgery using lasers or incisions — never a first option — should only be done if the patient isn’t prone to keloid formations.

Newer and safer forms of radiation applied to the scar tissue sometimes follow surgical excision in the first few days after removal. This very specific type of radiation only goes a couple of millimeters below the skin and helps those who have recurrent keloids.
While your scar may not fade completely, with proper management, others may not notice your blemish.

Loriann Hoff Oberlin is a freelance health writer.