It is impossible to make a scar disappear completely, even with recent developments and advancements like laser therapy. Though there are special creams and scar-reducer plasters, which may improve their appearance, a scar's final appearance can't be controlled by creams or plasters. However, it is possible to improve the appearance of scars through ultrasound techniques for better penetration into the skin. It takes about a year for a scar to heal completely. Most of the significant changes are in the first 6 months. A scar may go through several stages of healing before the redness fades and settles down into a fine whitish line. While surgery scars often fade naturally over time, post-surgical care of an individual can make a big difference to their overall appearance. How a scar ultimately looks depends upon how well it heals. Once the healing process begins, proper wound care, intensive barrier moisturizers, and silicone gels can make your surgery scar less visible.
How to care for surgical scars?
Irrespective of the type of surgery proper post-surgical care is important for better healing of surgical scars. Below are a few common ways to care for surgical scars.
- Broad-protection sunscreen: Sunscreen is an essential step in the aftercare process. A broad-protection sunscreen with sun protection factor or SPF 30 and above can help to reduce discoloration (or scar hyperpigmentation) and help the scar to fade faster after it has healed.
- Wound care: A common mistake most people make is to let the wound “breathe” immediately following surgery. If you do this, it will form a thick scab and then the new skin cells won’t be able to migrate in and heal the wound. It’s important to cover the wound immediately with various creams, ointments, and gels to promote the healing process. The wounded area should not get wet since it may interfere with the scabbing process.
- Silicone gels: Regular application of topical silicone gel can improve the texture, color, and height of the scar, while also acting as a barrier against bacteria. Silicone gels may improve the appearance of scars by increasing hydration and limiting the overproduction of collagen (although some collagen production is necessary). Look for skin-healing ingredients and antioxidants, such as quercetin in these formulations. Depending on the size and severity of your scar, silicone gels also come in sheet form which can be applied to the skin for up to 12 hours a day, for several months.
- Petroleum jelly and Vitamin E: Wounds with scabs take longer to heal, so it’s essential to keep the area and the surrounding skin well hydrated. Vitamin E cream and petroleum jelly are sufficient to keep the scar moisturized. Treat the area with a liberal coat of petroleum jelly before covering it with a clean dressing to prevent germs from penetrating the wound. Also, avoid any antibacterial creams since many people become allergic to topical antibiotics, which will slow down the healing process.
- Scar massage: A couple of weeks after surgery, you can begin massaging your scar daily. With your fingers, place firm pressure on any area where thick scar tissue can be felt beneath the skin. Massage back and forth and in circles. Do this until the skin on and around the incision feels like your normal, unscarred skin. Be patient because it can take months to see the maximum benefit.
- Tension: You should try to avoid putting increased tension on the area over your scar. If there is an incision over a knee, don’t go to the gym to work on squats. The same principle applies to scars on other parts of the body.
- Smoking: Nicotine restricts blood flow to an incision and prevents important cells from getting to the area that needs to be healed. To reduce your risk of healing problems, nicotine use (cigarettes, patches, chew, etc.) must be stopped 4 weeks before and after surgery.
- If scarring is unsightly, uncomfortable, or restrictive, treatment options may include:
The following are common scar-minimizing procedures:
- Dermabrasion: It may be used to minimize small scars, minor skin surface irregularities, surgical scars, and acne scars. It involves removing the top layers of skin with an electrical machine that abrades the skin. As the skin heals from the procedure, the surface appears smoother and fresher.
- Chemical peels: The top layer of skin is removed with a chemical application to the skin. By removing the top layer, the skin regenerates, often improving the skin's appearance.
- Collagen injections: One type of collagen (made from purified cow collagen) is injected beneath the skin. It replaces the body's natural collagen that has been lost. There are several other types of injectable materials that can also be used.
- Cortisone injections: These types of injections can help soften and then shrink hard scars.
- Cryosurgery: Cryosurgery can help reduce the size of scars by freezing the top skin layers.
- Laser resurfacing: It uses high-energy light to burn away damaged skin.
- Punch grafts: Punch grafts are small skin grafts to replace scarred skin. With a special tool, a hole is punched in the skin to remove the scar. Then the scar is replaced with unscarred skin (often from the back of the earlobe).
- Surgical scar revision: Surgical scar revision involves removing the entire scar surgically and rejoining the skin. This will cause a new scar to form. However, the goal of this surgery is to create a less obvious scar. Surgical scar revision is usually done on wide or long scars, which healed unusually, or scars that are present in very visible places.
- Radiation therapy: This is not used often. It's used mainly for scars resistant to other treatments.
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Leffell DJ. Time (and Care) Heals All Wounds. 2000. https://medicine.yale.edu/dermatology/dermsurg/Chapter%2018%20Time%20and%20Care%20Heals%20All%20Wounds_36907_284_5_v1.pdf