Don't hide your scars. Wear them as proof that God heals.
Scars can have both – a physical and psychological impact on sufferers. Scars may cause physical problems like severe itching, tenderness or pain. A wound that crosses a joint or a skin crease may also lead to a scar contracture. Similarly with scars that continue to grow (hypertrophic scars and keloids), they can limit movement and can even be functionally disabling.
The physical appearance of some scars may also be more obvious as they can continue to be red and raised. Some problematic or abnormal scars may continue to grow past the wound bound- aries or may take many years to soften and fade.
At times the psychological aspects can outweigh the physical ones for even the smallest of scars. For some people a scar is a constant reminder of the traumatic event that caused it. This can result in distress, poor self-esteem and difficulties in social situations, all leading to a diminished quality of life. People with scars may feel different and stigmatized and the reaction of others can be hurtful, particulary at impressionable ages. For children and teenagers, scarring can have a major psychological impact. At these ages, there is a need to feel normal or attractive and anything out of the norm can single out the individual. To be different because of scarring may lead to loss of self-confidence and feelings of inferiority.
To date, scars cannot be removed completely. But with effective management, the appearance and side effects of a scar can be improved significantly in most cases. In addition, the likelihood of developing abnormal scars can be reduced effectively if treatment starts shortly after wound closure. Any scar can be perceived as a personal problem. Some may learn to accept their scar, but many never forget it. It is widely accepted by psycho logists that proactively treating to reduce the visibility of a scar can actually help boost self esteem.
Scars almost always result from trauma of some kind (surgery, accident, disease) and are a natural part of the healing process. The more and the deeper the skin is damaged, the longer and more complicated the rebuilding process – and the greater chance that the patient will be left with a noticeable scar.
A normal scar usually develops during the first 48 hours after wound closure and can fade between 3 and 12 months with an average time of 7 months. Various factors can interfere with the wound-healing process and alter it in some way to cause an “overwhelming” or continuation of the scarring process. As a result, an abnormal scar develops, which may have the following effects: • Grow bigger • Remain red/dark and raised without fading • Cause discomfort, itching or pain • Restrict the movement of a joint • Cause distress because of its appearance
Your epithelium (thin tissue forming the outer layer of a body's surface) serves an important aspect to your barrier function. Water loss through the outer layer is minimized by a functional stratum corneum, and disturbances in barrier function are associated in many dermatologic conditions with increased inflammation or contact exposure to irritants. When your barrier function is disrupted by tissue injury, restoration can lag behind.
That is why it is important to create a very healthy environment to prevent water loss by a liquid or high-humidity environment to reduce inflammatory processes and consequently a reduction in the over growth of collagen. These can be different for every individual as there are over 1000 genes that are either upregulated or downregulated for your barrier health and the tendency to heal with excessive or hypertrophic scarring.
As well as each individual's “tight-skinned” characteristic of the human skin, which is tightly adherent to the underlying muscle layer. Thus, our wounds heal only part by wound contracture, with both a delay in restoration and also tension forces due to the constraints on skin contraction by adherence to the underlying deeper tissues. Silicone gel sheets and silicone cream both reduce scarring, by controlling signaling for the inflammatory mediators affecting hydration. Hence...an optimal environment for your barrier health and scar revision.
A wide range of options is available for the treatment of abnor- mal scars. Though the selection of the most appropriate treatment can only be made after a thorough assessment of the scar. Concerned patients should consult their physician when consider- ing more radical therapy options.
Invasive options include surgery, injected steroids, cryotherapy, laser therapy, microneedling, chemical peels and and more. Noninvasive options include compression therapy, topical steroids and a large number of different creams and lotions, that can support the healing process. But the evidence base for many of these treatments is poor, and some may only have a placebo benefit. Silicone gel is the only non-invasive option for which evidence- based recommendations have been made for scar management by leading specialists worldwide. It is recommended as first line therapy for a wide range of scars.
Silicone gel sheeting has an almost 40-year history, with widespread clinical use for 20 years. Studies show a compelling mechanism based on the properties of silicone gel, which normalize transepidermal water loss in scars with a deficient barrier function. Keep the barrier healthy and strong!
It is important to remember that a wound does not become a scar until the skin has completely healed. Until that point a clean, warm, moist environment should be maintained and movement should be restricted in order not to place tension on the wound or surgery. Consultation should be sought from your health professional should you have any concerns.
Abnormal scarring occurs more often in higher-risk groups which include people with darkly pigmented or very fair skin, those who have previously suffered from abnormal scarring, during hormonal changes (e.g. puberty, pregnancy) or when the wound or injury is more severe such as with burns and major trauma. The main principles of wound management for optimum scarring include the following:
Defining the cause of the wound – Mostly obvious, but in some cases this may prove more difficult (e.g. defining a pressure ulcer from a diabetic ulcer). Control factors affecting healing – For example: health of the tissue surrounding the wound, infection risk, blood sugar management, medication interactions, etc. Select the appropriate dressings – Dependent on factors such as amount of dead tissue involved with the wound, amount of moisture or exudates, signs of infection, type of wound, stage of healing, etc. Plan for management – If the wound-healing aim is not being achieved, it is important that you are under direct supervision of your health care professional.
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Téot, L., Mustoe, T. A., Middelkoop, E., & Gauglitz, G. G. (2020). Textbook on scar management: State of the Art Management and Emerging Technologies. Springer.