Scars that are formed from wounds that go deep enough to destroy the inner layers of the skin are not reversible because of the permanent damage and too much replacement of normal tissue with scar tissue.
Many superficial scars fade over a period of time but the skin cannot return to its original form. For a newly formed scar, one may give it a chance to fade, even if it takes a year or more. It may be safer than tampering with it and developing a worst condition.
If a scar is a sure, prominent nuisance and one wants to have it removed or reduced, there are a number of medical options for treatment.
We get wounded regularly in small measures. A woman cooking might get a cut from a sharp knife or a burn from hot oil splattering from a frying pan. Kids playing often get a scrape on the knee or elbow or other parts of the body. Teenagers irresistibly pick their pimples leaving dark spots and dents. Some persons may experience a great wound at some point in life. Serious accidents happen, leaving physical scars that can change ones social behaviour and relationships.
For minor injuries we should respond with a first aid. The wound should be cleaned so that bacteria or other microbes do not have a chance to attack it and then petroleum jelly (Vaseline) may be applied as a protective cover. Presence of bacteria could stimulate the body’s defensive cellular mechanisms that can enhance scaring. Petroleum jelly keeps the would moist and prevents formation of a dry scab and minimizes scaring. In the kitchen, when fast action is needed, any oil may be put on a burn or wound before better care is received.
Certain topical products can be kept in the first aid box for treating minor wounds. Cocoa butter cream is an example. Some products contain vitamin E which helps scars to heal well. For large wounds and burns, special products for protecting the wound are made of silicone gel or hydrogel sheets or non-adhesive gauze pad. Simple bandage may suffice. Such covering should be changed regularly to keep the wound sanitized. After the wound is healed, regular application of sunscreen with a high SPF can help reduce the hyperpigmentation that accompanies scar formation.
When a scar is well established such as in the case of tribal marks, some forms of surgery may be used to improve the appearance or to partially erase the scaring.
Ablative and non-ablative laser treatments are used. Ablasive treatment involves removal of surface skin cells. Non-ablative lasers do not affect surface cells but target skin tissue below the surface using heat to stimulate collagen production. Carbon dioxide abrasive laser and laser skin resurfacing can be used to improve different forms of scars. Abrasive laser can be used to remove tattoos and for extreme cosmetic makeovers. Abrasive lasers are generally used for atrophic scars. Fraxel laser treatment can be used for acne scars. Acne scars can also be improved with microneedling. This involves the use of tiny needles to prick the skin and stimulate collagen production in acne dents. It can be used to improve facial looks with a smoother and toned skin. Apart from acne scars, microneedling may improve wrinkles and large pores. Non-abrasive lasers are used for hypertrophic scars and keloids. Laser treatments are done by board-certified cosmetic surgeons or dermatologists. They assist the patient in the recovery process.
Steroid injections can be used to flatten raised or protruding scars such as some forms of raised tribal marks, keloids, and hypertrophic scars. Steroid injections into scar tissue may help to flatten it. Combination therapy with the use of fractionated carbon dioxide plus topical steroidal drug triamcinolone is being used for scar treatment with some measure of success.
Chemical peeling is a controlled destruction of surface cells of the skin using a chemical rather than laser. Dermabrasion or microdermabrasion is used to try to regularize the surface of the skin. For severe scars, a surgical skin graft or an excision may be performed. Scar revision means cutting the scar tissue out and guiding the healing.
Cryotherapy is the use of liquid nitrogen to freeze and destroy cells and this can be applied to keloids or raised scars. On the contrary, filler injections using collagen as filler are used to raise atrophic or deep scars to the level of the normal skin. The procedure is repeated regularly.
Whatever the condition of the scars one bears, one should try to live above them or beyond them and not allow them to limits one’s life. There will be busybodies who like to pay attention to other people’s flaws, but such people can be ignored.
Dr. Theresa Adebola John is a lecturer at Lagos State University College of Medicine (LASUCOM) and an affiliated researcher at the College of Medicine, University of Tennessee, Memphis. For any comments or questions on this column, please email [email protected] or call 08160944635
Methods for improvement of scars and tribal marks - The Nation Newspaper
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