What is the proper way to take care of a scar?

Every day, people ask me about scars and the best way to minimize them. While scars can never be totally avoided, we plastic surgeons know many tricks and techniques that help to hide scars (check out my blog post from June). Regardless of the placement of a wound, proper scar care in the weeks to months following surgery is an essential.

In the early stages of healing, we need to ensure that the cells in the wound have the best possible environment to initiate the healing process and start forming a scar. I’ll discuss proper wound care in a future blog post.

After about two weeks of healing, the initial surface healing is complete. At this point we stop referring to the area as a wound and start to call it a scar. This is the time to consider scar care. Initially, a scar is a bundle of collagen that your cells have created. Over the next year, your body remodels this bundle of collagen until it assumes its final lasting appearance. To minimize the appearance of any scar, we can act during this initial year when the remodeling process is still active.

Fortunately, we have several options available for minimizing a scar’s appearance and here we will discuss three.

1) Massaging a raised scar can help the remodeling process.

Putting pressure on a scar helps to flatten it and blend it into the contours of the surrounding skin.

2) Topical treatments can also be helpful (and there are many!).

Many patients ask me about Mederma®. Mederma® is a topical gel containing onion extract. Many years ago, I tried it on a scar on my abdomen. It made the surrounding skin itch and flake, but it didn’t do much for the scar. Later I learned that studies have failed to show that it is any better for scars than plain petroleum ointment (also known as Vaseline®).¹

Unlike onion extract, silicone gel has excellent data supporting its use in scar treatment.

While we aren’t sure about how it works, we know that it decreases inflammation, itching, and pain associated with the scar and improves a scar’s surface appearance. Many formulations are available over the counter and you can also buy it from our office. Studies have shown that you can use it for up to a year on a fresh scar to improve its appearance. I strongly recommend silicone gel for facial scars starting about two weeks following surgery or an injury.

3) Applying sunscreen is also an important component of proper scar care.

Scars are quite sensitive to the sun and easily burn. Zinc oxide or titanium oxide based sunscreens are a must if you want your scar to be as minimal as possible.

By using silicone gel and sunscreen, you can help a scar heal as well as it can. In some cases, these measures may not be enough to minimize a scar and surgical scar revision may be necessary. These techniques will be discussed in future blog posts.

Citation:

1) Thomas JRT and Somenek M. Scar Revision Review. Arch Facial Plast Surg. 2012; 14(3):162-174.