We occasionally receive questions by email or in the comments section. Let us know if you have any questions related to scars, scar treatment or scar prevention and we will try to answer them. You can ask the questions anonymously via the comments section below. And remember, the only stupid question is the one you don’t ask.

 

In a recent interview with Life & Style, the former star of “The Hills” described a variety of post-surgery scars ranging from a two-inch long blemish under her chin to lumpy legs, uneven breasts and bald spots left from a brow lift.

“People have fewer scars from car accidents than I have on my body,” Montag told the magazine.

All plastic surgery but especially major surgeries like tummy tucks and breast reductions, can involve scarring. Ask your doctor to show you a picture of what the scar looks like beforehand. Another important question is what sort of treatments they offer to minimize scarring, for example silicone gel (e.g. Strataderm), silicone sheeting or laser procedures. It’s not always easy to know in advance whether or not you’re likely to scar. Some people are more prone to scarring than others. People heal differently, and patients with a poor history of wound healing or keloid scars are at high risk of scarring.

British biopharmaceutical company Renovo announced that its Phase I dose ranging clinical trials designed to establish the safety of Juvista® following the surgical excision of bilateral earlobe keloids met all primary safety objectives. However, due to the insufficient sample size there is no data about efficacy of the product.

Juvista (INN: Avotermin) is a therapeutic application of human recombinant Transforming Growth Factor Beta 3 (TGFβ3). Clinical trials are investigating the effects of intradermal injection of Juvista applied to skin wounds created either by surgical incision or excision, at or shortly after the time of surgery on the appearance of the subsequent scar.

When your wound starts to heal the body produces more collagen which gathers around the damaged tissue and seals it. However, in keloid scars the collagen production doesn’t stop and the scar extends beyond the borders of the original wound in the form of dense fibrous tissue.

Keloid scars are raised and range in consistency from soft and doughy to hard and rubbery. They can appear anywhere on the body although they usually form in the area of shoulders, cheeks, earlobes and neck area. Burn scars or infected lesions, including acne, are more likely to form keloids. Keloid scars sometimes itch and may be painful. Keloid scars are 15 times more likely to occur in darker-skinned individuals, may be familial, and tend to develop more readily during and after puberty.

While keloid scars are difficult to treat, combination treatments seem to be the most effective. International Clinical Recommendations on Scar Management highlight a primary role for silicone and intralesional corticosteroids in the management of a wide variety of abnormal scars including keloids. Silicone is also recommended as first-line prophylaxis for keloid scars. Other options include surgery (high risk of recurrence), radiotherapy, cryotherapy, and laser.

If your skin is keloid prone, you should avoid piercings, tattoo and any unnecessary incisions, such as plastic surgery. You should treat acne thoroughly to reduce lesions and potential for scarring or, if surgery is necessary, silicone may be combined with intralesional steroids or other treatments (above) to reduce the likelihood or size of keloid scarring.

In a cesarean birth (C-section), the baby is delivered through an incision in the mother’s abdomen and uterus (womb). C-Section births exceed 30% in USA, Brazil, Italy, Mexico, Turkey, Korea, Portugal, Australia, Thailand, and other countries. China is the only country where C-section births exceed 40%. The number of cesarean sections in the U.S. has risen nearly 46% since 1996.

Every C-Section is a major abdominal surgery that leaves a scar. The size of your C-section scar will depend on several factors: the size and position of the baby, whether the C-section was planned or not, etc. Generally, the C-section scar is around 4-6 inches (10-15 cm) long and 1/8 inch (0.3 cm) wide.

Usually the “bikini cut” incision is used but sometimes the “classical” incision will be made vertically from just below the belly button (naval) to just above the pubic bone. To close the wound, some surgeons prefer to use staples whereas others still use suture; there is little statistical evidence to show that one way or another will increase or decrease the size or the appearance of the scar.

Treatment. Initially, the C-section scar will be red, raised and could itch. After the wound is closed you should start using a silicone based product like Strataderm to make the scar softer, flatter and smoother and to relieve itching. The majority of women will develop “mature” C-section scars by the sixth month after delivery. If you have darker skin and/or are prone to keloids you should consult a physician before the C-Section.

Acne is the most common skin disorder, affecting around 15% of the adult population and up to 80% of adolescents. Facial scarring because of acne occurs to some degree in most cases. The majority of acne scars are flat and depressed below the surrounding skin (atrophic), generally small and often round with an indented or inverted centre. To prevent acne scars, do not pop, squeeze, or pick at acne; do not pull scabs of acne; seek treatment early for acne that does not respond to OTC medications.

Types of Acne Scars:

–          red and/or hyperpigmented marks: a post-inflammatory change that usually disappears in 6-12 months

–          acne scars – icepick: depressed scars, deep, narrow and sharp; usually too deep for dermabrasion or laser skin resurfacing

–          acne scars – boxcar: depressed scars, round with sharp edges

–          rolling acne scars: depressed scars, wavy texture in the skin

–          keloids and hypertrophic scars are raised acne scars that may become larger and more noticeable, sometimes painful and itchy.  

Silicone gel like Strataderm is effective for treatment of acne scars and prevention of keloids and hypertrophic scars. Other effective treatments for depressed acne scars include laser skin resurfacing, dermabrasion, scar surgery (punch excision, punch elevation, punch graft, subcutaneous incision), fillers, chemical peel, microdermabrasion and similar procedures that you should discuss with your dermatologist. For raised acne scars, like keloid and hypertrophic scars, your doctor might consider options like intralesional injections, cryotherapy, surgery, laser and light therapy. Your dermatologist will be able to create a treatment plan based on the type of your acne acne scars, results you can expect, and your medical history.

Acne Scars:

Capstone Therapeutics announced that they have met the objectives of their second keloid trial for AZX100.

AZX100 is currently being evaluated for safety and efficacy of medical applications such as the prevention or reduction of hypertrophic and keloid scarring following excision of keloid scars.  Other proven clinical options for prevention of keloid scarring include application of silicone (e.g. Strataderm) after surgical resection which prevented development of hypertrophic scars and keloids in 75-85% of cases.

More information about keloid scarring:

Factors Affecting Abnormal Scarring

How to Avoid Abnormal Scars