Scarred for Life? Not Anymore; Beauty News on Treating Scars

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NY Dermatologist Joshua Fox, MD, on the latest dermatological treatments for treating scars.

We literally wear the story of our lives on our skin. Our largest organ is subject to a host of injuries, burns, acne attacks, bites, rashes and surgical incisions over a lifetime, all of which can leave enduring marks. But a disfiguring scar isn’t always inevitable, nor does it have to be permanent, says Dr. Joshua Fox, founder and director of New York & New Jersey-based Advanced Dermatology, PC & the Center for Laser & Cosmetic Surgery. “We now have some keys ways to help prevent scars, and even treat existing scars so they’re much less noticeable.”

What Causes Scars to Form?
After any kind of an injury, the formation of a scar is dependent on a number of factors, according to Dr. Fox:

  •     The location of the injury. If a wound is on the jawline, ears, back, chest, breasts or joints (the fingers, knees, elbows or shoulders), it’s more prone to scarring than are injuries elsewhere on the body.
  •     How deep the injury is. The deeper the cut or burn, the greater the chance of scarring. Always consider seeing a doctor for stitches if you suffer a deep cut or if a cut is on your face.
  •     If a hard scab forms. A scab hinders the growth and migration of new skin cells over the wound. Don’t pick at scabs, because you’ll lift off new skin cells and delay healing, both of which increase the risk of scarring.
  •     If the wound gets infected. The more inflammation, which accompanies infection, the more likely a scar will form.
  •     Your skin tone and family history, may make you prone to an overly aggressive healing process and the development of thick scars called keloids, elevated scars which extend beyond the original borders of the injury and scar. Darker-skinned people have a greater risk of developing keloids than lighter-skinned people.
  •     Your age. Typically as you get older, scarring becomes more likely as the wound-healing process becomes less efficient and the skin takes longer to heal.

Over-the-counter Remedies and Scar Prevention
To lessen the chances of scarring, clean a wound or cut with mild soap and water and apply a thin layer of an over-the-counter antibiotic ointment or Vaseline ointment on it if it is a clean cut. “The ointment helps new skin cells migrate to the damaged area as the wound closes, and kills bacteria that could cause infection,” Dr. Fox explains. Cover the injury with a nonstick bandage to create a moist environment for healing and protection. Gently clean the wound and replace the bandage daily until the injury heals. Be on the lookout for these signs of infection: the wound becomes painful or warm to the touch, develops red streaks, oozes yellow pus, or if redness extends beyond the site of the injury. Although none of these signs are diagnostic by itself, you should still see your doctor. Sometimes you may need an oral antibiotic or other treatment.

Once the wound heals (whether it’s from an injury, a burn or a surgical incision), you can apply silicone sheeting such as Curad Scar Therapy, Neosporin or ScarAway for at least 12 hours a day to reduce the risk of scarring, says Dr. Fox. You can even use silicone sheeting to treat a pre-existing scar. These sheets work by mimicking your skin’s natural barrier, putting pressure on the wound, and hydrating and softening the scar so it fades or softens somewhat. There are also other new wound dressings to help speed up the healing process. .

You might also try a cream containing an extract of onion called Mederma that claims in clinical research to show a reduction in scarring; likewise, for a cream called Bioskinrepair, which is made from a serum produced by land snails. Both products have antioxidant properties and reduce inflammation. “However, you have to be prepared to commit to using these products one or more times a day for several weeks to see results,” he says. In addition, a product with copperbromide which appears to promote wound healing. There are also new super hydrating wound creams like Biafine which seems to speed the healing, thereby lessening the risk of scarring.

What a Dermatologist Can Do about Scars
If a scar persists and makes you self-conscious or causes pain, a dermatologist now has an arsenal of treatments to treat it. “The good news is that there are so many options for scar treatment today, and we can individualize each case to the best therapy depending on where the scar is located and what type of scar it is and its color,” notes Dr. Fox.

For instance, steroid injections can often reduce inflammation in raised scars (such as keloids and another type called hypertrophic scars, which are raised and red, but don’t move beyond the borders of an injury as keloids do) and make them less noticeable and red. A laser treatment can then be performed to remove the top layer of skin and resurface it. “You need to stay home after these procedures since your skin can be raw,” Dr. Fox explains, “but research shows they tend to be effective in creating a smoother and less visible appearance to the scar.”

Most recently, Fraxel laser treatments have become available, which can reduce the appearance of a scar without significant downtime in two to five treatments. Your skin might be red or puffy for a day or two afterwards. The Fraxel laser causes tiny injuries deep in the skin, treating a small area at a time, which is referred to as the microthermal treatment zone (MTZ). This laser penetrates into the skin, purging, or breaking up old damaged scar tissue and prompting the formation of fresh, healthy collagen. The Pixel laser using a fractionate CO2 laser is able to accomplish what the Fraxel does in less treatments but with downtime. The Smoothbean laser also decreases scars, especially acne scars, in several treatments with no downtime. The VBeam can help flatten scars, get rid of a chronically red scar or even help depressed scars like a stretch mark.

Your dermatologist can also excise (cut out) the scar, or even graft new skin from another site to the scarred skin. This is typically done for scars from burns.

Injectable fillers such as Restylane, Juvederm and Radiesse can be used to raise depressed or pitted acne scars. The injections typically have to be repeated every few months. Exfoliating treatments such as microdermabrasion and chemical peels may also improve the appearance of acne-pitted skin, as can intense pulse light (IPL) Photofacial treatments. Your dermatologist or laser surgeon will know which treatment is best for your particular scar to meet your budget and timeframe, adds Dr. Fox.

About Dr. Fox: Joshua L. Fox, M.D., F.A.A.D., earned his medical degree from the Mt. Sinai School of Medicine in New York. He completed an internship at Maimonides Hospital in Brooklyn, followed by a three-year dermatology residency at the New York University School of Medicine. A Fellow of the American Academy of Dermatology, Dr. Fox is a leading authority in the field of dermatology, with an expertise in skin cancer, acne, cosmetic surgery and laser procedures and is the author of many dermatologic publications. He is the founder and director of Advanced Dermatology, P.C. of New York and New Jersey and the Center for Laser and Cosmetic Surgery and is a spokesman for both the American Academy of Dermatology and the American Society of Dermatologic Surgery. He is the director of a fellowship program in Laser & Cosmetic Surgery. http://www.advanceddermatologypc.com/index.html. Dr. Fox is also the founder and President of The New Age Research Foundation, a national, non-profit [501 (C) (3)] health organization committed to improving the quality of life of those with skin conditions through research and education.

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MELISSA CHEFEC
MCPR
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