Aesthetic Doctor and Plastic Surgery Trainee Raina Rodrigues talks: Scar Management
I’m a mother to a beautiful 11 month old little sleep thief, who made her entrance into the world via a planned C-section. I had full confidence in my excellent obstetrician, however, I do understand that the final quality of my scar would depend on my care as much as her wonderful surgical expertise. My roles as an aesthetic doctor and plastic surgery trainee have placed me at a great advantage, in that I could practice scar prevention rather than scar treatment. This meant I had a tube of KELO-COTE ready and waiting for me at home!
Any time someone undergoes an operation or sustains a skin wound (I should know, I’ve just completed a PhD in burns, wound healing and scarring) I generously dish out my 2p on wound management and scar prevention. The three pillars of this advice are sunscreen, massage, moisturise. When exposed to the sun, healing skin and scars pigment differently to normal skin. A generous application of sunscreen (to the whole area, not only to the scar) will prevent the scar being more noticeable due to it being lighter or darker than surrounding skin. Massage helps to flatten a scar and shortens the time to for it to mature and take on its final appearance. This should be regular and frequent, I advise massaging a scar at least three times a day. A silicone gel such as KELO-COTE traps the moisture on the healing scar keeping it just where we want it. Various pre-clinical and clinical studies have shown that this hydration reduces redness and decreases collagen, helping to convert the healing tissue into a flat and pale scar, which is what we want.
I am the medical director of Aesthetic Virtue, a small chain of medical cosmetic clinics in London and in Malta, offering scar treatments among others (mainly facial rejuvenation procedures). We perform about 20 scar treatments every month. By the time patients come in to see us, they generally would have tried various methods of improving the scars themselves. Depending on the type of scar, we offer various treatments. The commonest procedure we carry out is steroid injections for keloid scars, which are raised pigmented scars that often itch and grow beyond the margins of the originally injured skin. For such scars we recommend a course of a few injections at 6 weeks intervals with the use of occlusive hydrating silicone gels such as KELO-COTE and sunscreen (in exposed areas) to be applied twice daily by the patient at home. Very often patients present to us early on following an injury or surgery. Scars take 12-18 months to reach their final “destination” and there is no indication for steroid injections until this time has elapsed. Our advice for scar management follows the above mantra: massage, moisturise + sunscreen. This same advice applies to hypertrophic scars. These are scars that are red and raised, but do not grow out with the margins of the original wound. Such scars are often an “enthusiastic” part of the normal wound healing process. Only rarely do these scars persist as such, and only very rarely is steroid injection indicated.
Being a KELO-COTE user myself, it really requires no extra effort to incorporate this into daily routine, even as a sleep-deprived near zombie mummy. It doesn’t rub off onto or stain clothes when dry and its application literally takes all of 10 seconds. I’ve found that it’s easiest to apply just after a shower and before bed, but different routines would suit different people. While a C section scar is usually neatly hidden from public view both on the beach and under clothes, having seen the negative effect unsightly scars can have on some of my patients, I was keen to do whatever was in my ability to achieve the best scar possible. So far, I am pleased to report that the evidence of my baby’s entry into the world is shaping up into a relatively inconspicuous flat thin neat line. To be fair, I also did have an amazing obstetrician!
Alas, scarless surgery and skin healing doesn’t exist, except in unborn babies (a lot of research into this is currently going on), so until something revolutionary comes along we need to continue using the tools available to us in our armamentarium. As always, prevention is key.
These are the views of blogger and do not necessarily represent the views of Alliance.