09 May Medical Moment: Preventing Scarring
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Dr. Paul Koelliker
Dr. Paul Koelliker answers this week’s question: How can I prevent scarring?
Scars are created after skin, and sometimes the underlying tissue, is injured and the wound has healed. Scars occur from lacerations, abrasions, skin infections, and surgery.
The severity of the injury is the biggest factor in determining how large a scar will be. Genetics also plays a role. Some individuals scar more than others given a similar injury.
In order to reduce scar formations, proper wound care and care of the scar after the wound has healed is important. Large wounds should be cared for by a healthcare provider. Smaller wounds that do not need formal medical care should be thoroughly washed to ensure no foreign material remains. Antibiotic ointment can be used to keep the healing wound moist and prevent infection. Wounds should be covered when a person is in contact with direct sunlight. Tetanus may need to be updated even for small wounds. Once the wound is no longer open, wound care shifts to scar care. Scars take up to 18 months to reach their final strength and appearance. Scar tissue is frequently absent of hair follicles and some sweat glands which makes the appearance of scars differ from that of the surrounding tissue. Care for a scar begins with avoiding ultraviolet light. This is best accomplished by covering the scar or using powerful SPF sunscreen. Ultraviolet light disrupts the cell reorganization process and impedes scar contraction. Ultraviolet light can prevent scars from healing optimally and can even lead to larger cosmetic defects. Scars should be kept moist. Application of vitamin E lotion to the scar, or over the counter scar creams, will keep the scar moist. Using Vaseline or a similar petroleum jelly has been shown to yield similar results. Whatever ointment you chose, apply it two or more times daily and massage it into the scar, don’t just lightly apply the ointment onto the surface of the scar. If good scar care fails to yield satisfactory cosmetic results, a patient can find further treatment from a plastic surgeon or dermatologist. Steroid injections, laser treatments, and surgical scar excision/revisions are methods used to improve the appearances of scars.
Editor’s note: The Telluride Medical Center is the only 24-hour emergency facility within 65 miles.
Dr. Paul Koelliker
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