Preventing & Treating Hypertrophic Scars & Keloids Fall/Winter Newsletter 2016

The Dermatologist; Volume 24, Issue 2, February 2016

Screen Shot 2016-08-22 at 5.40.50 PMThick, ropey scars which develop after surgery or injury can be painful, itchy, and embarrassing for patients. Preventing the formation of these scars and proper treatment of developed scars is possible to reduce uncomfortable symptoms and improve the appearance.

First, we must understand how these types of scars occur and who is at highest risk of developing one. A keloid or hypertrophic scar usually occurs after abnormal wound healing. Normal wound healing involves a delicate balance between a complex series of steps. When an imbalance in the steps occurs, a keloid or hypertrophic scar is the result. In addition, there are also many risk factors for developing a keloid scar. These include the site on the body where the injury or surgery occurred. The earlobe, neck, chest and back are high risk areas for keloid formation. Genetics and family history are also strong determinants of keloid formation. Lastly, the African American population and the age group of 20-30 year olds have higher risk.

The best way to treat a hypertrophic or keloid scar is first trying to prevent it. When trying to prevent a scar from forming, it is imperative to get the wound to heal as quickly as possible with the least amount of inflammation. Faster wound healing usually leads 
to less scar formation. Deep wounds are usually cleaned and closed with stitches to help them heal more quickly. Reducing tension on the wound by minimizing exercise 
in the area of the wound also promotes faster healing. Both deep and superficial wounds should be bandaged with vaseline applied directly to the wound and a bandage placed over it. Keeping the wound bandaged is important to help prevent infection. Infection of a wound leads to increased inflammation and higher risk of scar formation. Keeping the wound moist with Vaseline will also allow it to heal more quickly.

Unfortunately, not all scars can be prevented. If a keloid or hypertrophic scar does occur, there are now a multitude of effective treatment options. Daily application of a silicone gel patch, Silagen®, available in strips $44, dots $30 and gel $46 (sold
 at skinfo®) to the scar can minimize scar formation and help reduce already developed scars. Injections of tiny amounts of dilute steroids and injections of a medication called 5-fluorouracil have been proven to be effective 
in flattening scars, improving discomfort and itching of scars, and improving the appearance of scars. Laser therapy with pulsed dye laser has also been shown to be effective in preventing and treating scars. There 
is now no reason to live with painful, itchy and unsightly hypertrophic and keloid scars. These scars can safely and effectively be treated.