Excessive Scarring: Prevention & Management
(BlackDoctor.org) — Excessive scarring is the result of many factors, including extensive trauma to the tissues around a wound, the length of time that the wound is open before it heals, the location of the wound on the body, as well as skin color. People with higher quantities of skin pigmentation from melanin tend to make thicker and darker scars.
When more than enough scar tissue is formed following surgery or trauma, the scar is considered to be hypertrophic. Hypertrophic scarring is characterized by rapid growth in the first several month, accompanied by itching and skin darkening from excess inflammation. These types of scars generally shrink over time, but can leave unsightly skin deformities.
Although hypertrophic scars may be very dark and thick, they should not be confused with keloid scars. Keloid scars can be thought of as a severe form of scarring in which large scars form even after minor cuts or scratches. Keloid scars are more persistent, don’t fade, are constantly painful, itchy and have a tendency to reoccur after surgical excision.
Despite release of several new therapies for scar management that offer hope to patients with excessive scarring, the first consideration in scar management is prevention. Method of care during the management of the open wound is influential, so providing a healthy environment for the wound to heal is essential. Once the wound is closed, treatment can begin to minimize scarring, itching and excess pigmentation.
One very basic and important management approach is limiting inflammation, which is paramount to reducing the potential for excessive scarring. It is important not to scratch or rub scars. Do not use alcohol-based therapies that irritate the incision.
As far as treating an existing scar, there are many different types of treatments available. While steroids are traditional therapy for scar treatment, their adverse side effects prevent routine use on all cuts or scratches. However, non-steroidal, anti-inflammatory drugs (NSAIDS) have recently been found to provide an effective option in scar management. In particular, they reduce troublesome symptoms such as excessive itching (pruritus) and pigmentation.
Regardless of which treatment option you choose, always consult with either a primary care physician or a dermatologist to ensure optimal healing and prevention of further damage and infection.