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.
4 Misconceptions About Hypertension
(BlackDoctor.org) — Are you worried about high blood pressure in yourself, a family member, or a friend? Your concern is well founded. If left untreated, high blood pressure can lead to a range of health problems, including heart disease and stroke.
Within the African-American community, those with the highest rates of hypertension, are more likely to be middle aged or older, less educated, overweight or obese, physically inactive, and to have diabetes. In 2006 the death rates per 100,000 population from high blood pressure were 15.6 for white males, 51.1 for black males, 14.3 for white females and 37.7 for black females.
Knowing more about high blood pressure can help you prevent this condition from damaging your health, or the health of someone you love. You can start by learning what’s true about this condition — and what’s not.
Here are 4 common misconceptions about high blood pressure:
1. High Blood Pressure Isn’t a Big Deal
Early on, you may not notice symptoms of high blood pressure, so you may not be too concerned. However, in the long run high blood pressure can kill you. Normally, your heart beats regularly, pumping blood through the vessels all over your body. As the blood is pushed by the heartbeat, the blood in turn pushes against the sides of your blood vessels. Blood vessels are flexible and can widen or constrict as needed to keep blood flowing well. For a variety of reasons, your blood may begin to push too hard against the blood vessels. This is high blood pressure.
High blood pressure can lead to damage of your blood vessels, heart, kidneys, and other organs in your body. Heart disease and stroke, both caused by high blood pressure, are the first and third leading causes of death in the U.S. The scary thing about high blood pressure is that you may have it without even knowing it. That’s why doctors often call high blood pressure the “silent killer.” Health care professionals agree: High blood pressure is a big deal.
2. High Blood Pressure Can’t Be Prevented
Perhaps you have other relatives with high blood pressure. Maybe you’re a member of a group of people who are at greater risk. For these or other reasons, you may be tempted to think that there’s nothing you can do about high blood pressure.
Here is some good news about high blood pressure: Even if you have many risk factors, there are steps you can take to prevent high blood pressure:
• Keep your weight at a healthy level. You can accomplish this by a combination of healthy eating and regular exercise.
• Eat a healthy diet. This includes eating only the amount of food your body needs and choosing foods high in nutrients and low in fat, sugar, and salt.
• Limit how much salt you eat. Most of the sodium you eat is in the form of salt. It may be salt that you add at the table or salt added to processed foods you consume.
• Limit how much alcohol you drink.
• Don’t smoke tobacco, and minimize your exposure to secondhand smoke.
• Get regular exercise. Try to get at least 30 minutes of activity each day. Exercise relieves stress and helps you control your weight.
• Don’t let stress build up. The chemicals your body makes in response to stress make your heart beat harder and faster and your blood vessels tighten. All this makes blood pressure higher.
Ask your doctor for suggestions about high blood pressure and how to prevent it. Your doctor may refer you to other health care professionals who can help.
3. It’s OK As Long As One Number Is Normal
You may notice that when your doctor measures your blood pressure, the reading includes two numbers, one written on top of the other. These numbers can be confusing. The top number is called your systolic blood pressure. This number represents the force of blood through your blood vessels during your heartbeat.
* 119 or below is normal systolic blood pressure
* 120-139 is prehypertension
* 140 and greater is high blood pressure
The bottom number is called your diastolic blood pressure. This number represents the force of blood through your blood vessels in between heartbeats, while your heart is resting.
* 79 or below is normal diastolic blood pressure
* 80-89 is prehypertension
* 90 and greater is hypertension
Many people pay more attention to the systolic rate than the diastolic, but experts say that the heart can tolerate a high top (systolic) number better than a high bottom (diastolic) number.
Blood pressure does change throughout the day, depending on your activities. Blood pressure changes over time, as well. Systolic blood pressure tends to rise as you get older. Diastolic blood pressure may decrease as you get older.
If either of your blood pressure readings is consistently above normal, then you need to take action right away. You and your doctor can develop a plan to treat high blood pressure or even prehypertension before damage to your organs occurs.
4. Treatment Doesn’t Work
Give up your favorite foods. Take drugs with annoying side effects. These are some things you might fear when you think about high blood pressure treatment. It is true that it may take some time to develop a treatment plan that works best for you, because high blood pressure often has several underlying causes. In many cases, the specific cause of high blood pressure may not be evident.
Your doctor will work closely with you to determine which combination of treatments works to best control high blood pressure. Your treatment plan is likely to include the following elements:
The DASH eating plan. The Dietary Approaches to Stop Hypertension (DASH) plan includes eating less fat and saturated fat as well as eating more fresh fruits and vegetables and whole-grain foods. Limiting use of salt and alcohol can also help lower your high blood pressure. A dietitian can help you find ways to meet these goals without giving up your favorite foods or great flavor.
Weight Control. Being overweight increases your risk of developing high blood pressure. Following the DASH eating plan and getting regular exercise can help you lose weight. Ask your doctor to help you determine a goal. Your doctor can also refer you to other health care professionals for assistance in setting up a weight loss plan.
No smoking. Tobacco smoke can make blood pressure rise. It can also directly damage your heart and blood vessels. Talk with your doctor about ways to quit.
Medication. Your doctor is likely to prescribe medication to control your high blood pressure. It’s common to take more than one drug to treat high blood pressure. Your doctor may ask you to switch drugs or change the dosage until you find a combination that works best to control high blood pressure with the fewest side effects for you. Medications used to treat high blood pressure include:
- Diuretics to reduce the amount of fluid in your blood by helping your body rid itself of extra sodium.
- ACE inhibitors, alpha-blockers, and calcium channel blockers to help keep your blood vessels from tightening.
- Beta-blockers to prevent your body from making the hormone adrenaline. Adrenaline is a stress hormone. It makes your heart beat harder and faster. It also makes your blood vessels tighten. All of this makes blood pressure higher.
In fact, if you work with your doctor to develop a comprehensive program for managing your high blood pressure, that plan can work. To maximize the benefits of your plan, follow these steps:
- Check your blood pressure as often as recommended by your doctor.
- Follow your treatment plan consistently. Let your doctor know right away if you have problems with parts of the plan. Your doctor may refer you to other health care professionals who can help.
- See your doctor as often as requested. Bring your blood pressure records to show your doctor how the plan is working.
- Ask your doctor or pharmacist for information about medication side effects. Know when to call your doctor if there is a problem.
Learning about high blood pressure and how it can harm your health is the first step in controlling this condition — so you can remain healthy for years to come.