Scars, an inherent part of the body’s natural healing process, emerge when the skin undergoes damage, be it from accidents, injuries, or surgical procedures. The Cleveland Clinic explains that during the healing process, the body constructs new tissue made of collagen to bridge the gaps caused by the damage. Dr. Jill Salyards, a board-certified dermatologist and founder of Refine Dermatology in Knoxville, Tennessee, elucidates that scars form post-healing because the new collagen filling the wound doesn’t match the texture of the surrounding skin. It’s important to note that nearly all wounds result in some degree of scarring, with exceptions for very superficial injuries.
However, scars are not homogenous; their type and final appearance are influenced, in part, by how the wound is treated during the healing process. The severity of the wound also plays a role, as Dr. Jeremy Brauer, a board-certified dermatologist and founder of Spectrum Skin and Laser in Purchase, New York, points out, stating that the deeper the injury, the higher the likelihood of scarring. Scars can manifest as flat or raised, with flat scars being less visible than raised scars, such as keloid and hypertrophic scars, which result from thick tissue formation. Stretch marks are also classified as a type of scar.
Diverse Nature of Scars: Tailoring Care for Optimal Healing
Scars that are prominently visible can evoke unwanted attention and create insecurities, prompting some individuals to seek ways to prevent or minimize scarring during the healing process. Others may wish to ameliorate painful or uncomfortable scars. However, the decision to prevent scars is subjective. If scars do not cause discomfort, such as pain or itching, there may be no need for treatment. In fact, some individuals take pride in their scars, viewing them as symbolic of life experiences, such as women who have undergone C-sections or individuals who have weathered serious health events.
According to the American Academy of Dermatology (AAD), proper wound care practices can minimize or even prevent scarring if desired. Here are 10 dos and don’ts to consider for preventing fresh wounds from leaving lasting scars:
1. Do Keep the Wound Clean
When a wound occurs, it is crucial to keep it clean from the outset. Dermatologists recommend maintaining cleanliness throughout the entire healing process. Dr. Salyards advises against using hydrogen peroxide or other antiseptics, as they can exacerbate scarring by increasing inflammation and harming the healing skin. Instead, she suggests cleaning the wound with mild soap and water. Dr. Brauer emphasizes the importance of continued cleanliness until the wound is fully healed.
2. Don’t Delay Stitches When Necessary
While not all wounds require medical intervention, the severity of a wound may necessitate stitches. Getting stitches can expedite the healing process, potentially minimizing the appearance of scarring. Dr. Aanand N. Geria, a board-certified dermatologist and founder of Geria Dermatology in Rutherford, New Jersey, underscores the importance of timely stitching to prevent the accumulation of germs or bacteria, which could lead to infection. If uncertain, seeking immediate medical evaluation is recommended.
3. Do Keep the Wound Moist
After cleaning the wound, maintaining moisture is crucial for scar prevention. Dr. Brauer suggests using emollients like petroleum jelly to delay scab formation. Research supports the idea that moist environments reduce scar formation compared to dry conditions. Dr. Salyards recommends moisturizing with petroleum jelly and covering the wound with a nonstick dressing until it is fully healed or sutures are removed.
4. Don’t Pick at the Wound
Picking at the skin, whether it’s an active breakout or a healing wound, is discouraged by dermatologists. Picking can worsen acne and scarring and increase inflammation and scarring during the wound-healing process. Dermatillomania, a condition where individuals compulsively pick at their skin, can lead to injury, infection, and scarring.
5. Do Use a Wound Dressing
Applying a wound dressing directly to the wound helps protect it, keeps it moist, and prevents exposure to the surrounding environment. Dressings, such as bandages and gauze, should be changed regularly. Dr. Brauer recommends using a dressing with a nonstick surface to keep wounds covered and avoiding exposure to air.
6. Don’t Skip Sun Protection
Sun protection becomes even more crucial when dealing with recent wounds to reduce potential scarring. Wearing sunscreen with SPF 30 or higher and reapplying every two hours while outdoors is recommended. Sunscreen helps prevent scars by shielding them from the sun, reducing scar hyperpigmentation.
7. Do Use Silicone Scar Sheets
Once the wound is healed, transitioning to silicone scar sheets can aid in scar prevention and improvement. Dr. Geria suggests using silicone sheets within the first year of scar formation, as they have been shown to be effective. Silicone gel and sheets remain the preferred treatment for scar management among healthcare professionals.
8. Don’t Overexert the Area
Minimize movement in the area of a new scar to allow it to heal properly. Overexertion can alter the scar’s formation, making it thicker or wider. Gentle scar massage during the first year can significantly impact healing by breaking up tissue that might lead to thick scars.
9. Do Be Wary of Scar Creams and Topical Products
Not all scar creams are created equal, and dermatologists often recommend silicone sheets over scar creams. If opting for a scar cream, choosing one with silicone gel is advised, as it has been shown to be effective. Evidence supporting other topical scar management methods is limited.
10. Don’t Have Unrealistic Expectations
Scars take time to heal and fade, and realistic expectations are crucial. Despite following proper wound care practices, some factors affecting scarring are beyond individual control. Certain people, particularly those with darker skin tones, may be more prone to keloid scars, which may not disappear completely. While scars are permanent, treatments are available to make their appearance less visible.
Seeking Treatment for Scars
While preventing wounds is the primary means of averting scarring, caring for active wounds is the next best step. Keeping wounds clean and moist during the initial stages and transitioning to silicone gel scar sheets after healing can yield visible improvements within a couple of months. It’s important to recognize that scars, although permanent, can be managed, and dermatological interventions may help improve their appearance.