The Philippine Dermatological Society in its desire to help the public distinguish legitimate, board certified dermatologists from fake pseudodermatologists, conceptualized the making of a sign or symbol that PDS members can easily display or use in their respective clinics. The "Seal of Excellence" was thus finally made public last .. Accidents or injuries befall even the most cautious among us. And mishaps leave physical marks like scars.
Some people just simply live with their scars, and even make them a conversational piece.
On the other hand, those with unsightly scars — particularly on the face, arms, legs and thighs, chest and abdomen — suffer from emotional distress and low self-esteem.
Getting rid of scars, however, is not as simple as applying a “miracle, all-purpose” cream, as being advertised and claimed by some chemical enterprises. It involves a treatment process, and it is prudent for patients to seek sound medical advice to avoid expensive and ineffective or even harmful treatments, according to the Philippine Dermatological Society (PDS).
Understanding why scars and keloids develop, and how these could be treated would be an advantage. Below are some helpful tips and information compiled by the PDS.
Info, tips on scars
Scars come in all sizes and shapes. Scars are simply a change in the skin’s appearance following repair and recovery from deep wounds, surgical operations, pockmarks from chickenpox, and burns, among other skin aberrations.
In all, scarring is the attempt of the skin to restore itself back to its original form, and represents the last stage of the natural healing process.
But, scars are not just literally skin-deep. Scars over movable joints as in the fingers, wrists, elbows or knees may result to contractures and impair mobility.
Worse, they cause psychological and emotional distress, especially when scars are located on the face, neck, arms and legs.
Different scars from different injuries
Scars differ depending on the cause of injury, the extent of damage, and the body area affected. They may be flat, depressed, thickened, or develop into keloids.
Keloids, which have a thick, ropelike surface, develop when injuries or surgeries are located in the chest, back, shoulder, and posterior part of the neck. They persist over time and continue to enlarge or extend beyond the original site of injury or surgery.
The deeper the skin damage, the more prominent is the scar.
Areas that are likely to develop prominent scars are: the skin over movable joints such as the elbows and knees; the tight skin, such as on the jawbone; and thick skin, such as on the upper back. Scars that cross natural lines, such as the horizontal forehead creases, are likewise noticeable.
One’s heredity or genetic make-up also plays a part in the skin’s scarring process. For instance, the same type of injury might cause an almost invisible scar in one person, while forming a keloid in a genetically-prone individual. Further, dark-skinned races are especially prone to form keloids.
Scars never really disappear, but they improve and become less apparent with time. However, depending on the particular scar, this process may be hastened with treatment.
Preventing scars
Can we prevent scars? Yes, if we avoid injuries due to accidents and carelessness.
For persons at risk because of their occupation — such as soldiers, firemen, policemen, and athletes, among other physically challenging and dangerous professions — they should always wear prescribed safety clothing, jackets, headgears or helmets, elbow and kneepads, and boots or footwear, among other protective paraphernalia.
And extreme caution should be undertaken when handling potentially-damaging chemicals, equipment or machinery.
Those individuals who are keloid-formers, PDS cautions them to ably protect their upper back, chest and shoulder areas. When these are accidentally injured, they may result in scars that would later develop into keloids. And in case surgery is a must, PDS said surgeons would institute proper preventive measures to lessen the chances of a keloid forming.
If you have wounds or skin lesions, such as due to acne, eczema or insect bites, refrain from scratching them, the PDS advised.
Finally, do not self-medicate. What works for others may not be good and applicable for you. Worse, it may even aggravate your skin condition.
Scar treatments
All scars become less apparent through the years. But still, there are persistent scars, which could be made “less-apparent” and “more presentable” through medical or surgical treatments. There are many options available depending on the type of scar, its location and duration.
For hypertrophic scars and keloids, intralesional steroid injections by the dermatologist may soften and flatten them. Steroid injections work by decreasing collagen formation and inflammation. Large keloids may not respond to this treatment and there are even some which need to be made smaller through surgery or laser treatment before steroid injections are given. There is however a risk that the keloids will grow bigger after surgical manipulation.
For those who cannot tolerate the pain of steroid injections, especially children, silastic gel sheeting is an alternative option. They flatten hypertrophic scars and keloids by hydrating the skin.
Certain lasers may also be used to target the blood vessels that are feeding the keloid, thus decreasing the redness and further growth.
Even after keloids have flattened, there is a possibility of recurrence if they are traumatized or irritated.
For depressed scars, options include injection of “filler materials”, dermabrasion, and treatment with resurfacing and subsurfacing lasers. Chemical peels and microdermabrasion are also options for superficial scars and can be combined with bleaching creams and sunscreens to lighten hyperpigmented scars.
Surgically removing an existing scar and replacing it with a less noticeable one may be done for wide, long and bizarre-shaped scars. Contractures can also be treated by excision and skin grafting.
But before anything else, the PDS recommends that it is important to discuss the matter thoroughly with a board-certified dermatologist so that treatment procedures and expected results are clearly understood. Usually a combination of different modalities and repeated treatments are required. It is imperative that realistic expectations be set regarding the extent of improvement since 100% disappearance is impossible. For those stubborn cases, cover-up foundation, hairstyle and clothing can help hide the scars.
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