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Optimal care and tips for the invisible scar
Most people find scars an unattractive reminder of past injuries or operations, although health problems can also be caused by severe scarring of the tissue. Dr. Timo Spanholtz, specialist for plastic and aesthetic surgery, explains which care measures can lead to a perfect scar image, what is often forgotten and which products are available on the market.
Even today, scars on the face are considered chic in some circles! If you can't believe this, think of "striking student connections", which saber-struck status symbols on their faces and even sewed horse hair into the wounds to make the scar more visible. Most patients, however, have exactly the opposite interest.
After plastic surgery operations such as facelifts, breast augmentation, breast lift or tummy tuck, our patient's wish is the opposite: an invisible scar. And not just because red scars or bulging scars interfere with aesthetics - scars can also cause pain, excruciatingly itchy or restrict the body's mobility. Scar healing takes a long time, since the wound initially heals, but the scar itself “matures”, so it slowly adapts to the “normal” surrounding tissue in a long process. Scar healing is influenced by countless factors, which is why scarring can also be disturbed in many cases.
Scar types: Doctors divide fibrous, sclerotic, atrophic, hypertrophic and keloid scars
|Fibrous scar||"Normal" scars||Mostly slightly different appearance to the surrounding skin, otherwise inconspicuous||no|
|Sclerotic scar||Shrink scar||Scar with very hard, contracted tissue; often functionally handicapped||Early stage: scar care Late stage: surgical removal, new suture and immediate scar care|
|Atrophic scar||Sunken scar, retracted scar||deep scar with surrounding crater, may not be able to move over the surface||Early stage: scar care|
Late stage: surgical removal, new sutures and immediate scar care
|Hypertrophic scar||Exuberance scar, bead scar|
(in the "normal" frame)
|"Too much" scar tissue formation limited to the edges of the scar can occur during maturation and then regress again||Intensive scar care, possibly in combination with additional procedures (cortisone injection, mesotherapy, etc.)|
|Keloid scar||Exuberance scar, bead scar|
(no longer in the "normal" framework)
|This special form of scar growth affects the scar itself AND the adjacent “healthy” tissue||Complex therapies conceivable; consult with plastic surgeon or dermatologist|
You yourself can influence the maturation of the scar with a few simple measures. We have put together a few tips for you based on our years of clinical experience.
Scar care cream, scar care plasters, sun protection - which is the right thing?
Unfortunately, many surgeons do not recommend scar care after an operation because they understand the scar as a "fateful consequence of the operation" or are more interested in the results of the actual operation than in the quality of the scar. For many years there have been various scar treatments on the market such as Bepanthen® (which offers a practical massage stick), Scarsil®, Contractubex® or Kelofibrase®. Many products use more conventional ingredients such as onion extract, allantoin or heparin. Unfortunately, products that have also been required, such as scar patches, have so far been available from a few suppliers. Innovative or even patented active ingredients that specifically influence scar maturation are also the exception.
So far, only one of the products has integrated sun protection, which is especially important for scars on bare skin. The exception here is Scarcare®, a new scar care with three ingredients, which in combination should enable optimal scar maturation. The patented "Active ingredient of the year 2015" Spiralin® (awarded, among others, by the trade journal "Aesthetic Dermatology") is obtained from a microalgae organism that is millions of years old and is said to have a positive effect on the surface of the scar via its bactericidal (bactericidal) effects. The regenerative power with which Spiralin® supports scar maturation is also proven. The second ingredient, emu oil (known from the treatment of burn scars) and integrated UV protection round off the Scarcare® products. Scar care sets can also be ordered, which contain detailed instructions for scar care in addition to the required products.
What else can you do to support scar care?
No matter which product you choose: It is important to massage the scar regularly. Optimally, the scar cream is massaged directly into the young scar. It is best to start scar care as early as possible and perform it disciplined and regularly. Of course, this can sometimes be "annoying", but the result ultimately remains throughout life.
We recommend the following procedure to our patients: After showering, the scar is intensively massaged for 8 to 10 minutes using the scar cream with circular and powerful movements. After this, cream residues are removed and the scar is covered with a scar plaster (as an alternative to the plaster, the Scarcare® scar stick can be used on unclothed skin areas). In the evening, the patch is removed, the scar massaged again with scar cream and covered with the identical patch (this can sometimes be used for up to 3 to 4 weeks).
How long should a scar be cared for?
From our experience, scars ripen at different speeds. In a few cases, the final result can be seen after 8 to 10 weeks, but the care often has to be carried out for up to six months. As long as the scar is hard and reddish, care should be continued to further optimize training. Care should only be completed when a skin color (or a slightly whiter shade) has been reached.
What you shouldn't forget!
An important detail that is often forgotten and to which we would like to refer again: If you are exposed to sunlight during the formation of the mature scar, you must protect the scar with a UV blocker. Otherwise, it can lead to unsightly and permanent pigmentation. If the product you selected does not offer an integrated UV filter, it is advisable to carry a separate sun protection cream with you (SPF> 25). Only when the scar is completely pale and soft can UV protection be dispensed with.
Finally, we have summarized common scar care products for you and sorted them according to a few criteria.
Scar care products in alphabetical order, without claim to completeness
|Surname||Price / milligram or milliliter||patented active ingredients||other ingredients||UV protection||Peculiarities||further products in the field of scar care|
|Bepanthen scar angel||0,70 €||Dexpanthenol, silicone||Cream tube with integrated massage roller|
|Contractubex||0,26 €||Heparin, allantoin, onion extract||Intensive patch for the night|
|Dermatix gel||2,10 €||Silicone, vitamin C.|
|Kelo Cote Gel||1,00 €||Silicon dioxide, polysiloxane||Silicone spray, Kelo-cote UV (SPF 30)|
|Kelofibrase||0,20 €||Heparin, camphor, urea||only available in pharmacies|
|Scarcare scar care||1,40 €||Spiraline||Emuoil, Dimethicone, silicone||Yes||Developed by surgeons, UV protection in all products||Intense patch and care stick for on the go|
|Scarsoft||1,20 €||Silicone, onion extract, vitamin E, sodium hyaluronad|
Dr. med. Timo A. Spanholtz, specialist for plastic and aesthetic surgery, head of the practice clinic at the Rosengarten
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch
- Practice clinic on the rose garden: scar care (access: 16.09.2019), praxisklinik-rosengarten.de
- American Academy of Dermatology: Proper wound care: How to minimize a scar (accessed: September 16, 2019), aad.org
- American Society for Surgery of the Hand: Scar Management (accessed: September 16, 2019), assh.org