Part One of this series (available elsewhere on this site) described how and why scars happen, the four kinds of abnormal scarring, and how some people are predisposed to scarring more than others. Part Two focuses on how to treat and prevent scars at home and what medical and surgical resources are available to those interested in scar removal.
Why Children Scar Easily
Children are particularly vulnerable to scarring because their immature epidermal and dermal layers often overcompensate for an injury. What's more, parents sometimes rely on traditional wisdom in treating a cut. While such remedies as "letting the air get to it" and keeping the wound sterile are sometimes helpful in treating the wound itself, they often also facilitate scar tissue buildup.
Treatments to Avoid
Vitamin E and Hydrogen Peroxide: Experts recommend shying away from such recent and fashionable remedies as coating the wound in a Vitamin E ointment or treating the wound area with hydrogen peroxide. Recent studies have shown hydrogen peroxide will destroy new skin cells, while one-third of those treated with Vitamin E will suffer an allergic reaction.
Exposure to sun and air: "Letting the air hit it" was for many years believed to expedite healing time, since the skin was able to interact with cooling air and moisture. But now research shows ultraviolet rays can promote scar tissue discoloration. And moisture might keep the skin lubricated, but it can also deliver bacteria that might harm the open wound.
Over-sterilizing: Traditional wisdom argues for keeping a cut or abrasion as germ and bacteria free as possible. Nevertheless, the American Society of Plastic Surgeons recommends against a sterile wound environment that prevents the new skin from developing a healthy relationship and resistance to common bacteria. The wound should still be debrided - cleaned of all dead skin cells, dirt, and other foreign material - but total elimination of all organic matter inside the wound will not help prevent scare tissue formation.
Proven Treatments to Practice
Keep the cut covered: Experts recommend keeping the wound bandaged and moist, using an anti-biotic ointment for several days. This will prevent the wound from drying out and necessitating collagen fiber formation.
Keep pressure on the cut: Hypertrophic scars form when the scar tissue pops above the field of surrounding skin. Applying pressure will restrain the collagen fibers from rising past the wound's horizon. Silicone gels and pads are often used to keep steady pressure on the wound.
Medical and Surgical Treatments
There are many medical and surgical treatments for scarring, including:
- surgical revision, which involves removing the scar and stitching the skin up again;
- dermabrasion, or removal of raised scars with special equipment that "sands" down the scar tissue. It's mostly effective with sun blemishes and other minor scars;
- cryotherapy, or freezing the scar tissue with liquid nitrogen and removing the scar area; it's routinely effective in treating hypertrophic and keloid scars.
In many cases simply covering the scar with hypoallergenic cosmetics will reduce their appearance. The case for concealment is often therapeutic more than medical: concealing the scar while it heals allows the patient time to adjust to its presence.
Finally, laser surgery is a popular (if expensive) method still considered experimental. The Food and Drug Administration recently approved a laser intended to treat acne scars.
Preventing Injuries Prevents Scars
Since prevention is the best medicine, taking steps to insure children avoid injuries is the most effective means of treating scars before they have a chance to form.
Make sure children are adequately equipped for activities in which they participate, wearing all recommended padding and helmets. Children skateboarding, in line skating or riding scooters should avoid areas of uneven terrain such as gravel, broken concrete, and potholes.
Children can also benefit from talking about their scars, including describing how they feel the scar affects them emotionally. Experts agree that improving the child's self-image will greatly help them adjust to a scar's presence.