Scar Free || Treatment options for scar minimisation explained!

October 20, 2016October 20, 20161 Comment

It’s all fun and games until you end up over the handle bars of your bike….scenes of tears, scars or worse, Brad Pitt-less – that is if you’re Angelina! Unless you live in a bubble or are Teflon coated, chances are you won’t have a skin which is ‘Scar Free’. Whether from surgery, pool dives gone wrong, cuts, stretchmarks or even acne; scars are an inevitable tracing of a life well lived. Wherever the skin has been broken and needs to repair itself, there will be a story to be told with a scar.

Defintion:Scar – a mark left on the skin or within body tissue where a wound, burn, or sore has not healed completely and fibrous connective tissue has developed.

Any injury to our skin can result in a temporary or sometimes unwelcome permanent scar. If it’s not a conversation opener at a dinner party, we spend a lot of time disguising, covering or wanting to get rid of them.

Unlike the gorgeous Kate Middleton, your scar isn’t hidden beneath your hairline, there are a number of scar minimisation treatment options available to help reduce the appearance of those unwanted scars.

Skin heals unpredictably and so it can tough to predict the nature and extent of scarring after an injury or operation. Multiple factors including skin type, age, health status and the depth and nature of the injury to the skin all contribute to how a scar heals and what residual signs or scars may be left. Different skin types also have an impact on how the skin heals For example, Asian or darker skin types have an increased risk of developing keloid, hypertrophic scarring or post inflammatory hyper pigmentation.

First up….Types of scars

Mature scars are scars which have completed the healing process. These types are definitely more challenging to treat.

Flat scars are scraped knees, abrasions or common superficial injuries.

Atrophic scars are indented or depressed scars where and include the destruction of the supporting structure of the dermis- seen in post acne scarring.

Keloid or Hypertrophic scars occur from superficial to deep injury of the skin and more commonly affect darker skin types or those with an Asian descent. They may undergo surgical revision with no guarantee of resolution. Keloid scars usually occur from the chest up, where scar tissue grows outside the borders or boundaries of the original scar or injury – seen in tribal markings or facial piercings.

Hyper-pigmentation This is where there is a darkening of the skin caused by an increase in melanin production in the post inflammatory phase of a wound repair. Sun exposure during the healing process can exacerbate this.

Hypo-pigmentation is a loss of melanin to the site of injury and may be permanent or temporary depending on the depth of injury.

Early tip; Before that scar horse bolts…… Good wound care and scar prevention is always better than seeking scar minimisation treatment options.

A quick tour on how the skin heals…

There are three phases in wound healing and they all overlap each other ultimately resulting in the healing of a wound-

Inflammatory phase– the bodies first response, is to stop the bleeding and send in it’s army of protective cells to ward off infection as well as cells that will direct the healing process .

Proliferation phase– is the crucial rebuilding stage where epithelial cells (skin cells) resurface the wound — seen in a scab.

Maturation phase– this is the final stage and the replacement of collagen from type III to type 1.During this phase erythema or redness decreases. This phase may take up to 2 years to complete.

Myth busting….A common misconception is that wounds should be air dried and a scab allowed to form. Recent studies now confirm that keeping wounds moist and covered with dressings not only reduces pain and the risk of infection but also results in faster healing times when compared to dry wound healing.

Tip; A quicker a wound heals the less of a scar it will form.

You’ve got that Scar now what?

Treatments explained….

Sunscreen – Sun protection is vital for minimising the appearance of scars preventing hyper or hypo pigmentation – Use a broad-spectrum sunscreen to protect against UVA and UVB rays.

Tip; the zinc in broad-spectrum sunscreens has great healing properties in addition to sun protection.

Massage the wound gently – this helps in breaking down and lessons the risk of thick scarring from forming. Massaging should only be performed during the maturation phase of healing.

Retinols – when applied topically these Vitamin A derivatives help to control hyperpigmentation whilst facilitating cell renewal.

Silicon gel sheeting – Putting a sheet of silicon gel on a scar every day may help it fade or keep it from getting worse. The sheeting is available at pharmacies or from dermatologists and should be used for at least 3 months.

Concealer – A quick fix! Pick a shade that is waterproof and most effective with the colour of your scar and skin tone. For a pink scar use concealer with green undertones, for a brown scar, try a concealer with a yellow undertones.

Bleaching creams – May be effective for dark hyper pigmented scars.

Dermal fillers – Injecting substances such as collagen or fat can immediately raise sunken atrophic scars. However, this treatment isn’t permanent and may need to be repeated regularly to maintain benefit.

Steroid injections – These may help flatten raised scars, but a long-term course may be needed note-Long term use of steroids in the skin may also cause a thinning of the skin.

Dermabrasion – This procedure abrades the surface of the skin,helping to reduce the look of raised scars.

Microdermabrasion – a less invasive process, helping superficial scarring.

Laser resurfacing – The skin surface is removed with lasers, or lasers are used to work on the collagen in the dermis without removing the upper layer of skin.

Micro-needling – Small needles are delivered into the dermal layers of the skin, to break down scar tissue and stimulate the formation of new collagen.

Subcision – The sharp edge of a hypodermic needle is used to break down fibrous connective strands underneath the scar to improve appearance .

Surgery – You can’t remove a scar entirely with surgery, but you can alter its size, depth, or colour. Surgery isn’t suggested for hypertrophic or keloid scars because it can make them worse.Consult with an experienced Plastic Surgeon or Cosmetic Surgeon prior to considering this option.

The good news is scars do resolve themselves significantly over time but some may never completely disappear.It’s good to know however, that for those people who can do without the permanent reminder of a life well lived, there are many scar minimisation treatment options available.

Have you had any success with removing scars?

Susan x

AT WAR WITH PIGMENTATION – MY TOP TIPS!

May 3, 2016December 10, 2016Leave a comment

We Aussies love our sunburnt country! Many Australians will have experienced a ‘Sunburnt Sunday’. Unfortunately, those lazy Sundays spent in the sun can manifest in pigmentary dischromias in the skin. These pigmentary dischromias are caused by the accumulation of UV exposure and referred to as photoaging. Unwanted dark spots, uneven skin tone, solar lentigines (brown age spots) and even Melasma-a condition which can be triggered by the sun, hormones or have a genetic influence are a visible reminder of our fun in the sun.

Thankfully, there are a number of treatment options available to reduce the appearance of pigmentation, all involving persistence, patience and a little light based intervention. Depending on the type and severity of pigmenation treatment options can be tailored to skin type with great outcomes and happy campers!

When 2 tribes go to war- Hyper vs Hypopigmentation

Hypopigmentation is the absence of melanin and is caused by sun damage, seen in conditions such as Idiopathic Guttate Hypomelanosis and Vitligo. Idiopathic Guttate Hypomelanosis appears as ‘white spots’ in sun exposed extremities like arms and legs. Vtiligo includes larger areas of depigmentation and may be caused by an autoimmune disorder, triggered by sunburn, stress, genetics, viral infections or even physical trauma to the skin. In a recent blog I’ve detailed available treatments options – From Valentino to Vitligo for further reading. Fungal infections such as Tinea Versicolour or Pityriasis Alba may also temporarily cause hypopigmentation and are successfully treated with anti-fungal or over the counter steroidal creams.

Hyperpigmentation occurs when the cells, which produce pigment in our skin called melanocytes, are overactive and produce an excess of melanin, resulting in an uneven distribution of pigment.-the cause of which can be due to sun damage, hormones or disease-which in some cases are more difficult to treat.

Personally, I have a love/hate relationship with hyperpigmentation. I hate that hyperpigmentation is a visible sign of aging-photoaging. Conversely, I love the outdoorsy lifestyle which keeps me on the hyperpigmentation treadmill of triggering pigmentation and it’s subsequent removal! I also love the many treatment options available used to treat my hyperpigmentation .I’ve used them all……well most of them, to successfully fade and treat my pigmentation…..here are my tips!

Weapons of mass pigmentary destruction

Home care arsenal – ingredients to look for and include in your skin care!

Sunscreen – prevents the oxidative stress caused by UV rays leading to pigmentation
AHA’s BHA’s and Exfoliators – shortens the cell cycle, removes superficial skin cells, interferes with pigment transfer and allows deeper penetration of lightening agents
Vitaminc C- inhibits melanocyte proliferation
Licorice extract
Bleaching agents Hydroquinone, Kojic acid, Azealaic acid and Arbutin
Retinols accelerates cell turnover
Niacinamde/Nicotinic acid/ Soy acts as a skin lightener working by inhibiting melanosome transfer from melanocytes – keratinocytes in the production of melanin.

Tip; Allow 12 weeks to see an improvement. As a point of reference, take a photo so you have something with which to compare and track improvement.

Bring on the big guns !

Lasers/ IPL – treat pigmented lesions by selective photothermolysis, Heating the targeted tissue, effectively destroying the pigmented cells.
Chemical peels are another great treatment option to consider.They can vary in strength and depth of penetration and should be tailored to skin type. Combinations of Glycolic and Lactic acids have been found useful in treating pigmentary disorders by lifting and exfoliating the superficial pigmented layers of the skin.
Kligmans formula – a combination topical therapy containing Vitamin A, Hydroquinone and a corticosteroid-prescription only and not advised for long term use.
Transexamic Acid an oral treatment used as a treatment for heavy periods it has been found to inhibit tyrosinase activity aiding in prevention of melanin production.

Understanding the types and causes of pigmentation will contraindicaciones del viagra en adultos mayores determine which treatment options will achieve the best outcome. Together with a tailored home care program ‘Winning the War’ against pigmentation has never been clearer!

Need some help with diagnosing what type of pigmentation you have, drop me a line?