Pressure therapy is a standard treatment to prevent hypertrophic scars (mainly burn scars). Pressure therapy involves wearing garments made from elasticized fabrics or wearing masks/collars made from hard materials maybe with a silicone top layer. The exact reason why pressure works is still not fully understood. It’s thought that pressure controls collagen synthesis and limits the supply of blood, oxygen and nutrients to the scar tissue. It may also have a role in reducing inflammation.
Scars and skin graft donor sites need regular creaming (moisturisation) to prevent the area from drying, cracking and becoming sore. The oil glands in your skin which usually provide moisture can be damaged or destroyed by the injury. The surface layer of the skin which prevents water loss is damaged. Therefore, the healed skin lacks the moisture needed. Silicone works by sealing in the moisture and hydrating the scar. Through providing occlusion (covering) and hydration to the outer layer of the epidermis evaporation of water is reduced from the skin. Silicone treatment aims to flatten, soften and reduce the redness and discomfort of your scar over time. Silicones possess many skin-friendly properties; they are easy to use and remove, painless, can be worn for long periods, are resistant to microbial growth, and are waterproof.
Moisturisers increase the water content (hydration) of the stratum corneum (top layer of the skin) which fills the spaces between partially desquamated skin flakes and makes the skin appear smoother. In normal skin there is minimal water loss through the epidermis to the surrounding atmosphere. Due to damage to the skin barrier, young and inflamed scars have higher amounts of water loss; this is increased by dry skin. There is a wide range of over-the counter moisturisers available, some products claim to reduce the appearance of scars.
For newly healed wounds and scars that are exposed to sunlight it is vital to use a moisturiser with SPF protection. Because the melanocytes (pigment-cells) are unbalanced and fragile in these areas, they can over-react to normal sun exposure. This can cause the new skin or scar to become permanently darker in colour (hyperpigmented).
Several prescription and over-the-counter topical agents are available, many claim to alleviate symptoms, improve the appearance of scars and accelerate wound healing. Topical therapies have the advantage of being easy to use, are easily available and deliver the ingredients directly to the scar. Patients often decide (maybe based on word of mouth) themselves on which topical agents to use rather than through recommendations from a scar specialist. Topicals are not usually effective on their own and other treatments are also usually necessary. Some information on common topicals is given here:
Scar massage is a non-surgical technique used in day-to-day scar and burn care. There are multiple techniques that can be used and that are quite easy to apply.
