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Early treatment essential for scars

Georgia Merton gmerton@pharmacytoday.co.nzWednesday 05 July 2017, 4:01PM
Early treatment essential for scars

An impressive scar can make a good story, but aside from that they don't hold much appeal. Fortunately, treating most types of scar follows a straightforward formula.  

Where your customers' options vary depends on the timing, explains dermatologist Louise Reiche. For immediate post-wound cases, especially where they've just had their stitches out, she says medical tape is the best option.  

"Early application helps to disperse the pressure away from the line of the scar and spreads it to surrounding areas, reducing pressure on the wound-healing component," says Dr Reiche.  

A dermatologist in Palmerston North, she has recently delivered workshops on scar healing and other skin care for pharmacists at the latest Pharmaceutical Society symposia.  

Dr Reiche says the early and correct use of medical tape will help prevent the prevention of thickened (hypertrophic) scars, or keloid scars, which are overly thickened scars where the healing process has been exaggerated. She always recommends the tape be applied perpendicularly to the wound.  

Although she says getting tape on early is more important than the actual nature of the tape, there are different options to consider for different patients, such as elderly patients with delicate skin for whom micropore tape can help.  

"Obviously, it's important to ask for allergies and, if there are any, then give a hypoallergenic tape," says Dr Reiche.  

"Also it depends on the anatomical site and whether cosmetically they want to use something narrower or skin-coloured, or if it can be covered with clothing," she says.  

Scar sidebarPharmacist Catherine Armes says, for her, the gold standard for anyone with a scar is silicon. In particular, she's seen really good results from the silicon patches, which work in a similar way to tape by distributing pressure.  

"We had a customer who'd had thyroid surgery, so she had a scar on her neckline, and she was absolutely amazed by how much it reduced her scarring. Even her surgeon couldn't believe it," says Mrs Armes, who works at Simply Pharmacy in Albany, Auckland.  

According to Dr Reiche, the general rule of thumb for post-suture taping is to keep it on for the same amount of time the stitches were in. However, for wounds on the upper torso and arms, six to 12 weeks is recommended.  

And for those with older scars that are already thick or raised?  

Dr Reiche says tape may still be effective but at this stage she would recommend a topical cream such as Hirudoid.  

Bepanthen scar treatment cream, she says, is also a good option, and one which Mrs Armes frequently recommends to her ­customers.  

"Massaging a scar can help a bit, too, as it increases blood flow," says Dr Reiche, and she believes that while evidence may be lacking for the effectiveness of oils like rosehip or Bio-Oil, it can certainly make people more comfortable.  

Pharmacist Geraldine Phillips, whose popular pharmacy in Auckland's Herne Bay is full of natural products, says her go-to is the Mebo range, and rosehip oil, with which her customers have had great success.  

"We've seen it work on all sorts of things," says Ms Phillips. "Somebody spilled Roundup on their foot and it cleaned up the scars from that. It's not a fast fix but it's worth it." 

It doesn't always take an injury to get scarred, and the skin can bear the marks of conditions like eczema, acne and chickenpox.

According to Dr Reiche, the treatment for this permanent scarring is the same as for wound scars: tape and topical cream.  

"If a thick scar persists after that, they should go and see a dermatologist," she says, and explains that the best way to minimise scarring in these cases is to improve scar prevention by properly treating the cause.  

Stretch marks, which are often associated with pregnancy but can be a symptom of non-pregnancy- related weight gain, are also a form of scarring. Dr Reiche says the best results have been seen with topical retinoids, and newer red stretch marks will respond better than old white ones.  

While healing is slower with age, Dr Reiche says one advantage of ageing is that scars tend to get thinner and less obvious. GM

 
 
 
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