Scar care
definition
For many people, scars represent physical (pain, itching), but also emotional (aesthetic impairment) stress. For this reason, scar care is of great importance for the physical and emotional well-being of those affected.
The term scar care therefore summarizes measures that are intended to either reduce the rate of complications when a scar is healed (e.g. to avoid inflammation and reduce pain) or to improve the cosmetic result. The latter can be influenced particularly effectively within the first two years through regular scar care, while with older scars a positive influence is only possible to a small extent.
The various measures described below are also of great importance for long-term freedom from symptoms, as inadequate scar care can lead to unpleasant complications such as inflammation or painful adhesions long after the scar has actually formed.
What should you watch out for in scar care?
Despite the different types and causes of scars, there are some basic rules that should generally be observed.
This includes regular (preferably daily) cleaning of the scar with clear water, unless this is contrary to an express medical instruction. On the other hand, contact with soaps or shampoo should be avoided with fresh scars, as the ingredients they contain can irritate the scar and the underlying tissue.
The scab, the body's own protective layer over a wound, commonly known as crust, falls off by itself after the healing process is complete. So in order to prevent the scab from accidentally coming off prematurely during scar care, the scar should only be dabbed lightly after cleaning and not wiped dry.
In addition, scars should be protected from particularly high or low temperatures. Both extremes can actually slow down the healing process. Until the scar has completely healed, visits to the sauna or solarium and ice baths should be avoided, and excessive and long exposure to the sun should be avoided.
It is advisable not to wear close-fitting clothing in the area of the scar or wound, both in the case of scars as a result of a medical suture and in the case of unsutured scars with scabs (e.g. abrasions). Such clothing can on the one hand irritate the tissue through friction and on the other hand lead to premature detachment of the scab.
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Care of specific scars
Surgical scars
The surgeon's instructions always have top priority in scar care after an operation. This resulted from the fact that scars differ greatly depending on their location and extent, but also on the type of suture, and the surgeon, as the "cause", obviously knows the scar situation best. Nevertheless, the following basic guidelines can be formulated.
In scar care following an operation, two phases can be distinguished, which are separated from each other by the pulling of the threads. Before the threads are pulled, the skin is not yet completely closed (the threads are supposed to help with this closing process), so other scar care measures must be used than after the skin has been completely closed.
So-called healing ointments can be applied even before the skin is closed, i.e. when the threads have not yet been pulled. These support the healing process of the tissue and ensure that the skin remains elastic in the affected area. When choosing a suitable healing ointment, it is best to seek advice from the pharmacy and, if necessary, ask specifically whether it is a product that is suitable for the treatment of not yet fully closed wounds.
Jerky and strongly stretching movements in the scar area should be avoided both before and after pulling the sutures in order to prevent the scar from bursting.
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After the wound has been completely closed and the sutures removed, massaging the scar area can help mobilize the scar and thus make it flatter, softer and more flexible, which can prevent the occurrence of later complications due to adhesions. There is also the possibility of using silicone gels. These should be applied at least twice a day over several weeks and lightly massaged into the tissue. This promotes the healing process and improves the elasticity of the scar tissue. An alternative that is easier to use are scar plasters on a silicone basis, which can be stuck to the scar for 12 - 24 hours and develop effects similar to those of silicone gels. The advantage of all silicone products is the complete absence of pharmaceutically active ingredients, which is why there are no known side effects.
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Caesarean scars
The scar from a caesarean section differs from superficial skin scars, which e.g. caused by abrasions or the removal of a mole, through the inclusion of all deeper tissue layers up to the inside of the uterus. For this reason, the caesarean section scar poses a special challenge in terms of scar care. In the course of the healing process, which often takes several months, adhesions, sensitivity to weather, numbness, pain, burning or itching often occur in the area of the scar; in other cases the scar heals completely without complications.
In order to prevent the occurrence of the complications mentioned or at least to alleviate their severity, scar care is of great importance practically from the time of the suturing by the delivering doctor. The measures of scar care include regular cleaning of the scar with clear water and then careful drying. Soap should not be used for cleaning until the doctor has removed the stitches. It is also advisable to wear additional clothing in the first days to weeks after the birth to prevent the scar from chafing.
In order to protect the scar from excessive strain and stretching, no abdominal muscle training should be performed in the first four to six weeks after the birth. It is also advisable to roll over your side when getting out of bed and to lift yourself out of your legs and not too hard.
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If the symptoms such as pain, itching or burning worsen over the course of the procedure, it is essential to consult a doctor as well as in the case of signs of inflammation (severe reddening and overheating, pain), bleeding or oozing of the wound.
continue reading: Pain after caesarean section
Scars after eyelid surgery
Scar care is an important factor in achieving a satisfactory visual result of an upper eyelid lift, although the surgeon's skill is obviously the main factor.
Also after an upper eyelid lift, as with all surgical interventions: It is highly recommended to follow the surgeon's instructions on scar care or to ask him specifically about such, if he has not provided sufficient information on the further procedure. Some surgeons recommend completely avoiding the use of an ointment to promote scar healing. Others are in favor of massaging Bepanthen, silicone ointments or vitamin A ointments onto the scar area. In the case of the Bepanthen ointment in particular, however, allergic reactions are often reported, which is why its use is only recommended with reservations. From the above it can be deduced that it is of secondary importance which ointment is used - the massaging and moistening / greasing of the scar tissue that is achieved is much more essential for scar healing.
In the first week after the operation, make-up should not be applied to the scar area, as make-up particles can lead to a so-called "scar tattoo" in this way.
More on this: Eyelid lift
Scars after breast surgery
Even after a breast operation, the surgeon's recommendations regarding scar care are of the utmost importance. Nevertheless, some basic rules apply, which are presented below.
In the first two to three months after the procedure, the tension on the sutures should be kept as low as possible. Since even simple shoulder movements, which every person performs many times a day, also move the chest area, this relief of the seams is particularly difficult during breast operations. For this reason, it is advisable to immobilize the seams with strips of fleece or silicone plaster. In order to stabilize the breast and thereby relieve the skin, a bra should also be worn at night for the first few weeks.
A regular scar massage, which by the way can be wonderfully combined with massaging in greasy ointments, has a long-term positive effect on the elasticity and mobility of the scar tissue. However, it should only be started after the sutures have been removed (unless absorbable sutures have been used). The ointments used here include e.g. Bepanthen or the more expensive silicone ointments and gels.
In addition, the scar area should not be exposed to direct UV radiation as this can irritate the scar and impede the healing process.
Inform yourself: Risks of breast surgery
Scars on the face
Good scar care is particularly important on the face, as conspicuous scars here have particularly severe aesthetic impairments.
Another peculiarity of scar healing on the face is the increased tensile stress on the skin. This, in turn, occurs because the skin lies very close to the bones and is not separated from them by broad layers of muscle or fat, as is the case on almost the entire rest of the body (apart from e.g. hands and feet, shins, knees ). To counteract this tensile load, scar plasters can be used to stabilize the skin around the scar.
If a wound has been sewn on the face, it is advisable to take care that no shampoo and dirt dissolved in it get into the wound until the threads are removed while showering. The risk of this can be minimized by washing your hair and scalp with your head tilted back. In addition, it makes sense to slightly elevate the upper body when sleeping to counteract the swelling of the tissue under the seam.
In addition to the measures mentioned, it is advisable to use a scar cream, whereby the same rules apply as for scars in other parts of the body.
What scar creams are there?
The range of scar creams is extremely broad and difficult to survey. The difference between gels, creams, ointments and oils lies in the ratio of greasy and aqueous components to one another and the viscosity of the wound care agent. Nevertheless, the term cream is often used as a generic term for all wound products that can be applied to the skin. In any case, the decisive factor for the selection of the wound remedy is the content.
Creams with onion extract are tried and tested and are intended to prevent the formation of bulging scar tissue (see also “Home Remedies”). In addition, as with flu-like infections, it acts as a “natural antibiotic” (similar to coconut oil, see below) and thus prevents inflammation of the scar.An example of a wound remedy with onion extract is Contractubex®, which also contains allantoin (which is supposed to accelerate the healing process and reduce itching) and heparin, which is supposed to promote blood circulation and thus also help accelerate healing. Kelofibrase®, in which urea takes over the role of allantoin, also contains heparin.
A large group among the scar creams are those containing silicone. These are mostly gels that are applied to the scar and, with the help of the silicone contained, lay a waterproof protective layer on the scar. This not only makes it difficult for dirt or pathogens to penetrate the wound, but also prevents the scar tissue from drying out. Examples of such wound products are the Kelo-Cote® preparations or the Bepanthen® series. Lately, most scar cream series also have variants with integrated UV protection, which is said to have a positive influence on the healing process.
Also read: Bepanthen® scar gel
Coconut oil for scar care
One of the most popular natural scar care products is coconut oil. It has an antibacterial and anti-inflammatory effect, similar to onion extract (see above). But it also supplies the skin with vitamin E and vitamins from the B group and in this way helps to accelerate the healing process and to achieve a more elastic scar tissue. For this reason, coconut oil is a useful addition to other wound products - with smaller, cosmetically less stressful scars, even a single attempt with coconut oil can be promising.
Read more about this: Proper skin care
Bepanthen ointment
The scar gel from Bepanthen is, in a sense, the classic among wound remedies.
It contains silicone, which puts a fine film over the scar and protects it from the penetration of dirt or bacteria as well as from drying out. It also contains dexpanthenol, which also binds water in the skin and thus maintains the moisture balance in the scar tissue. The integrated massage roller, which contributes to better blood circulation and a more elastic scar structure, is particularly clever.
More home remedies for scar care
The most popular classic home remedies for scar care include onion extract and coconut oil. Both have an antibacterial effect and thus reduce the risk of inflammation of the wound. Coconut oil also contains various vitamins that accelerate the healing process. Accordingly, special vitamin E oils can of course also be applied to the scar.
Other, less frequently used home remedies are aloe vera (has a cooling and anti-inflammatory effect), lavender oil or rose hips, with which the scar can be rubbed several times a day. Lemon juice can lighten the scar tissue and thus reduce color differences to the surrounding skin. Rubbing in honey or cocoa butter gives the scar tissue much-needed moisture and thus has a positive effect on the healing process. Olive oil, on the other hand, is said to have a positive influence on the elasticity of the scar tissue.
