How to prevent scars

Scrapes, cuts, burns, gashes and surgical wounds all have one thing in common: they can leave a permanent mark on skin. If you suffer an injury – whether big or small – there is a chance you will end up with a scar. Let’s learn more about the healing process and scar prevention.

How wounds heal

Inevitably, the deeper the wound is, the greater the potential for scarring. To better understand why this is so, let us examine the structure of the skin. Skin is a vital organ composed of three distinct layers: the epidermis, dermis and hypodermis.  

The key role of the epidermis is to act as a protective barrier against external aggressions and retain water in the skin to prevent dehydration. It contains no blood vessels.

The dermis is the layer involved in the healing process. It contains fibroblasts, cells responsible for the production of the collagen and elastin needed by skin to rebuild itself after an injury, and blood vessels.

Lastly, the hypodermis, the underlying layer, is rich in vascular and fatty tissues. It helps regulate the temperature of the body and protect it from trauma.

So what does all this mean for wound healing?

• A surface wound that only affects the epidermis will not bleed or leave a scar.
• A wound that reaches the dermis will bleed, but generally not scar.
• An injury to the hypodermis will leave behind a scar after it has healed.

Once an injury has occurred, either due to an accident or a medical intervention, a complex healing process begins. We can simplify it by breaking it down into three main phases: inflammation, repair and remodelling.  

The objective of the first phase is to put a stop to the bleeding and clean the wound by eliminating bacteria and foreign substances. The second phase involves the formation of new blood vessels to carry nutrients and oxygen to cells, the multiplication of fibroblasts to fill in the wound and the reconstruction of the epidermis around the site of injury. The third phase, which can last up to 2 years after the wound has closed, restores the tensile strength (or resistance) of injured skin.

Factors that affect healing

Many factors can influence the rate and result of the healing process.

• Age: the younger you are, the faster you heal, but scarring can be more pronounced
• Genetics
• Skin pigmentation: people with black or Asian skin are more likely to experience scarring
• Size and location of the wound: the chest, back, outer arm and joints scar more easily than other body parts
• Infection
• Malnutrition and deficiency in vitamins and minerals
• Obesity
• Diabetes
• Poor blood circulation
• Stress
• Smoking

Wound care

You can easily treat life’s little cuts, scrapes and other mishaps by following these few easy steps:

• Clean the wound with water and a gentle unscented soap or saline water. Remove any debris. Avoid the use of rubbing alcohol, since it can dry and irritate the injury and hinder the healing process.
• Apply an antibiotic ointment to prevent infection.
• Protect the wound with a bandage and change it every day. Keeping the wound site moist promotes healing.
• Once the healing process has begun, you can help it along with the use of a moisturizing and scar-reducing cream. Other than creams formulated specifically for this purpose, you can also apply vitamin E, aloe, green clay, emu oil or thyme honey to the wound site in order to speed healing and minimize scarring.

For larger injuries, you will want to consult your family pharmacist, a doctor or a nurse to find out if you need stitches or special dressings.

Here are some tips to speed the healing of all types of wounds, either accidental or surgical:

• Eat well.
• Do not touch or pick at the wound, scab or stitches.
• Minimize stress.
• Quit smoking .
• Do not expose the wound to the sun, since this increases the pigmentation of the scar. Once healing is complete, apply sunscreen containing an SPF of at least 30 for the next 24 months.

For larger scars (e.g. post-surgical scars), a daily massage to soften skin and keep scar tissue from adhering to the dermis is recommended.

 
Treating residual scars

The healing process can leave behind supple scars that are practically invisible or more painful, unsightly scars (pigmented, depigmented, retractile, sunken, hypertrophic, keloid). If you have a visible scar you would like to minimize, here are things you can try.

Silicone gel compresses, available at the drugstore, are an interesting option for reducing the redness, swelling, itch and tightness associated with scars. Some products can even be used several years after the wound has closed. To learn more, talk to your family pharmacist or doctor.

Medical interventions can also be considered. These include collagen injections, steroid injections, surgery, skin restoration and laser treatment. Before going forward with any such procedure, you will need to learn more about associated risks and costs. Dermatologists are the experts in this respect. They can advise you on the medical intervention that will be most suitable to your particular situation. Generally speaking, you will need to wait at least one year after the closure of the wound to try any of these techniques.

Pharmacy services

Your family pharmacists can give you the advice you need on caring for a wound and show you the products that can promote healing. Talk to them: It’s what their job is all about!