Scar looks and feels different because it is composed of tissues which are different. Due to this scar has different biomechanical and light reflecting properties. And at times it can lead to significant distress in those with these scars.
A scar is a living tissue that changes its composition over a period of time. We know this as scar remodeling. Many therapies exist to favorably alter the appearance of the scar. They vary in their simplicity and invasiveness. There are certain activities that can be done by anyone to make scars better. We commonly ask our patients to perform these to have a better-looking scar. These would be,
- Massage: Gentle massage can be started approximately 2 weeks after surgery. Massage is done with fingertips along the line of the scars. It can be done with an emollient or moisturizer.
- Sun protection: Dark skin individuals are prone to get changes in pigmentation of the scar. The scars in sun-exposed areas can end darker or lighter than the surrounding skin. Sun protection can be achieved by means of sunglasses, hats or simply taping the area when out in the sun.
- Sunscreen: Use of sunscreen is beneficial in the reduction of pigmentation abnormalities. Sunscreen has to be applied regularly and daily. Sunscreen application should be used even if the individual is exposed to indirect (inside room or shade) sunlight. Its use should not be restricted to the time under direct sunlight. Both sun protection and application of sunscreen is applicable to scars found in exposed parts of the body.
- Silicone sheet: Silicone sheet application has favorable effects on scar remodeling. These sheets are transparent and pliable and can be cut to overlap the scars. They have to be constantly used to obtain the benefits. Silicone sheets help in making the scars softer and more pliable. It also helps in reducing the symptoms associated with problem scars. Silicone sheets are especially useful in individuals prone to prominent scars. In individuals prone to hypertrophic (prominent) scars we routinely prescribe their use once the suture-line is left open.
- Pressure application: Application of pressure most commonly done by a pressure garment favorably influences the appearance of a scar. Since this requires a lot of commitment and compliance we advise this modality for individuals prone to hypertrophic scarring.
In most instances, scar remodeling favorably affects the scar. Scar remodeling is greatest during the initial one to two years. This usually leads to more supple and flattened scars. Because of this, we tend to postpone any surgical scar treatments until one to two years since we would like to reap the benefits of scar remodeling.
To conclude, though one can't completely eliminate scars, it is possible to influence the outcome of scars by means of simple techniques that be done by the patient. With compliance, a patient can end up with more acceptable scars.