scars

Scar Guide

An introduction to everything scar related

So, you’ve had and operation or an accident which has left you with a wound. Your wound seems to be healing well but you are concerned about the scar and how it is going to affect your life, moving forward.

A scar on your face or arms can be particularly noticeable, but scars can also cause issues in other places. Will that continue?

You may be wondering: how can I best care for my scar? And how can my scar heal as optimally as possible? Read on. Hopefully you’ll find reassurance and guidance in the pages of this site.

Take care of your scar

When the skin heals, after an accident or surgery, a scar remains. Most scars look red and swollen at first, but these symptoms can disappear over time. A normal scar becomes flatter after 6 to 9 months. The tissue also becomes softer and the colour lighter. In order to understand how treatments work it is best to look at the reasons and processes involved in scar creation.

What is happening when scars are formed?

A shallow wound generally does not develop a significant scar. In these cases the underlying tissues are able to re-create much of the skin structure and so the scab will detach, leaving behind normal healthy skin.

Any deeper skin wound however, will always result in scar formation. This is because the injury has gone deeper than the layers of the skin needed for normal skin repair and the skin begins to lose large amounts of moisture through the wound.

This loss of water is recognised by the body which reacts by producing something to quickly and effectively block the wound and prevent this loss of moisture. It needs to act quickly so it produces more connective tissue made from collagen. (Think of it a bit like plugging the hull of a small boat if it sprung a leak. Anything will do to fill the hole and stop the boat sinking!)

This connective tissue is not the same as healthy skin, but under normal circumstances the production of this tissue slows down and the wound is left to close naturally leaving a flat, pale , flexible line of connective tissue where the injury took place.

Problem Scars

In problem scars the production of connective tissue continues after the wound has fully sealed. Its almost s though the body doesn’t get the message from the skin that the loss of moisture has stopped, so it produces far more collagen than is necessary. This results in Hypertrophic and Keloid scars.

Some people are, unfortunately, more likely to develop a so called “problem scar”. If any one or more of the following factors are present.

Hereditary tendency – abnormal scars can run in families.
Young age – children’s scars are affected by their faster metabolism as they are constantly growing.
Dark skin colour or very pale skin. Both extremes of the skin colour spectrum can experience a greater propensity for problem scars.
Wounds that are still not closed after 2 weeks.
Scars on joints or breastbone – tissue that is constantly moving tends to be more prone to problem scarring than skin which remains relatively still.

Hypertrophic Scar

Research has shown that 1 in 2 scars become hypertrophic after surgery

You can recognize a hypertrophic scar by the increase in redness and thickening of the scar tissue. It protrudes directly above the healthy skin edge without spreading out beyond the line of the original wound. In addition, the scar can itch, hurt and pull on the skin.

How does such a scar develop?

A wound causes moisture loss through the skin. The body tries to protect itself from dehydration by creating extra scar tissue. So-called thickened scar tissue.

A hypertrophic scar usually occurs about 6 weeks after the wound has closed. Healing can take 1.5 years.

Keloid Scar

If the scar grows beyond the edges of the original wound, it is called a keloid scar

A keloid scar is a proliferating problem scar. The scar grows beyond the edges of the original wound. And has a bright red to purple colour. Spontaneous recovery is not possible. Without treatment, the scar will continue to grow and proliferate.

What is a keloid scar?

A keloid is a benign growth. It is caused by excessive production of scar tissue, which results in a thickened scar. The scar grows beyond the original wound edges. The scar can cause many complaints such as itching, tight skin and pain. The skin is often pink or purple. In addition to the fact that the scar is thickened or raised, it is also smooth and often shiny.

How does a keloid scar form?

Genetics and skin colour play a major role in the development of this type of scar. If you have dark or very pale skin, for example, you have an increased risk of getting it. They mainly occur on the chest, back, shoulders and earlobe. If an inflammation occurs during the healing process, a keloid can develop.

How do you treat the scar?

Nowadays, we know a lot about how to care for a scar. Although it is sometimes difficult to prevent the formation of a scar completely , we can positively influence the recovery process. A scientifically proven treatment method uses silicone sheets or silicone gel , which are known worldwide as the best option for both the prevention and treatment of scars.

First used in 1983, silicone has been shown to be simple, safe and effective. It works by limiting moisture loss by a process of occlusion, basically putting a layer over the top of the wound which effectively stops the skin surface losing moisture. The theory is that occlusion amplifies the message to the skin that the excessive moisture loss has stopped and so the skin stops producing the connective tissue, thereby halting the growth of the scar.

Daily use of a silicone sheet or silicone gel has been shown to:

Relieve itching
Reduce pain and irritation
Help with redness
Soften the skin
Reduce the thickening of the scar

Silicone helps the skin to retain moisture and ensures that the scar recovers faster and better.

Silicone therapy can help the scar heal, but additional treatment may be necessary. It is crucial to hydrate the scar well. By limiting moisture loss, symptoms such as redness and a tight feeling can decrease. Silicone is the most commonly used and scientifically proven treatment method.

How soon should I start silicone therapy?

It is important to be patient and not start too soon. Silicone therapy should only be initiated AFTER your wound has healed and sealed. All the scabs from the wound and any stitch points must have fallen away. If you are a little further down the journey its good to know that after wound closure, you have two years to influence the shape of your scar.

Beyond that timeframe, you can no longer do anything about the shape of your scar but you can still influence the stiffness, itching and pain. The sooner you start with silicone scar treatment, the better your scar will heal.

So start treating your scar with silicone immediately after the wound has closed. Then you run less risk of complaints such as itching and redness getting worse and you have the greatest chance of a scar that is barely visible and almost unnoticeable.

Silicone sheets or gel?

That depends on your scar and your personal situation. Consult with your doctor which format is most suitable for you.

A Silicone sheet is a flexible product used for scar treatment with silicone . It conforms well to the body and has good adhesive strength. They are produced in a range of thicknesses and whilst all have the same effect, the choice depends mainly on the location of the scar.

Silicone gels are usually transparent and self-drying gels, made of medical silicone. The gel forms a thin layer on the skin, without being absorbed. The layer ensures that the moisture balance in the scar can be restored, making the scar less visible and reduces any complaints.

Modern silicone gels are considerably less sticky than their earlier counterparts. This means that make-up and skin camouflage can be applied over them in a matter of seconds without it smearing or streaking. Another advantage is that some silicone gels are produced with an in-built Sun Protection Factor. All scars should be protected from direct sun exposure for at least 2 years and these products make the whole process simpler.

There are a few guidelines to help you choose.

Silicone gel is suitable for small scars on visible areas such as your face or neck.
Silicone sheets are suitable for larger scars and for scars on parts of the body that are covered by clothing.
For scars on joints and skin folds or other “moving” parts of the body, there are lightweight silicone sheets or you may prefer to keep reapplying the gel.

The ultimate clinical outcome is generally the same whichever format you choose. It’s more a case of convenience and personal choice as, if you don’t use it – it won’t work.

The best result is achieved when the silicone sheet completely covers the scar, with an overlap of approximately 2 cm around the scar (on the healthy skin). You can cut silicone sheets to the desired shape and size, remembering to create round corners and not square ones, to increase durability.

Two Brands of silicone for you to consider

Both BAP ScarCare and Scarban brands are made from Medical Grade Silicone and both are registered Medical Devices, manufactured in a medically approved facility in Belgium.

Both consist of Silicone sheets and second-generation, non-sticky silicone gels

BAP ScarCare Gel also has an spf 40 version for use specifically on the face.

Both brands of sheets have 2 thicknesses to encompass the various needs of the individual patients

BAP ScarCare sheets are transparent, making them less visible on the skin

Scarban sheets are peach-coloured but the backing is fabric, making them a little more flexible and allowing the products to be made into a wider range of shapes and sizes to suit a greater number of different recovery needs such as hands and face.

Scarban sheets also have an in-built UPF sun protector incorporated into the product and come with their own washing liquid to lengthen their active lifespan

Silicone or scar cream?

Both silicone therapy and hydration are mentioned in the international guidelines for scar treatment.

Often, simple moisturisers are recommended by practitioners but they only serve to create a smoothing layer on the surface of the skin and water-based moisturisers can actually make the skin lose moisture by evaporation. We advise that you combine silicone therapy with a good hydrating scar cream, such as ALHYDRAN . Silicone works on the skin and limits moisture loss. The cream works in the lower levels of the skin and draws moisture to the places where the skin needs it. These solutions reinforce each other.

Reduce scars on your hand and fingers

Perhaps the most difficult place to properly care for wounds and scars is on your hands and fingers.

You use your hands every day, so accidental damage is common. Depending on the severity of the injury to your finger or hand, any deep wound will produce a scar.

Sometimes surgery is needed to correct a problem with a hand or finger, resulting in a surgical scar .

In short: scars on hands and fingers are common.

Your body will try to repair the skin on your hand. If all goes well, it will become a normal scar. Unfortunately, there is a chance that the wound will develop into an abnormal scar. This can cause complaints, such as:

Redness, itching and pain
A 'pulling' feeling, as if the skin is too tight
Excessive growth of scar tissue

All of these complaints can interfere with the dexterity of your hand and this can sometimes seriously affect your ability to pick up and hold objects or perform simple tasks such as fastening buttons or writing. Had scars can seriously affect you quality of life.

Proper care of the scar helps to prevent the above complaints. That is why we developed the Scarban Hand & Finger Range. With these special silicone devices it is a lot easier to properly care for scars in those places.

For additional hydration and to assist in the application of the gloves and finger caps, consider combining the Scarban products with Alhydran cream. You can also use Alhydran when you are resting the skin from the Scarban.

Reduce the effects of scars following breast surgery

If you have had breast surgery, for example, a breast reduction or enlargement, or have undergone a mastectomy or lumpectomy for cancer treatment you will be all too aware of the wounds that these interventions can produce.

Like all scars, those on or near the breast can take between 12 and 18 months to fully mature following surgery so the use of scar recovery treatments is not just a cosmetic process. Excessive build-up of connective tissue, caused by abnormal scar development can leave the scars feeling hard and thickened as well as being raised and reddened. A wound on your chest has a high risk of developing abnormal scars. This is because there is quite a lot of tension on the skin here. 50% of surgical scars become hypertrophic . It is therefore important to start treatment as soon as possible after wound closure.

How do you care for a scar after breast surgery?

Treatment will help to make the scar less itchy and less prone to remaining red and raised, but it will also help to accelerate the maturation of the scar, making it more settled, quicker than if left alone.

The secret lies in treating the scars as soon as possible after the wounds have healed and sealed. Once all the scabs have detached from the wound itself and the suture points you should take immediate steps to keep the scars well moisturised and prevent moisture loss. Silicone therapy is an effective method for treating scars. This relieves scar symptoms such as thickening, pain, redness and itching, and helps prevent abnormal scar formation. In addition, treatment with a moisture retention cream such as Alhydran will improve the softness and suppleness of the scar, making it soft to the touch and flexible.

The effect has been scientifically proven.

Scarban Elastic – specially designed to be used on breast scars

We have developed various pre-formed silicone dressings especially for the treatment of scars associated with breast surgery. They are easy to use and care for and, like all Scarban products are designed to reduce and prevent scar complaints, such as itching and raised, red scars as well as helping to accelerate the maturation process of the wound. It is important that you start the treatment as soon as possible after the wounds have closed.

Are you concerned that an abdominal wound will lead to a highly visible scar? Taking steps early can help to minimise the visual aspect of the scar and will also help to speed up its maturation, making the skin stronger, quicker.

An abdominal scar is often caused by surgery, for example, after a tummy tuck, laparoscopy, liposuction or caesarean section . Others may be caused by trauma associated with an accident where the injury may be less precise than the careful, planned incision performed by a surgeon.

A Scar is a natural outcome of major deep trauma to the skin. As your body repairs the skin itself, scar production begins to occur in order to help minimise moisture loss. In many cases this goes well, but abnormal scar production can occur. The chance of an abnormal scar depends on all kinds of factors. A scar on your abdomen has an average risk of abnormalities, but as 50% of scars after an operation become hypertrophic, surgical intervention increases that risk.

Fortunately, you can treat abdominal scars following the closure and healing of the surgical wound. Intervention at this stage can reduce the chances of an abnormal scar developing as well as reducing issues surrounding redness, thickening, dryness, itching and pain.

How do you treat the scar?

It is important to prevent moisture loss in the case of scars. Silicone therapy is an effective method for treating scars. This will relieve the scar symptoms and help accelerate scar maturation and prevent abnormal scar formation. It is important to start treatment as soon as possible after wound closure. The effect has been scientifically proven.

There are several products you can use to treat the scar.

Your face is the main way that the world sees you. This is why we take so much time paying attention to how we look. It’s therefore not surprising that a scar on the face can have devastating effects on our self-esteem.

The skin of the face is relatively thin and perceived to be delicate, yet it is constantly exposed to the elements. Nevertheless, any wound on your face could become a scar later. Even a scrape or scratch can become a scar. To minimize the chance of a scar or to reduce its visibility, there are simple steps you can take.

How do you get a scar on your face?

A scar on your face can be very noticeable and can have various causes. The cause and recovery of the wound affect the development of the scar.

As soon as a wound occurs that is not superficial, the chance of a scar is already quite high. For example, a graze or a scratch on your face can become a scar, as long as the wound is deep enough.

Accidental Facial Damage

Scars on the face can be caused by an accident. This can be a fall or a blow, after which the wound needs to be stitched. Even deep facial wounds that are managed at home can create scars.

The face and neck are more likely to have burns than you might expect, accounting for 40-50% of patients with severe burns admitted to burn centres.*

Learn more about a facial burn scar.

_{* Source: Baar van ME. 2009 Epidemiology of facial burns in the Netherlands. PhD research. https://cutt.ly/PwZYDdBa}

Surgical Operations of the Face

Have you had surgery on your face? Then the chance of a hypertrophic scar is 50%. This applies not only to operations following an accident, but also to cosmetic procedures, such as eyelid correction. With every operation, a deep cut is made through the skin, which makes the chance of an abnormal scar much greater.

The Consequences of a Facial Scar

Regardless of the cause of the scar, an abnormal scar on your face can be the cause of unpleasant feelings, both physical and psychological. Your face is probably the last place that you would wish to have a noticeable scar. No matter where it is on the face, it is likely that you will feel that everybody is looking at your “disfigurement” and this can affect your confidence.

While a normal scar is usually thin and pale it is usually hardly noticeable. However, an abnormal (hypertrophic or keloid) scar is noticeable because it is often thickened and/or discoloured. These types of scars can also affect to mobility of the face, restricting the creation of expressions and therefore affecting our ability to communicate effectively. So much of our interpersonal communication with our friends and family is non-verbal.

Read more about the different abnormal scars here .

Complaints due to abnormal scars on your face

The chance of an abnormal scar on your face is very high, because the skin is under more tension. And if you have undergone surgery, the chance of a hypertrophic scar is even 50%.

When an abnormal ( hypertrophic or keloid ) scar develops, this scar can cause many unpleasant complaints such as:

Thickening
Itch
Discoloration
Pulling sensation
Pain

How do you treat the scar?

You may also need to consider the ability to apply makeup or skin camouflage to the affected area to help to make the scar be less prominent in the early days, post-treatment. Always choose a non-sticky Silicone gel, such as BAP ScarCare gel which is especially formulated to dry almost instantly to leave a non-greasy foundation for make up.

Finally, bear in mind that all scars should be protected from the ultra-violet radiation associated with sun exposure, particularly in the first 2 years following surgery. For this purpose, there is a BAP ScarCare gel with a built-in spf 40 to meet that need.

There are several products you can use to treat the scar