Friday, February 17, 2012

Managing Your Scar

What is a scar?
Scars result when the body repairs skin wounds caused by surgery, accident or disease. They are the natural result of the healing process. The longer it takes a wound to heal and the more damaged the skin, the greater the chance of a noticeable scar. The location on the body or face as well as the patient’s age and skin type will affect the way a scar forms. Older skin tends to scar less visibly whereas younger skin tends to over-heal resulting in larger and thicker scars.

Why are scars visible?
Mature scars become visible if they are raised, indented, or if they exhibit a different color or texture compared to the surrounding skin. Additionally, scars that cross wrinkles or natural expression lines will appear more visible because they neither follow a natural pattern nor look like a naturally occurring line.

Why do scars form?
All skin wounds will result in a scar. When a skin wound occurs from surgery, accident or disease, the body will respond with normal wound healing. Wound healing is characterized by three sequential and overlapping phases.
  •  Inflammation: In the first phase the body tries to heal the skin wound by a process of inflammation. During this time the scar will be swollen, tender and red. This phase can last up to two weeks.
  • Proliferation: In the second phase the body starts the skin repair process by depositing scar tissue within the wound. In this phase, which may last up to six weeks, the scar will become raised and hard as large amounts of collagen are being laid down within the scar. During the proliferation phase a scar is considered immature and is characterized by the three R’s: red, raised and rigid.
  • Remodeling: In this third phase the body works on the scar to soften and flatten it. During this period the scar will become more mature as some of the collagen disappears. This phase can last from twelve to eighteen months.

How can I lessen my scar?
Scar formation and scar maturation are ongoing processes. Scars continue to grow and change throughout the recovery process which may take from twelve to eighteen months. Scar massage is an effective way to decrease scar tissue build up and help make scars less noticeable. Massage will not help soften a scar more than two years old.

What is scar massage?
Scar massage is one method of softening and flattening scars. It serves several important functions:
  • Promoting collagen remodeling by applying pressure to scars
  • Helping to decrease itching
  • Providing moisture and flexibility to the scar

When should I start massaging my scars?
You should start massaging your scars two weeks after surgery. Wait until the sutures have been removed and all scabs have fallen off by themselves. Do not pull your scabs off.

How do I massage my scars?
Use the pads or soft tips of your fingers to massage the scar and tissue around the scar. Massage in all three directions.
Circles: Using two fingers make small circles over the length of the scar and the skin surrounding it.
Vertical: Using two fingers massage the scar up-and-down.
Horizontal: Using two fingers massage the scar from side-to-side.

How much pressure should I apply?
You should apply as much pressure as you can tolerate. Begin with light pressure and progress to deeper and firmer pressure. Massage lotion in, applying enough pressure to make the scar area lighten in color or turn white.

How often should I massage my scar?
Massage should be done two to three times daily for ten minutes each time.

How long is massaging necessary?
You should massage your scars as instructed for at least six months following your surgery or injury. Massaging for more than six months will not hurt your scars and may actually prove beneficial.

When should I stop massaging?
Stop massaging and contact your doctor if you experience any of the following:
  • Redness
  • Bleeding
  • Scar feels warmer than the skin around it
  • More pain than usual at the site of the scar

What else should I know about scars?
While your scars are healing, you should avoid sun exposure. Sun exposure may cause your scars to hyper pigment, or turn darker than the surrounding skin. You should use sun block with an SPF of 35 or greater and wear protective clothing at all times. Keep your scars away from the sun for at least one year following your surgery.

What lotion should I use?
  • Use any moisturizing lotion that will keep your skin soft and supple.
  • Do not use heavily perfumed lotions.
  • Do not use any lotion containing vitamin E for the first month following your surgery or injury. You may use vitamin E containing lotions after the first month.

The following is a list of some examples:
Copper Scar Cream®

Friday, February 3, 2012

Butterflies and Roses

The newly diagnosed breast cancer patient reminds me of a butterfly. Shrouded in transcendent beauty; their fragile nature can be so easily tossed to and fro by the winds of adversity. During this dread experience, they make their way along the path of life with great difficulty sometimes appearing as if there is little direction to their forward progress, yet somehow making it to their intended goal. Sometimes only with great difficulty is their destination accomplished. Sometimes, the flight is smooth and undaunted and occasionally the path leads to an untimely end.

For those who survive and endure the flight the reward is met by a transformation of resolve and duty to help protect the species. At this point they become as roses. Majestic, beautiful yet delicate and filled with sweet nectar of life from which the butterfly may draw its sustenance. The rugged thorns, spawned by adversity, provide an unyielding source of resiliency and protection to the fragile butterflies that descend upon these flowers for sustenance. It is a magnificent transformation that occurs in the lives of these women whom I admire greatly. To play a small but instrumental role in that transformation from despair to hope, to a new fulfilling and more meaningful life, is a daily inspiration and constant testament to the undaunted human spirit. The sadness of those who enter and do not leave only strengthens my resolve to fight cancer together and search harder and work more diligently.

To be among the butterflies and roses has been a pleasure, at times chaotic and thorny, but for the most part beautiful and rewarding. It is my hope that we can all embrace the beauty and hope life brings despite the adversity and sorrow we each must face.

-Charles E. Cox, M.D.