My Evidence-Based Scar Treatment

Summary

This video script delves into the science of scarring, explaining the anatomical components of skin and the wound healing process through various phases. It addresses common questions about scars, discusses factors that impede healing, and offers advice on optimizing the post-operative process. The video also introduces a custom-made silicone-based scar gel, 'Feel Confident,' designed to improve the appearance of scars, and provides guidance on when to use laser treatments or microneedling for scar management.

Takeaways

• 🧬 The skin is composed of the epidermis, dermis, and basal layer, each with specific functions for protection, strength, and cell regeneration.
• 🚑 Wound healing is akin to disaster response, involving immediate care, reconstruction, and eventual beautification, albeit often leaving scars as signs of damage.
• 🩹 The inflammatory phase of wound healing is crucial for releasing substances like VEGF and initiating the healing process, peaking within hours and lasting about a week.
• 🌱 The proliferative phase involves epithelial regeneration, fibroplasia, and collagen formation, which is vital for re-establishing the skin barrier and building strength.
• 🔄 Maturation and remodeling can last 12 to 18 months, during which the scar strengthens, decreases in size, and redness, reaching 70-80% of normal skin's tensile strength.
• ⚠️ Abnormal wound healing can result in various types of scars, including contracted, rolling, hypertrophic, atrophic, and keloid scars, which may require different treatments.
• 💊 Factors like diabetes, malnutrition, and tobacco use can impede normal wound healing, highlighting the importance of managing underlying health conditions.
• 🛠️ Optimal surgical technique, including tension reduction during closure and appropriate suture selection, is crucial for minimizing scarring.
• 🧴 Post-operative wound care involves keeping the wound clean, reducing movements, and transitioning from ointment to scar gel to promote healing without drying out the wound.
• 💡 The custom-made 'Feel Confident Scar Gel' is designed with silicone and natural oils to improve hydration and reduce excess collagen production, aiding in scar reduction.
• ☀️ Sun protection is important during the healing process, as UV exposure can worsen the appearance of scars, recommending the use of SPF 50 over the scar gel.

Q & A

What are the main anatomical components of the skin?

The main anatomical components of the skin are the epidermis, which provides a protective waterproof layer and color; the dermis, which provides most of the skin's thickness and toughness; and the basal layer, which continuously replicates and pushes dying keratin to the surface.

What is the role of collagen in the skin?

Collagen in the dermis provides intrinsic strength through extensive cross-linking, similar to a braided rope, and is crucial for the skin's toughness and integrity.

How is the process of wound healing typically divided?

Wound healing is typically divided into several phases: the inflammatory phase, the proliferative phase, and the maturation and remodeling phase.

What happens during the inflammatory phase of wound healing?

During the inflammatory phase, there is platelet adhesion and aggregation, release of active substances like VEGF, initial vasoconstriction followed by vasodilation, and reparative cells move in to begin the healing process.

What is the purpose of epithelial regeneration in the proliferative phase of wound healing?

Epithelial regeneration in the proliferative phase is critical for re-establishing the barrier to protect underlying tissue from bacteria and other foreign materials.

How long does the maturation and remodeling phase of wound healing typically last?

The maturation and remodeling phase of wound healing typically lasts for about 12 to 18 months, during which the scar gradually becomes stronger and shows a decrease in size and redness.

What are some factors that can impede normal wound healing?

Factors that can impede normal wound healing include diabetes, hypothyroidism, malnutrition, immunodeficiency, radiation exposure, retained foreign bodies, and tobacco use.

What are some tips for optimizing healing after surgery?

To optimize healing after surgery, it's important to control underlying medical conditions, use great surgical technique, reduce tension during closure, and select appropriate sutures.

How should post-operative wound care be managed for a surgical incision?

Post-operative wound care should involve keeping the wound clean, reducing movements involving the incision, removing surface sutures at the appropriate time, and transitioning from ointment to scar gel to promote healing.

What is the purpose of using a scar gel after surgery?

Scar gel is used to normalize the hydration of the scar, inhibiting the instruction sent to fibroblasts to produce excess collagen, and to improve the appearance and texture of the scar over time.

What are some alternative treatments for scars, and when might they be appropriate?

Alternative treatments for scars include silicone sheets, steroid injections for elevated scars, surgical revision for wide or cross-hatched scars, and laser resurfacing or microneedling for specific types of scars, depending on the stage of healing and the nature of the scar.