About Scar Treatment.
- Type after scratch
- Causes of noticeable scratches (hypertrophic scars and keloids)
- Treatment after noticeable scratches (hypertrophic scars and keloids)
- Treatment after noticeable scratches (stain contract)
- Treatment after scratches in which there is trouble in appearance (solid scars)
1. Type after scratch.
When scratches, cuts, acne, and surgical wounds heal, they can leave itching. In general, the deeper the scratches, the more visible the scratches are, which can cause cosmetic problems. Even if it is so big, shallow scratches can have significant scratches.
It has begun to appear that initially, the flesh changes color from red to white over time, and such scratches are called “mature stains”. In general, the treatment of mature scars is only a matter of appearance, so it is often not possible to cure them by applying for health insurance.
On the other hand, for a while after the scratches form, the scratches may become reddish and swollen. This is called a “hypertrophic scar.” Deep scratches often result in hypertrophic scars, and most scratches result in hypertrophic scars when they are found in the joints, neck, or other areas where the body moves.
I think it’s good to think that there are hypertrophic scars that don’t catch inflammation easily. Because the itch on the joints is always stretched, there is inflammation every time, and it is not easy. It can take 1 to 5 years for the swelling to disappear completely.
Some scars are more inflammatory than hypertrophic scars and are called “keloids”. Kellogg’s begins largely with the “Kellogg’s Constitution” described below and can be inherited. There may be small bumps on the cheeks that you don’t particularly notice, such as acne or folliculitis, and something that seems to have suddenly appeared in empty areas.
It can occur on the chest, shoulders, abdomen (especially the lower part of the cesarean section), pierced the arms with BCG injections or pierced the ears. Some people can make keloids from an early age, and some people can make keloids as they get older.
There are various causes and causes of deterioration. Recently, even such keloids can be completely cured if they are treated early and firmly. For patients with keloids, please consult your local plastic surgery department.
If hypertrophic scars and keloids are not treated, or if treatment with debilitating effects is continued, the fibers slowly accumulate and harden, causing joints and such fragments to break. This is called a “stain contract”. If a scar heals, it will take a long time for it to soften, so surgery should be considered.
2. Causes of Significant Scratches (HyperTrophic Stains and Keloid).
Adult scars, hypertrophic scars, keloids, and scar contraction are a balance of local and systemic factors. When various adverse conditions become prevalent, it is thought to become a condition of calculus or scarring.
1. Local issues
2. Systemic Difficulty (Called Constitution and Fault Factors)
1) Scratch depth
Hypertrophic scars and keloids can result from burns, trauma, follicles, surgical wounds, BCG and piercing holes. The skin is made up of epidermis and dermis, but it develops when there are scratches in the deep part of the dermis (reticular dermis).
Even pimples do not form keloids in the pores near the surface of the skin, but deep in the pores near the roots of the pores.
2) How to heal wounds
If the wound heals slowly, the risk of hypertrophic scars and keloids increases. Even in shallow scratches, if it is scratched with itching, or if the joints are itchy and scratched every day, the inflammation can spread to deeper areas, and hypertrophic scars and calluses may develop.
For example, with a BCG injection, the injection site may become red and swollen for months without the so-called “keloid ion”. Also, with the piercing, pus may appear every time you put it on and off. These are the risk of developing hypertrophic scars and keloids.
3) Strength on the wound
It has long been known that hypertrophic scars and keloids are often found in areas such as the anterior region, the shoulder blades, and the lower abdomen where the skin is stretched during daily activities.
On the other hand, hypertrophic scars or keloids are rarely found in the parietal region (upper of the head) or the tablets posterior region (shin).
Even if you try to pinch the skin, these parts are difficult because the bones are at the very bottom, and the movement of the body does not pull the skin. In addition, hypertrophic spots and keloids are rare in the upper eyelids. It is believed that the skin of the eyelids is loose and there is no tension even when the eyes are firmly opened or crushed.
2 Systemic Difficulty (Called Constitution and Fault Factors)
1) Pregnancy and female hormones
It is known that hypertrophic scars and keloids increase during pregnancy. Hemangiomas are also known to worsen during pregnancy, increase local blood flow during pregnancy (30-50% in 32 weeks of pregnancy, increase blood volume) and increase estrogen/progesterone during pregnancy.
This is thought to be due to the vasodilator effect of sex hormones or capillary growth. When patients with hypertrophic scars and keloids undergo pseudomonopasal therapy for uterine fibroids and endometriosis, their inflammation is reduced, and not only the incurable symptoms such as itching but also gastrointestinal symptoms such as spots and redness disappear. Is done. Then it becomes a solid stain.
2) High blood pressure
In patients with high blood pressure, arteriosclerosis increases vascular resistance, and blood flow is as fast as pinching a tube that drains water. Therefore, it is thought that hypertrophic scars and keloids increase. Be careful if hypertension patients undergo major surgery.
3) systemic inflammation
With a major injury or burn, there is strong inflammation throughout the body. At this point, a systemic inflammatory response (cytokine storm) occurs. In this case, a scar that does not normally form a hypertrophic scar or colloid may become a hypertrophic scar or colloid.
4) Excessive drinking and exercise
Many patients suffer from hypertrophic scars and keloid pain after drinking or exercising. It is thought to be related to the dilation of blood vessels and rapid blood flow.
Therefore, it is important to avoid excessive drinking and exercise that put pressure on the wound. This type of lifestyle is considered to be one of the deteriorating factors.
5) Genetic problems
There are patients who have inherited severe keloid from their parents and children, and both mothers and daughters have cesarean section wounds with hypertrophic scars.
Research is underway on a genetic factor called single nucleotide polymorphism, but the fact is that it cannot be said that “if this point appears in the gene, hypertrophic scars and keloids will form.” Research is ongoing.
3. Treatment after noticeable scratches (hypertrophic scars and keloids).
1. How to avoid surgery
1) Medication was taken
Then last is said to be effective as oral medicine. It is an anti-allergic agent that suppresses chemical transmitters produced by various inflammatory cells in hypertrophic signs and keloid tissues, thus suppressing itching and other subjective symptoms and healing the wound itself. Is considered.
The Chinese herbal medicine Seri Y2 can also be used. Because these effects are not very strong, they are used in combination with other treatments.
There are many effective ointments. Antibodies such as steroid ointments and creams for the purpose of suppressing inflammation, non-steroidal anti-inflammatory agents, and heroin ointment, which is a substance of heparin. Although hypertrophic scars with mild inflammation can be cured, it is currently difficult to treat with the agents of Kelod’s condition.
Steroid tape (Drainson tape or plaster alone) is used. In particular, Eclat ® plaster is very effective and very effective for adults with thick skin. Drains tape is also effective for thin-skinned children and the elderly. Prolonged use will improve the swelling of hypertrophic scars and keloids if they do not cause haste.
4) Comfort, compression, reality
Hyper-traffic stains and blemishes worsen in areas where the skin is stretched during daily activities, so it is effective to heal scratches and surrounding skin.
Fixing is also effective for silicone tape, medical paper tape (surgical tape), silicone gel sheet, polyethylene gel sheet, bandages, belly bands, supporters, clothing, corsets, etc. It is also a treatment that should be combined with other treatments.
You may be given a steroid (Canacol). Redness, swelling, pain and itching of the skin are reduced. If the effect is too strong, the result can be a non-stain. Like ointment, since it is a steroid, it also lacks the ability to thin the surrounding skin and spread capillaries.
Also, injections in severe scars cause pain, so skilled and efficient injections require expertise. Care should be taken in women as steroids can cause menstrual irregularities.
Vasoactive lasers (lasers that reduce the number of blood vessels) are effective in treating keloids. A common example is the ND: YG laser, but health insurance is not currently treatable.
In addition, various treatments have been reported, including treatment using liquid nitrogen, but the current situation is that only a few are effective.
2. How to operate
1) Thoughts about surgery
Hypertrophic scars and keloids are often cured without any surgery, but surgery is indicated if they cause lubrication (causing scar stains) or if a particular place of decoration becomes a problem on the spot. So far, however, it has been said that keloids with high inflammation should not run smoothly.
Because keloids are easy to reattach, a simple surgery can make them bigger than before. Although many doctors still think so, it has become possible to devise a method of stitching in plastic surgery that will prevent recurrence as much as possible, and surgery to completely correct the problem. Radiation therapy should be performed after. ..
Local anesthesia can be used if the anesthesia is small, but anesthesia is usually used if it is large. The depth of the itch is to excise the hard tissue until it reaches the level of fat.
3) Suture method
After removing the hypertrophic stain or keloid, it is important to break the wound, but the most important thing is not to clean the appearance but to prevent the keloid from recurring. Kellogg’s is thought to be sensitive to scratches that are subject to pulling forces, so it’s important to consider the direction of the scratches, stretch them in advance, and sew them carefully, considering that He will be dragged away.
Sew it firmly in a deep place so that the dermis, which contains hypertrophic stains and keloids, is not affected. Before stitching the dermis, it is important to create a situation where the edges of the wound are naturally connected.
4) Postoperative radiation therapy
Radiation therapy may be given after keloid surgery. The effect is to prevent scars from forming hypertrophic scars and colloids after surgery.
However, we should consider the damage to the surrounding normal skin as a side effect, and there is an undeniable possibility that the risk of developing cancer in this area will increase slightly in the future.
However, in recent treatments for keloids, radiation therapy has improved diet and irradiation procedures, so the risk of carcinogenesis can be reduced.
5) Post-surgery treatment
Hypertrophic scars and keloids may recur once with surgical and radiation treatment, but with localized skin enlargement after surgery. Therefore, it is important to fix the swelling with silicone tape or gel sheet even after the yarn has been removed, or to remove the swelling using steroid tape.
4. Treatment after noticeable scratches (stain contract).
1) The concept of treatment
A “scar contract” is a case of hypertrophic scars or calluses in areas where the skin is stretched, such as the joints and neck, if left untreated and as a result of continuing less effective treatment.
This is a state that has been created. If the scar heals, it will take a long time for it to soften, so you should consider surgery. It is important to provide effective treatment as soon as possible.
2) How to avoid surgery
Mild contractions can be adjusted with steroid tape (Drainson tape or plaster alone) or injection (cannula). In particular, Eclat ® plaster is very effective and very effective for adults with thick skin. Drains tape is also effective for children and the elderly with thin skin. Prolonged use will improve scar contraction if there is no itching.
3) How to run
Because the “scar contraction” can be made in a place where the skin is pulled, such as the joint or neck, change the direction of stitching in the zig-zag so that no force is applied in the pulling direction (Z or WW plastic surgery). Be ) Issue drag (stain agreement). Occasionally flap surgery is used, in which the adjacent skin is cut and folded like a puzzle.
5. Treatment after scratches in which there is trouble in appearance (solid scars).
1) The concept of treatment
White spots on the skin that do not shrink, such as scar contraction, any inflammation such as hypertrophic scars or keloids, or disappear over time. The texture is different from normal skin, and the appearance is often a problem.
For example, this is where the scratches like wrist cuts and burnout are left. Because these are cosmetic problems, many of them cannot be treated with health insurance (please consult your doctor about the application).
You can remove the stain and seal it. However, there is a size limit that can be removed because the surrounding skin hardens when you scratch a large area such as a scratch. If your scratch is large, you can insert a balloon called a spender under the surrounding skin to enlarge the skin area.
The spreader is placed under the skin in the first operation, and once every 1-2 weeks, the physiological saline is put in a balloon so that it can be inflated in the hospital, and after about 3 3 months, the second operation. Is done. Because normal skin area is large, it is possible to sew scratches that cannot be seen simply by cutting.
After surgery, the tendency to form hypertrophic scars becomes stronger, so it is important to fix it with silicone tape or gel sheet after removing the thread, or using steroid tape to eliminate the inflammation.
Functional lasers can be used to help regenerate skin by making small holes in the skin. These costs, which are considered difficult to improve by surgery, have been identified.
It is not possible to completely eliminate scratches, but there is a possibility that you can do it vaguely. In general, it is effective to target the laser once every January to February and eliminate it several times. After applying the laser, you should avoid direct sunlight for a while.
4) Makeup therapy
Special makeup can be applied after scratches (restoration makeup). Applying ultra-thin tape to the scraps with minor irregularities and applying the foundation on it will improve the appearance.
Not only does it look better, but you can also be confident that you can always hide the itchiness in the places shown, and you won’t want to be in public. It can also be thought of as psychotherapy.