Dos and Don'ts of Scar Prevention

Scars are a natural part of healing. But you don't have to wear your battle wounds as badges. These strategies can help reduce their visibility.

    No matter how careful we are, accidents happen. Whether it’s a toddler bumping his head on the sharp corner of a coffee table or an adult slipping up with a kitchen knife while slicing vegetables, injuries - and often lingering scars - abound. Though total scar prevention may be impossible after a cut, there are things you can do to lessen the severity of any lasting marks.

Scar Treatment: The About Scars

    The first thing to know is that scar formation is a totally normal part of the healing process. “When the skin is injured, collagen production goes into overdrive to fix the wound as fast as possible,” says Jessica Krant, MD, MPH, assistant clinical professor of dermatology at SUNY Downstate Medical Center and founder of the Art of Dermatology LLC in New York City. “This healing tissue doesn’t contain all of the normal parts of skin, so it looks different.”

    The appearance of any given scar depends on a number of factors. The shape, size, and depth of the wound contribute to the way a scar looks, as do the amount of blood that can get to the area, your skin color, and your skin thickness.

    There are three main types of scars. Normal scars are relatively thin, small, and flat. Hypertrophic scars are red, thick, and raised. Keloid scars are also raised, often dark or red, and, unlike hypertrophic scars, expand beyond the contours of the actual wound. Keloid scars tend to be genetic and can be hard to control or predict, says Dr. Krant. They come from an overproduction of collagen and can be treated by injecting steroid medication into the affected area . Consultation with a medical professional is the best route when dealing with a keloid scar.

Scar Prevention: Dos and Don’ts

    There are steps you can take - and mistakes to avoid - to help heal skin with as little residual scarring as possible. “The key to lessening scarring is to decrease the amount of work the body has to do to heal the scar,” Krant says. Here’s how:

• Get stitches if needed. Cuts that are spread apart or are deep often heal better when they are stitched by a medical professional. Keep in mind that stitches must be sewn as soon as possible, while the injury is fresh. If too much time elapses, the wound may become contaminated with germs or bacteria, and a doctor may not want to stitch it closed because of the threat of infection. Also, the wound may start to partially heal, which can hinder successful suturing. If in doubt about whether stitches are in order, see a doctor in a timely manner and let him decide the best treatment for the wound.
• Keep the wound moist. Apply petroleum jelly to the wound and cover it with a non-stick bandage. This can speed healing and minimize scarring, says Krant.
• Don’t fall for the false advertising of scar creams. You might have heard that vitamin E can help reduce scarring, but this has not been proven in a high-quality study (a double-blind, placebo-controlled trial). In fact, no over-the-counter product claiming to prevent scars has been scientifically shown to significantly improve scarring.
• Massage the wound. On the other hand, “massaging the scar daily with vitamin E may help promote a less visible scar,” says Krant.
• Avoid the sun. Keeping the scar away from sunlight can help minimize discoloration.
• Let it heal naturally. Don’t use hydrogen peroxide too frequently as it can cause continual irritation and slow the healing process. And don’t pick at scabs. “Scabs are nature’s biologic dressing,” Krant says. “Picking off a scab repeatedly when a wound is trying to heal will slow healing and increase scarring. ”
• Be patient. Healing takes time - possibly a long time. The first phase of healing takes three months, followed by a second phase that lasts another three months. At one year after the injury, the scar has basically formed, but even then it will still change and appear different a year after that. “The truth is, scars never stop changing and improving unless they are keloid scars, which continually worsen unless treated by a physician,” Krant says.