Anytime there is injury to the skin, either from trauma or from surgery, a scar results. Even plastic surgeons leave scars! In general, plastic surgeons try to place their scars in locations where they will either not be visible, or will fall in natural creases within the skin in order to minimize their appearance.
Many of us have received scar and wound care advice from our parents, well meaning friends, or even healthcare providers. This advice is not always backed up by scientific studies.
It is important to remember that deep or significant injuries should be evaluated and treated by a physician. Minor injuries can be cleansed with soap and water. Peroxide and Betadine are effective antiseptics; however, they are tissue toxic, and their use can actually result in slower healing wounds. Cuts and wounds should be kept moist, preferably with an antibiotic ointment such as bacitracin or Polysporin. Moist wounds,even those with stitches, tend to heal faster with less scarring.
After wounds are healed and stitches are removed, the best scar treatment involves use of silicone containing scar products. These are usually available as a silicone patch, or a silicone gel. These products are recommended to all of our surgical patients. There are many scar products available, but silicone products do have data to back them up. Despite popular belief, vitamin E does not have benefit in management of scars, and can actually cause skin rash, as well as in some cases have detrimental effects on scar treatment.
One of the most important aspects of scar management is diligent application of sunscreen. Scars do tend to sunburn more quickly, and can stay hyperpigmented. SPF 30 or higher is typically recommended.
It can take up to a year for scar to achieve its final, flat, faded appearance. Sometimes scars even look worse at about three months following an injury due to collagen remodeling. With patience and time, scars will typically improve. Occasionally surgical intervention is required if scars do not improve on their own.