DR. ASHISH GUPTA: SCAR WARS: MYTHS AND SOLUTIONS

Monday, December 2, 2019

SCAR WARS: MYTHS AND SOLUTIONS

Scar Wars: Myths and Solutions

Anyone who remembers his or her childhood would remember their falls, skids and skirmishes that left behind the tell tale signs we call SCARS. He or she has equal number of vivid stories to narrate with them. Some of the most common queries regarding scars are answered here.

Myth No.1: How many sutures will be put on the wound?

Answer: Scars do not depend on the number of sutures. Rather a thicker suture causes more scarring than a fine suture. Even though there are more stitches with the fine thread, they can be removed earlier leaving behind an insignificant scar.

(SUTURED WITH A THICK THREAD: TRAM TRACK SCAR)

Myth No.2: Sutures cause scarring of the wound.

Answer: Suturing a wound brings cut ends of skin together helping it heal faster. Any wound that takes less than 2-3 weeks to heal leaves a fine scar. We usually remove the sutures within 5-7days to prevent scarring.

(SUTURED WITH A FINE THREAD: NEARLY INVISIBLE SCAR)

Myth No.3: Dissolving sutures do not cause scarring

Answer: Dissolving sutures (absorbable sutures) are usually used to close the inner layers of the wound to prevent stretching of the scar. On the skin they can be used as a sub-cuticular (under the skin) stitch in a clean wound with healthy margins. When dissolving sutures are applied as normal sutures on the skin they may dissolve early in infection and the wound may gape open; or they may dissolve late and leave behind suture track scars.

Myth No.4: Glue is better than suturing and leaves no scars

Answer: Tissue glues are used in wounds that are well approximated (not gaping open). The scar shall depend on the approximation of the skin, the depth of the wound and site (immobile areas). If applied in a gaping wound, it tends to coat the wound edges and does not allow it to heal until the glue is scrapped off. Glue usually complements the suturing but not as a substitute.

(Note: No financial disclosures)

Myth No.5: Wounds left open dry faster

Answer: Superficial wounds like abrasions are left open with topical antibiotic creams and they usually heal within a week. Deep wounds like deep abrasions, contaminated wounds (dirt & debris), lacerations on hands, feet and face need to be sutured and dressed for early healing and better scaring. Scar depends on the extent of tissue loss and time taken for the wound to heal not if it was left open.

Myth No.6: Sunlight fades the scars

Ans: There’s nothing about tanning that’s healthy for your skin. UV rays lead to hyperpigmentation (make the scar darker). One should cover the scars with sunscreen with at least SPF 30—or better yet, covering with (white) clothing—to help the scars continue to fade and blend in.

Myth No.7: Scar creams make scars disappear

Answer: It is untrue. Multiple advertisements and scar creams claim to make the scar disappear. Once a scar, always a scar. We can improve the quality of the scar with these creams, make them lighter, with massage make them softer and with plastic surgery (techniques) and lasers hide them in the normal skin creases. But cannot make them disappear totally.

Myth No.8: Why revisit the plastic surgeon once the wound has healed?

Answer: Scars undergo numerous changes in the first 3 to 6 months in their colour, texture, size, height and feel. Reciprocally, equal number of interventions need to be done at appropriate time to get the best results whether you got stitches or left the wound to heal by itself.