Scars and How You Help Heal Them
Improving the appearance of scarred skin is not easy. With possibly the exception of young boys, ages 10 to 15, who proudly display theirs as a badge of honor, scars are largely regarded as cosmetically undesirable. Fireside Pharmacy now offers PracaSil™ Plus to serve not only as a standalone cream that can help lighten scars, but also as a base in which your practitioner can incorporate active pharmaceutical ingredients (APIs).
PracaSil™-Plus is an ideal choice for new scars, old scars, surgical scars, keloids, stretch marks, acne scars and any skin conditions. In order to determine which APIs to ask your doctor about first you must identify the type of scar in question.
Scars generally fall into three categories:
- Hypertrophic: Excessive scar tissue that protrudes above the height of normal skin. Scars do not extend beyond the confines of the original wound.
- Keloid: Excessive scar tissue that protrudes above the height of normal skin. More aggressive compared to hypertrophic; scars continually grow and invade the normal surrounding tissue.
- Flat (atrophic): Less aggressive – usually stretch marks and acne scars.
Hypertrophic scarring usually occurs after surgery, serious burns, or trauma that involves moderate to extreme penetration into the dermal tissue. For instance, wounds that experience a moderate to an extreme amount of inflammation are more likely to become hypertrophic. Usually within four weeks of the event you will notice hypertrophic scarring.
Both hypertrophic and keloid scars are the result of excessive collagen produced in the healing process. Due to the excess scar tissue, scars will appear raised, thick, and darker than typical scars.
Keloid development is much more problematic. The location of these scars is predominately formed on the earlobes, shoulders, anterior chest, upper arms, or cheeks. The inflammatory response seems to be less of a factor than on where the scar is actually located.
Unlike hypertrophic scars that become prominent as early as four weeks after trauma, keloids often develop months or years after dermal tissue penetration and show very little tendency to regress over time. And while hypertrophic scars remain confined to the area of the original wound, keloids extend into the surrounding tissue. PracaSil-Plus can aid in the prevention of excessive collagen production which causes these disorders.
Actives for Keloid and Hypertrophic Scars
APIs such as captopril, EGCg, tamoxifen, pentoxifylline, imiquimod, and tranilast are usually used to reduce the excessive collagen deposits these scars create. These ingredients have the greatest benefit in the early phase of scar development.
For old keloid and hypertrophic scars, steroids have been selected to reduce inflammation and bulk tension in skin tissue. Collagenase and hyaluronidase can also be incorporated into compounds to reduce scar components.
Flat scars, stretch marks, and acne scars do not have the same amount of inflammation or collagen deposits as keloid and hypertrophic scars. The main focus on healing flat scars should be to target the gradual renewal of the skin. Tretinoin is a useful agent, as it encourages skin turnover. The desired result is a renewed skin layer that has better character and quality than the existing scar tissue. Additionally, sodium hyaluronate and aloe may be included to increase the moisture content and to soothe the area during this renewal process.
Regardless of the type of scar, the length of therapy generally depends on how long the scar has existed. Older scars will generally require longer therapy. New scars may begin to fade in as little as one or two months, while older scars may take several months to show marked improvement. Call Fireside Pharmacy today and talk to one of our pharmacists about how you can start making your scars fade away today.
- Alster T, Tanzi E. Hypertrophic scars and keloids: etiology and management. American Journal of Clinical Dermatology. 2003;4(4):235-243.
- Ardekani G, Aghaei S, Nemati M, Handjani F, Kasraee B. Treatment of a postburn keloid scar with topical captopril: report of the first case. Plastic and Reconstructive Surgery. March 2009;123(3):112e-113e.
- Brown J, Bayat A. Genetic susceptibility to raised dermal scarring. The British Journal of Dermatology. July 2009;161(1):8-18.
- Chen J, Zhao S, Liu Y, Cen Y, Nicolas C. Effect of captopril on collagen metabolisms in keloid fibroblast cells. ANZ Journal of Surgery. May 23, 2014
- Lee Y, Minn K, Baek R, Hong J. A new surgical treatment of keloid: keloid core excision. Annals of Plastic Surgery. February 2001;46(2):135-140.
- Mancoll JS, McCauley RL, Phillips LG (1996) The inhibitory effect of tamoxifen on keloid fibroblasts. Surg Forum 47:718–720.
- Mikulec A, Hanasono M, Lum J, Kadleck J, Kita M, Koch R. Effect of tamoxifen on transforming growth factor beta1 production by keloid and fetal fibroblasts. Archives of Facial Plastic Surgery. April 2001;3(2):111-114.
- Mutalik S. Treatment of keloids and hypertrophic scars. Indian Journal of Dermatology, Venereology And Leprology. January 2005;71(1):3-8.
- Schneider M, Meites E, Daane S. Keloids: Which treatment is best for your patient?. The Journal of Family Practice. May 2013;62(5):227-233.
- Sidgwick G, Bayat A. Extracellular matrix molecules implicated in hypertrophic and keloid scarring. Journal of The European Academy Of Dermatology And Venereology: JEADV. February 2012;26(2):141-152.
- Syed F, Bagabir R, Paus R, Bayat A. Ex vivo evaluation of antifibrotic compounds in skin scarring: EGCG and silencing of PAI-1 independently inhibit growth and induce keloid shrinkage. Laboratory Investigation; A Journal Of Technical Methods And Pathology. August 2013;93(8):946-960.
- Suzawa H, Kikuchi S, Arai N, Koda A. The mechanism involved in the inhibitory action of tranilast on collagen biosynthesis of keloid fibroblasts. Japanese Journal of Pharmacology. October 1992;60(2):91-96. r1994;116(4):892-897.
- Turkovski I, Paramonov B, Antonov S, Kozlov D, Klimova O, Pomorski K. Comparative evaluation of the depth of collagen and hyaluronic acid hydrolysis in vitro by collagenase and hyaluronidase preparations. Bulletin of Experimental Biology And Medicine. July 2008;146(1):81-82.
- Uchida G, Yoshimura K, Kitano Y, Okazaki M, Harii K. Tretinoin reverses upregulation of matrix metalloproteinase-13 in human keloid-derived fibroblasts. Experimental Dermatology. 2003;12 Suppl 2:35-42.
- Verhaegen P, van Zuijlen P, Middelkoop E, et al. Differences in collagen architecture between keloid, hypertrophic scar, normotrophic scar, and normal skin: An objective histopathological analysis. Wound Repair and Regeneration: Official Publication of the Wound Healing Society [and] the European Tissue Repair Society. September 2009;17(5):649-656.
- Viera M, Amini S, Valins W, Berman B. Innovative therapies in the treatment of keloids and hypertrophic scars. The Journal of Clinical and Aesthetic Dermatology. May 2010;3(5):20-26.
- Zhang G, Cheng T, Gao W, et al. Vitamin D: a novel therapeutic approach for keloid, an in vitro analysis. The British Journal of Dermatology. April 2011;164(4):729-737.