Treating scars
(An Interview with Dr. NDTV)

DrNDTV:

What kind of scars cannot be treated?

When we talk about scars, there is a kelodial tendency that differs in people. The post-traumatic tattoo scar that is caused due to the infestation of different coloured foreign material in the body. Also, scars develop due to some diseases like small pox. These are very difficult to treat. Under normal circumstances, it is possible to reduce the extent of visibility of the scar. We cannot remove the scar completely but we can make them less visible and place them in a place where they are not really visible to the naked eye.

Are burns treated the same way as scars?

Burns depend on the period of contact of the object (causing the burn) and also the heat at the time of injury. If it is a superficial burn, it heals well. If it is a deeper burn, higher temperature burn or a chemical burn it can lead to a much more severe damage. The most important thing to do is to remove the damaged tissue as early as possible and replace it with the missing tissue. Suppose the skin is damaged, we do skin grafting to avoid tissue shrinking and as early as possible replace it with the similar tissue and also prevent too much movement. If we immobilise the area and allow the tissue to heal, the chances of healing are much better. Often in burn cases, there is an associated infection so we have to start with preventing infection, avoidance of any deeper damage, or any dead tissue in the body and allow and enhance the healing of the tissue.

If somebody catches fire, people generally cover up the person with a blanket. Is this a good thing to do?

Putting a blanket is not a good idea, the best thing to do is to pour cold water. Whenever there is a burn you must immediately pour water on that area.

I had an accident four years back and plastic surgeon treated me by putting a skin graft. The scar is there and the doctor has prescribed some ointment, but still it is giving me problem. What should I do now?

It’s very difficult for me to suggest anything without seeing you. Apparently if your doctor has done a skin grafting it means there was some damage to the tissue and tissue was deficient. And if you have kelodial tendency or if you have a tendency for thickening of scars, sometimes it takes more than five years for the scar to mature. Use Cica-Care silicon sheeting or application of steroid ointment helps reducing the scar formation.

I had herpes on the left side of my forehead some years ago. It has left a scar. It is a very old scar and the colour is a bit darker. I am so much used to it that whenever I see my face in the mirror I don’t feel any difference. Is there anything that can be done apart from surgery?

If the scar is not very much elevated, then if its only a matter of colour, you can use a skin colour foundation cream which is extremely good and you can cover the scars. Sometimes we do surgical tattooing on the scar to reduce the colour difference.

Is the surgery a long procedure?

No, surgical tattooing is not a long procedure. It just takes about two days time. It is like you get your name tattooed on the hand. Similarly with different machines, skin colour pigments are put on the scarred area, so it looks like a normal skin colour.

How can I remove a burn scar from my hand since I cannot afford plastic surgery?

If it is a very deep scar with a lot of scarring and loss of the tissue, then there is no way except replacing the tissue with the skin. But if it a superficial scar with simple colour difference and irregularity, then it can be improved by surgical tattooing or by superficial dermabrasion.

I have a 13 year old daughter. She has had three heart surgeries and there is a scar in the middle of her chest. I am told with time this mark will stretch more. What should be done?

Most of the scars after cardiac surgery become supple and soft and also become wider or stretched and particular in children when they are growing. So once the growth is completed, the doctor can remove that thin part of the scar which is stretched out and bring the skin together and suture them in a proper layer so that they don’t stretch out again.

I have a burn mark on my chest that was caused three years ago. Is there any cream to get rid of this scar?

Once the scar is thick, then there is no cream or ointment, which can remove the scar. If there is difference in colour and the rest of the skin is not very thick, then probably there are some creams that can reduce the pigmentation marks like hydroquinone, which can definitely help. There are certain creams that reduce the hardness of the scar that have some component of hydrocortisone. It is best to see a plastic surgeon who is the right person to decide the correct treatment.

If the scar is on the skin for a long duration, does it make it more difficult to get rid of?

No, if it is a matured scar, three years old or five years old, then it is the right time to get surgery to remove the scar and replace the tissue with the missing tissue. So the best time to get rid of a scar is after two years when it is matured.