We will review the treatment of scar (boil site) together

A scar is a boil, which is the formation of fibrous tissue at the wound site. Although the scar does not match the surrounding tissue, some scars overgrow. Hypertrophic scar enlarges and extends beyond the original wound. With time, hypertrophic scar does not get better, so how to treat it

A scar or boil is actually the skin’s natural reaction to the damage done to it, which appears as a raised and red tissue that turns white over time, or an indentation that is the same color or darker or lighter than the surface of the adjacent skin. The first type of scar is called hypertrophic scar and the second type is called atrophic scar. In natural skin, fibers in the form of taropods form the skin tissue, and these fibers are called “collagen”.

When the skin is damaged – whether due to burns or due to cuts or tears – these fibers break apart and lose their parallel and regular shape, and cells called fibroblasts are called to the damaged area. . These cells cause the edges of the wound or damaged area to meet, but sometimes insufficient regulation of their activity leads to the creation of an abnormal tissue, which is the scar. Some areas of the body are more prone to scarring, especially the head and face, shoulders, back and chest. Some people are also naturally prone to this condition, especially people with dark skin or black people. Acne, chicken pox, smallpox, some viral or bacterial or fungal infections of the skin, skin diseases such as porphyria or blistering diseases, along with cuts and tears in different areas of the skin and burns, are important factors in causing scars.

Another point that should be mentioned is that usually the raised or hypertrophic scar remains in the area of ​​the same wound or cut, but sometimes this increase exceeds the area of ​​the wound and becomes thicker, wider or more raised. In this case, it is called colloid.

The most important thing to prevent the creation of scars is to try to keep the skin healthy and not to cause any damage to its surface. Regarding acne disease, because sometimes severe and deep acne lesions can leave various scars, it is better to treat this common disease at a young age with sufficient care and under the supervision of a specialist doctor before reaching the stage of developing acne. Control the scar disease. Cuts and wounds that are treated quickly and under the supervision of a doctor with stitches or other wound closure methods have a lower chance of turning into scars. Burns – even if they seem limited and superficial – should also be considered important and taken care of from the very first stages by regular washing and removal of damaged tissues and the use of topical or oral medications so that they do not progress to scar formation. This issue also applies to severe skin diseases that have the potential to cause scars, and appropriate and rapid intervention is the most important factor in preventing future scars.

It is worth mentioning that some scars may gradually become smaller and more faded without medical interventions over a period of several months to several years, and if this condition appears after a while, the policy of patience and reflection may be the best way to deal with these lesions. Massaging a wound or cut has no effect in preventing scarring and sometimes even worsens scarring in the future. In some cases, due to the size of the surgical incision or the need to perform surgery on scar-prone areas such as the chest, shoulders, and shoulders, the possibility of scarring is high, it can be done by injecting corticosteroid drugs or methods such as the use of silicone gel – immediately or in a short time after surgery – he faced this possibility. In case of atrophic scars, it is possible to benefit from various gels or fillers to improve the appearance of the lesions. Smoothing lasers, such as Co2 or fractional or erbium: Yag lasers, along with radiofrequency radiation therapy and microdermabrasion are other treatment measures that play a role in improving scars. Regarding lasers, it should be noted that these devices often regenerate the skin of the damaged area, and this improvement can reach 50-70% if the treatment period is completed, which sometimes requires several treatment sessions. But expecting to have completely natural and smooth skin like the adjacent healthy areas may be a false expectation. Co2 lasers as well as erbium: Yag lasers, which emit wavelengths of 10600 nm and 2940 nm respectively, had opened their place in the treatment of scars several decades ago and were used in the treatment of raised and sunken scars. The main mechanism of operation of these systems was smart and calculated trimming of the damaged skin and helping collagen formation in the desired area, but gradually and with the efficiency of more advanced lasers and also observing some side effects of these systems such as long The time needed to repair the burn after the laser attracted most of the doctors to use the next generations of lasers. Fractional laser technique is based on the radiation of separate and delicate columns of targeted radiation, which, unlike the previous method, performs a superficial and delicate exfoliation of the skin, and in addition, the gentle heat caused by this radiation can damage the regeneration of collagen fibers. It has also been seen to help, but due to the low power of the energy emitted in this method, despite the fact that there are no complications such as long recovery time and other pigment changes, the treatment must be continued for several sessions to achieve satisfactory results. Both types of fractional CO2 laser and erbium: Yag can help in the treatment of scars. In some cases where the color of the scars is red and there is still an inflammatory background in them, another laser known as the PDL laser can be used, which has a wavelength of 585 nm and can reduce the red tint of these lesions and Flattening raised types of scars is also effective. There is also a type of light source called IPL, which emits a series of different wavelengths, and this method can also play a role in reducing the size and improving the appearance of scars. The point that should be considered in the laser treatment of patients suffering from acne scars is that in case of taking isotretinoin (Roaccutane or Decotan), the laser treatment should be postponed for at least 6 months to one year after stopping the use of these drugs. He said, because in these people, wound healing occurs slowly due to the effect of isotretinoin drug, and enough time should be given to restore the ability of the skin to regenerate.

The point that should be mentioned at the end is that sometimes the intervention of non-expert and inexperienced people in trying to remove scars leads to unfortunate and sometimes catastrophic results. The use of caustic substances such as various acids, which are sometimes used to remove scars by inexperienced people, can cause burns and aggravate the initial lesion. Removal of scars by surgery, if done by non-specialists and without meeting the necessary conditions, can be effective in worsening the condition. Many creams and products that are introduced as miraculous products to eliminate scars or are advertised in various media are not effective in reducing or improving these lesions and cannot be trusted.

3 December 1392 13:03

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