There are several types of scars, some of which can become raised, big and ugly. Luckily, there are some new over-the-counter products that can make a scar less noticeable. Before you try a topical solution, however, it's helpful to know what a scar actually is, and its life cycle.

Life cycle of a scar:

• Injury to your skin: A scar forms when you damage the deep, thick, middle portion of skin called the dermis. The injury could be small, like a pimple, or large, like a surgical incision. The dermis is a complex combination of blood vessels, hair follicles and oil glands. The dermis also contains touch and pain receptors.
• Healing begins: Whatever the size, cause or severity of your wound, your skin cells get right to work with the healing process. Within your wound are the fibroblasts -- the skin cells in the dermis layer. Fibroblasts make secretions to repair the damage to your dermis. These secretions are called collagen -- the all-important skin protein that knits your skin back together at the site of the injury. Collagen makes up about 75 percent of your skin.
• A scar is born: With the fibroblasts keeping the collagen busy, your wound heals as it should. A scar forms after the wound fully heals, which takes at least six months. Scars are normal and necessary. Most scars are flat, pale and no big deal.

Keloids and Hypertrophic Scars

Sometimes, however, fibroblasts decide to work some crazy overtime. Fibroblasts keep producing collagen to keep covering over the wound. With your collagen now working extra, your initial scar can seem to take on a life of its own. It can become raised, red, bulky and angry-looking.

A really big, piled-up scar is called a keloid. It is the result of your fibroblasts and collagen not knowing when to quit. A keloid is a raised, reddish, and rubbery nodule that keeps growing on top of the healed wound. A keloid can get as big as a baseball. In this case you'll probably want to refrain from telling your friends, "Let me show you my scar."

A hypertrophic scar is like a keloid, but much smaller. The hypertrophic scar forms on top of the initial wound but has the courtesy to stay within the wound boundary. Hypertrophic scars usually fade with time.

About 10 percent of the population gets keloids. Some areas of the body have a predisposition to keloids: the ears, outer arms, back and upper chest. All races develop keloids, though dark-skinned people seem predisposed to developing scars that enlarge with a raised appearance (keloids).

If you are under the care of a plastic surgeon and your scarring is the result of cosmetic or plastic surgery, ask your surgeon for his or her recommendation if over-the-counter treatment is sufficient; otherwise, he or she will prescribe that which best suits your personal case.

Topical Help

If you have a keloid or hypertrophic scar, you just want it to go away. You may want to go to a dermatologist who might be able to improve the appearance of your scar with surgery, steroid injections, radiotherapy, dermabrasion, laser resurfacing or filler injections.

While there's no way to actually erase a scar, there are non-prescription topical products that can help make your keloid or hypertrophic scar lighter, smaller and less noticeable. One good option is covering the scar every day for several months with an over-the-counter gel or spray containing silicone. Silicone goes on as a protective barrier and stays on all day.

Silicone scar treatments such as Dermatix Ultra, Scarguard MD Treatment and Kelo-cote are available in over-the-counter, non-prescription formulations. These products should be applied twice a day, sometimes for several months. Such products work best when used consistently.

You might give Kelo-cote Scar Gel a try. It's transparent and forms a protective silicone sheet on top of the scar. The Kelo-cote sheeting acts like an extra layer of skin it flexible, odorless, waterproof and breathable. Kelo-cote comes in a gel or spray. When used as directed, 100 milligrams can treat an area of 30 square inches (5 inch by 6 inch) once a day for about 12 weeks.

Scarguard MD Treatment is a brush on silicone along with hydrocortisone. It treats old, raised scars, keloids, and to help prevent scar tissue from forming after surgery or injury. This item is good for facial scars, as once it is dry, it can be covered with make-up.

Another over-the-counter product, Dermatix Ultra Advanced Scar Treatment, works as a protective barrier. It is a clear, fast-drying silicone gel that uses new technology -- a form of silicone called cyclopentosiloxane. The silicone stays on top of the scar instead of sinking in. Clinical research has shown Dermatix Ultra to be effective in softening, flattening, smoothing hypertrophic and keloid scars. It can even reduce the discoloration and itching of scars. Since it's clear and comfortable to use, you can treat your face with it and even wear it under makeup. In addition to silicone, Dermatix Ultra uses an exclusive form of vitamin C to help the process.

To use Dermatix Ultra, you will gently massage a small amount into the affected area twice a day, or as directed by your physician. Never use it on open wounds, and only on clean, dry skin. The Journal of Dermatologic Surgery published two articles (in 1999 and one in 2001) with findings that indicate no difference in the clinical results of using silicone gel or sheeting for treating keloids.

Scientists and researchers are still not exactly sure why silicone helps reduce keloids. They do know it can help "the appearance of scars." This is medical jargon for "It won't make the scar go away. It will only make it less noticeable."

Besides keloid and hypertrophic scars, over-the-counter silicone scar products can help with these:

• Burn scars
• Acne scars
• Stretch mark scars
• Plastic surgery scars
• Breast augmentation scars
• Breast reduction scars
• Post-laser peel redness
• Pregnancy scars
• Tummy tuck scars
• Caesarian section scars
• Mastectomy scars
• Hysterectomy scars
• Body contouring scars
• Body piercing scars
• Tattoo removal scars
• Cleft lip scars
  

So while you can't make a scar completely disappear, you can do everything in your power to make it less noticeable.

Thank you for taking the time to read this article. We hope you have found this information helpful.

Karen Nace
DERMAdoctor Staff Writer

(Any topic discussed in this article is not intended as medical advice. If you have a medical concern, please check with your doctor.)

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