Summary of Clinical Evidence for Efficacy of Scarfade

July 21, 2010 at 6:01 pm · Filed under Uncategorized ·Tagged ,

Hypertrophic scars and keloids are common after dermal skin injury. These are often characterized by erythema, firmness, elevation, pain and pruritus1. These scars may cause both functional impairment and lead to cosmetic concerns. Silicone gel sheeting (SGS) has been used for several decades to improve the signs and symptoms of hypertrophic scars and keloids. Proposed mechanisms for the efficacy of silicone gel sheeting have included increased hydration of the stratum corneum and dermis, changes in polarization, changes in oxygen tension, pressure effects, as well as mechanical protection, all which may lead to collagen remodeling and subsequent improvement of the appearance of the scar (reviewed by Bloeman, Mustoe1,2). As pointed out by Mustoe in his review, SGS has several potential limitations including difficulty of application on some parts of the body and the requirement of taping to secure the sheeting to the skin2. Also, patients may be reluctant to use the sheeting on unclothed areas during the day, leading to decreased compliance. Additionally, sheets must be washed to prevent infection. More recently, newer formulations of silicone that may be easier to apply and maintain than sheeting have been developed, including cream containing silicone oil and silicone gel applied from a tube. Topical silicone gels have been widely distributed throughout many parts of the world for at least 15 years. There are many published reports in the scientific literature evaluating the safety and efficacy of these silicone products for improvement the signs and symptoms of scars. Scarfade is a self drying silicone gel that has been studied for the management of the signs and symptoms of keloids and hypertrophic scars. The following is a summary of the clinical evidence generated for the safety and efficacy of silicone gels for this use.

The relevant literature was assessed using four different medical databases with several different key words as listed below. A total of 27 unique articles were found and are critically reviewed in this document.

1. Cochrane Collaboration
a. Search criteria = silicone
b. Limits = none
c. # of articles found = 13
d. # of articles excluded = 12
2. PubMed
a. Search criteria = Dermatix
b. Limits = none
c. # of articles found = 2
d. # of articles excluded = 0
3. PubMed
a. Search criteria = “silicone gel” and “scar”
b. Limits = Humans, Clinical Trial, Meta-Analysis, Practice Guideline, Randomized Controlled Trial, Review, English
c. # of articles found = 26
d. # of articles excluded = 3
4. EMBASE
a. Search criteria = Dermatix
b. Limits = none
c. # of articles found = 7
d. # of articles excluded = 5 (3 = irrelevant, 2 = included in PubMed search)
5. EMBASE
a. Search criteria = “silicone gel” AND “scar”
b. Limits = Cochrane review OR Controlled clinical trial OR Meta analysis OR Randomized controlled trial OR Systematic review AND Humans AND English
c. # of articles found = 16
d. # of articles excluded = 9 (all 9 were included in the PubMed/Cochrane search)
6. Ovid MEDLINE
a. Search criteria = “Dermatix” OR “silicone gel” AND “scar”
b. Limits = none
c. # of articles identified = 53
d. # of articles excluded = 38 (either irrelevant or included in other searches)

The results are grouped into 2 sections and ordered by the level of evidence of the study. The first section contains studies evaluating the safety and efficacy of silicone gel sheeting and the second section evaluates the safety and efficacy of Dermatix (Scarfade).

Section 1

O’ Brien and Pandit3 published a Cochrane review on silicone gel analysing 15 trials involving 615 people and found that SGS reduced the incidence of hypertrophic scarring in persons prone to scarring. SGS produced a statistically significant reduction in scar thickness and improved scar colour. The authors point out that many of the studies were highly susceptible to bias and of poor quality. This analysis only included articles published up to November 2007.
Level of evidence:I

Morganroth et al4 have reviewed the medical literature for data supporting the efficacy of over the counter (OTC) scar products used on fresh post-surgical wounds. The authors found that while published evidence does not support the use of most scar products, the silicone containing products were the only ones with evidence indicating they may improve post-surgical scar appearance. The analysis did not look at mature scars.
Level of evidence: I

Berman et al5 reviewed the clinical effects of silicone elastimer sheeting for hypertropic and keloidal scar management and found that the studies generally found these products to be safe and effective. However, the authors noted that the studies suffered from small sample size, lack of objectivity, lack of standardization of the patient population, and lack of control over patient compliance.
Level of evidence: I

Li-Tsang et al6 evaluated 45 Chinese patients with hypertrophic scars in a prospective randomized investigator-blinded controlled trial comparing a silicone gel sheeting (24 hours/day x 6 months) plus massage (15 min with lanolin) to massage alone. Scar thickness was improved at the 2 month (p=0.008) and the 6 month (p<0.001) time points. Pain, itching and pliability were also improved in the treatment group compared to the control group.
Level of evidence: II

Momeni et al7 studied the efficacy of SGS (Cica-Care) applied to hypertrophic burn scars in reducing scar interference with normal function and improving cosmesis. They performed a randomised, double-blind, placebo-controlled trial involving 38 people with hypertrophic burn scars. Each scar was divided into two segments; silicone gel sheet was applied randomly to one of the two and placebo sheeting to the other. Participants were seen again after 1 and 4 months. Their data and wound characteristics were collected using the Vancouver scar scale. After 1 month all scar scale measures were lower in treated areas, but only the vascularity scale was significantly different between the two areas. After 4 months, all scale measures except for the pain score were significantly lower in the silicone gel group than in the control group. The authors concluded that silicone gel is an effective treatment for hypertrophic burn scars.
Level of evidence: II

Wittenberg et al8 compared the efficacy of the 585-nm flashlamp-pumped pulsed-dye laser (PDL) and silicone gel sheeting (SGS) in the treatment of hypertrophic scars in lighter-and darker-skinned patients in a prospective, single-blind, randomized, internally controlled, comparison investigation in 20 patients with hypertrophic scars (19 completed the PDL treatments and 18 completed the SGS treatments). Mean scar duration was 32 months (range, 4 months to 20 years). Each scar was divided into 3 sections; each section was assigned to either PDL or SGS or control. There was an overall reduction in blood flow, volume, and pruritus over time. However, no differences were detected among treatment and control groups. There was no reduction in pain or burning (0-40 weeks), elasticity (8-40 weeks), or fibrosis (0-40 weeks, n = 5 biopsies) in the treated or control sections of the scars. The authors conclude that the improvements in scar sections treated with SGS and PDL were no different than in control sections. One criticism of the study (which the authors acknowledge) is the relatively small sample size reduced the power of the study to detect minimal differences between groups (only 74%)
Level of evidence:II

Ahn et al9 assessed efficacy of silicone gel sheeting (SGS) in 14 hypertrophic scars in 10 adults for 8 weeks in a randomized controlled unblended trial. The patients served as their own controls with mirror image or adjacent scars left untreated. Scars were evaluated objectively using a volume assessment with an impression mold. Treated scars were statistically significantly improved (p<0.05) in the treated group.
Level of evidence:III-1

Gold et al10 studied two groups of subjects: those with no history of abnormal scarring (low-risk group) and those with a history of abnormal scarring (high-risk group) to determine whether topical silicone gel sheeting can be used to prevent hypertrophic scars and keloids from forming following skin surgery. Patients undergoing skin surgery were stratified into high- and low-risk groups and following the procedure, patients within each group were randomized to receive either routine postoperative care or topical silicone gel sheeting (48 hours after surgery). Patients were followed for 6 months. In the low-risk group, there were no statistical differences between individuals using routine postoperative care or using topical silicone gel sheets. In the high-risk group, those using the SGS had statistically significantly fewer abnormal scars compared to controls (39% versus 71%). Those individuals having a scar revision procedure also showed a statistical difference if topical silicone gel sheeting was used following surgery.
Level of evidence:III-1

De Giorgi et al11 evaluated the effectiveness of a silicone gel in treating surgical wounds in 110 patients in a randomized controlled trial, carried out in a dermatology department of a university hospital. Patients applied either the silicone gel or zinc oxide cream to post-surgical scars twice a day for 60 days starting the day the sutures were removed. The total follow-up period was 8 months from the date of surgery. In the treatment group, 27% had formation of a non-physiological scar (diastasic scar in 15%, hypertrophic scar in 9% and atrophic scar in 3%). No keloid scars were recorded. In the control group, 55% had an altered scar (keloid scars in 11%, hypertrophic scar in 22%, diastasic scar in 18% and atrophic scar in 4%). The authors concluded that silicone gel is able to reduce the formation of keloid and hypertrophic scars and the signs /symptoms associated with the healing process.
Level of evidence: III-1

Berman and Flores12 compared the efficacy of a cushion of silicone filled with liquid silicone gel with silicone gel sheeting in the treatment of hypertrophic and keloid scars in 32 patients. The size, volume, symptoms (tenderness and itching), and signs (color and induration) of hypertrophic (10 patients) or keloid scars (22 patients) were measured at baseline at 16 weeks following use of either the silicone gel cushion or silicone gel sheeting, as determined by random assignment. Both the silicone gel cushion and the silicone gel sheeting treatments were effective in decreasing scar volume (53.0% and 36.3% respectively), reduction in tenderness (36.3% vs 33.3%), itching (45.5% vs 33.3%), and redness (0.1% vs 0.1%), and in the degree of softening (45.5 vs 25.0%). Both the silicone gel cushion and the silicone gel sheeting treatments were effective in the treatment of keloids and hypertrophic scars, although no statistically significant differences were found between the two treatment modalities. This was a relatively small and not well-powered study.
Level of evidence:III-1

de Oliveira et al13 compared silicone and non-silicone gels and control (untreated) in 26 patients with 41 hypertrophic or keloidal scars. Scar size, symptoms and induration were measured before and after the treatment period and while there were statistical differences between treatment and control groups, there was no difference between the silicone and non-silicone groups. Blinding in this study was only used for the intracicatrical pressure measurements. The scars studied in the de Oliveira report were at least 3 years old (as opposed to fresh). There was non-standard stratification of subjects into the three groups, and the types and causes of the scars in the different groups was not uniform nor controlled. Additionally, the study was not adequately powered to detect a difference between the two treatment groups.
Level of evidence:III-2

Sproat et al14, in a prospective randomized trial, compared intralesional Kenalog to silicone sheeting (Spenco) for hypertrophic sternal scars in 14 subjects. The primary outcome was patient preference. 11/14 favored the silicone gel group. This study is limited by small sample size, and lack of any objective parameters for evaluating the response of the scars to the treatment.
Level of evidence:III-2

Rhee et al15 evaluated the effect of silicone gel sheets to new scars after cosmetic surgery in 40 Asian patients in a prospective controlled trial. By 3 months, pigmentation, vascularity, and height of the scars were statistically significantly improved in the silicone gel group compared to the control group.
Level of evidence: III-2

Tan et al16 performed a prospective, non-randomized patient-controlled study aimed to assess the effectiveness of topical silicone gel sheet used for 12 weeks and intralesional injections of triamcinolone acetonide (40 mg/ml) in the treatment of keloids in 20 patients with multiple keloids. In each patient, three keloids of similar size were selected. One was assigned to no treatment (control) and one to each active treatment. None of the untreated control lesions showed any spontaneous reduction in size. Of the lesions treated with silicone gel sheet dressing, only 2 of 17 (12) showed a significant reduction in size (i.e. at least 50 reduction in size) at week 12. Of the lesions treated with intralesional injections of triamcinolone acetonide (40mg/ml), 16 of 17 (94) showed a significant reduction in size at week 12. Their results do not support the use of occlusive silicone gel sheet as an effective treatment of chronic keloid scars
Level of evidence: III-2

Majan17 compared the efficacy of a self-adherent soft silicone dressing (Mepiform) with ‘left-alone’ management of hypertrophic scars after cosmetic surgery in a non-blinded randomised controlled clinical investigation on 11 female patients aged 21–43 years. Treatment was initiated between two weeks and two months (mean 4.7 weeks) after surgery. All parameters in the Vancouver Scar Scale improved in both groups, Patients treated with the soft silicone dressing showed greater and more rapid improvements compared with the non-treated patients. Unfortunately, there was no statistical analysis of evaluating the significance of their findings. One subject had local skin irritation at the site of the scar.
Level of evidence:IV

Hirshowitz et al18 developed a silicone cushion with the purpose of increasing a negative static electric charge to accelerate the scar regression process. Thirty patients enrolled in the study (27 completed). Treatment with the silicone cushions yielded 63.3 percent cessation of itching and burning followed by pallor and flattening of the scar, some markedly so, over a few weeks to 6-month period. An additional 26.6 percent had their scars resolved in up to 12 months of treatment. This study is limited by a lack of a control group.
Level of evidence:IV

Eishi et al19 evaluated 6 patients with hypertrophic scars treated
With silicone gel sheeting (Cica-Care) for 24 weeks. They found that pain and pruritus decreased after 4 weeks and resolved after 12 weeks. Reduction of redness and elevation was observed after 12 weeks.
Level of evidence: IV

Brown20 published a case involving an 18-month-old child whose burn scar was treated for a period of 15 months with silicone gel sheets. The Vancouver Burn Scar Scale assessment showed improvement in the scar (score improved from 9 to 2). Unfortunately, the natural history of this scar without treatment is unknown.
Level of evidence: IV

Section 1b: Safety

Nikkonen et al21 examined twenty five consecutive Saudi patients who underwent treatment of hypertrophic scars using Cica-care silicone gel sheets. The scars were secondary to burns or traumatic friction injuries. The authors reported that problems associated with gel sheeting were common and included persistant pruritis (80%), skin breakdown (8%), skin rash (28%), skin maceration (16%), foul smell from the gel (4%), poor durability of the sheet (8%), failure of the sheet to improve hydration of dry scars (52%), poor patient compliance (12%) and poor response of the scar to treatment (24%). Most of these problems were eliminated by temporary interruption of treatment, more frequent washings of the gel sheet, better skin hygiene and occasionally by changing the brand of gel sheets. Permanent discontinuation of treatment occurred in only one patient and was because of lack of response to treatment.
Level of evidence:IV

Alexander and Ebrahim22 reported spontaneous bleeding in a keloidal scar treated with intralesional triamcinolone and silicone sheeting (Cica-care). It is impossible to discern from this report whether the bleeding was related to the silicone sheeting.
Level of evidence: IV

Section 2

Mustoe2, in 2008, reviewed the available literature on silicone therapy for scars. Results from clinical trials in that review suggest that silicone gel is equivalent in efficacy to traditional silicone gel sheeting but easier to use. Although high quality comparative clinical trials are lacking, the reported clinical studies suggest that silicone gel is at least as effective as SGS in scar management. There have been no reported safety issues.
Level of evidence: 1

Chan et al23 conducted a randomized, placebo-controlled, double-blind, prospective clinical trial comparing a silicone gel (Scarfade ) to a placebo gel in adult Asian patients with sternotomy scars after cardiac surgery. One hundred wounds in 50 patients were randomized into two arms with each patient serving as his/her own control with either the upper of the lower half of the scar receiving active or control gel twice a day. No side effect caused by the silicone gel was reported. Ninety-eight percent of patients had moderate to good compliance. The incidence of sternotomy scar was 94 percent. At the third month postoperatively, the silicone gel wounds were scored lower (better) when compared with the control wounds. The differences were statistically significant in all parameters, including pigmentation (p =0.02), vascularity (p = 0.001), pliability (p = 0.001), height (p = 0.001), pain (p = 0.001), and itchiness (p = 0.02).
Level of evidence:II

Karagoz et al24 compared the efficacy of silicone gel (Scarfade*), silicone gel sheet (Epi-DermTM), and topical onion extract including heparin and allantoin (Contractubex1) for the treatment of hypertrophic scars. Forty-five postburn scars were included in the study. Patients with scars less than 6 months from injury were assigned at random to three groups each containing 15 scars, and treatment with Scarfade, EpidermTM and Contractubex1 was continued for 6 months. Scar assessment was performed at the beginning of the treatment, and at the end of the sixth month when the treatment was completed by using the Vancouver scar scale. The difference between before and after treatment scores for each three groups was statistically significant. The difference between Scarfade group and Epi-DermTM group was not significant; however, the differences of the other groups (Scarfade-Contractubex1 , EpidermTM-Contractubex1) were significant. This study was not blinded.
Level of evidence:III-1

Signorini and Clementoni25 studied fresh surgical scars treated with silicone gel (Dermatix) in a prospective, controlled non-blinded trial in a group of 160 patients. All had undergone surgery 10 days to 3 weeks previously. The treatment group applied Dermatix twice a day for 4 months. The control group had no treatment initially but if there was clear evidence of developing hypertrophies, conventional treatments (pressure garments, intralesional steroids, or traditional silicone gel sheeting) were prescribed. The locations of the scars were controlled for. The patients treated with the self-drying silicone gel evidenced grade 1 (normal) scars in 67% of the cases at the end of the observation period, as compared with 28% of the control cases. Grade 2 (mildly hypertrophic) scars were noted in 26% in the treated group, as compared with 46% of the control group. Grades 3 (hypertrophic) and 4 (keloid) scars were noted in 7% in the treated group and 26% in the control group. These differences were statistically significant (p < 0.001).
Level of evidence:III-1

Lacarrubba et al26 examined 8 patients with hypertrophic scars in an open label trial in which subjects applied a self drying silicone gel (the authors do not state whether this is Dermatix or another self drying silicone gel product) to their scars. Three untreated scars in subjects with multiple scars served as controls. The scars were treated within 90 days of onset twice a day for up to six months. Scar size, redness and textural improvement were evaluated. The scars treated with the silicone gel had a 50-90% improvement in 5/8, had a 30-49% improvement in 2/8, and had a 10 years), and only gives overview of silicones in the rehab of burns.
Bloemen et al, 2009,
Prevention and curative management of hypertrophic scar formation Does not focus on silicone and does not review the literature critically
Fette, 2006,
Influence of silicone on abnormal scarring Does not critically appraise the literature
Gilman et al, 2003,
Silicone sheet for treatment and prevention of hypertrophic scar: a new proposal for the mechanism of efficacy Opinion on mechanism of action not clinical data
Hanasono et al, 2004,
The effect of silicone gel on basic fibroblast growth factor levels in fibroblast cell culture In vitro data on effects of silicone on fibroblasts

Paper – Author, year, title Reason for exclusion
Kloeters et al, 2007,
Hypertrophic scar model in the rabbit ear: a reproducible model for studying scar tissue behavior with new observations on silicone gel sheeting for scar reduction Rabbit ear model not clinical study
O’Shaughnessy et al, 2009,
Homeostasis of the epidermal barrier layer: a theory of how occlusion reduces hypertrophic scarring
Not a clinical study. This report deals with barrier repair, occlusion and scarring in an animal model
Reish et al, 2008,
Scars: a review of emerging and currently available therapies Includes many modalities and does not critically appraise silicone treatments
Reish et al, 2008,
Scar treatments: preclinical and clinical studies Includes many modalities and does not critically appraise silicone treatments
Tandara et al, 2008,
The role of the epidermis in the control of scarring: evidence for mechanism of action for silicone gel Rabbit model of role of epidermis in scarring
Watkins et al, 2008,
When wound healing goes awry. A review of normal and abnormal wound healing, scar pathophysiology, and therapeutics Does not critically appraise literature
Rea et al, 2008,
Use of the Internet by burns patients, their families and friends
Not related to efficacy of the topical silicone gel
Lalonde et al, 2005,
Magnetic resonance imaging of the breast: current indications
Irrelevant to topical silicone gel treatment for scars
Brown et al, 2002,
An association of silicone-gel breast implant rupture and fibromyalgia
Irrelevant to topical silicone gel treatment for scars
Rees-Lee et al,2008,
The indications for Versajet® hydrosurgical debridement in burns Dermatix is not indicated for surgical debridement
Fonseca Capdevila et al, 2007,
Prevention of scar sequels after excision of benign cutaneous lesions: Multicenter, prospective, open label, controlled study comparing a silicone gel versus silicone sheets in 131 patients with melanocytic nevi Not in English. Dermatix is not indicated for melanocytic nevi
Ralston 2003,
Do we need Harry Potter lessons? Letter referring to accessing/supply of Dermatix not efficacy

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Burns and Burn Scar Treatment

June 29, 2010 at 8:43 am · Filed under Uncategorized ·Tagged , , , , ,

Burns may result from a variety of different causes such as dry heat (fire, sun, etc.), liquids (steam, hot water, etc.), chemicals, electricity, and extreme cold. Over two million people in the United States are treated for burns each year and over three thousand die of severe burns. Burns differ in severity and are classified into three widely accepted specific levels as follows:

First Degree Burns The most shallow (superficial) of all burns, first degree burns are minor burns which affect only the outer or top layer of skin. They may cause pain, redness and swelling.

Second Degree Burns Also called partial thickness burns, second degree burns are more serious burns which affect both the outer and underlying layers of skin. Along with the pain, redness and swelling associated with less serious burns, second degree burns may also result in blistering.

Third Degree Burns Also referred to as full thickness burns, third degree burns are very serious burns which affect all three layers of skin. Usually the sweat glands, hair follicles and nerve endings are destroyed and the skin may become blackened and perhaps numb.

Burns, even when properly treated often result in scars. There are three main types of scars associated with burns:

Keloid Scars Scars that grow outside the edges of the burn site and may look like tumors or cysts on the skin. They are caused by the body overproducing Collagen at the burn site.

Hypertrophic Scars Similar to Keloid Scars, but not as serious. Hypertrophic Scars remain within the edges of the burn area and may appear as red, raised bumps.

Contractures These scars are associated with a tightening of the skin, ligaments or muscles underneath the burn site. They tend to limit movement.

There are several ways to treat burn scars, ranging from relatively inexpensive home remedies to expensive medical treatments.

Medical Treatments Plastic Surgeons, Dermatologists and other physicians may apply one or more of several different treatments for scars resulting from burns. Some examples are: surgical scar revision, skin grafts, demabrasion, laser resurfacing and chemical peels. In some cases two or more techniques may be combined to treat a scar.

Home Remedies There are a number of different creams, lotions, vitamins and other products that are said to help burn scars. From what I can tell, the most effective do it yourself treatments involve the use of some type of Silicone Gel or Silicone Sheet such as Scarfade Gel or Scarfade Silicone Sheeting. There have been studies published in reputable medical trade journals which substantiate the effectiveness of these types of products.

In the end it is up to the patient how to treat their burn scar, if at all. Again, scars differ greatly in their characteristics. Some are large and may actually limit mobility while others are very small and largely unnoticeable. Of course medical treatments are more expensive but in some cases may be necessary.

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Massage Therapy As A Treatment For Scars:

June 16, 2010 at 10:29 pm · Filed under Uncategorized ·Tagged , , , , ,

It has been claimed by many that Massage Therapy can be an effective method of Scar Treatment. While researching this I certainly found plenty of reference to this technique. I was however unable to find any articles on the topic published in trade or medical journals. That is not to say the method has no merit. In fact I did find several personal accounts claiming the method to be successful. Is it truly effective? I honestly can’t say. I will instead focus on simply describing the treatment and it’s claimed benefits and let the reader form their own opinion.

Purpose/ Theory: The basic theory of scar treatment via massage is that it remodels collagen and realigns scar tissue. To help you understand how this works, think of scar tissue as spaghetti noodles. When you place the noodles in a pot, they don’t lay flat. Instead they stick straight up in a criss-cross fashion. When a scar forms, the tissues will often act similarly, creating a scar that is raised above the rest of the skin (keloid and hypertrophic scars). When spaghetti noodles are in their package they lay down flat and neat. Theoretically, massage therapy can help the scar tissues to lay down neat and flat like spaghetti noodles in a package.

Benefits of Scar Massage: Aside from the realignment of scar tissue as described above, other claimed benefits of scar massage are:
1. Softer, more pliable scars
2. Reduced pain
3. Reduced itching
4. Reduced redness
5. Reduced tightness
6. Increased circulation and neurological function
7. Improved appearance
8. Improved motion (for scars that are causing tightness of joints)

Massaging a Scar: It is generally recommended to massage 2-3 times per day for roughly 10 minutes per session. Starting too early could lead to further damage. Massage should only be started after the wound has completely closed. When the wound is the result of a medical procedure seek the advice of the physician prior to beginning massage. Massage should be done with care. If the scar begins to get redder, more painful or otherwise uncomfortable, it is probably a good idea to stop. The most common method I found while researching this is to use the pads of the fingers to make gentle circular motions over the scar. Over time, as the scar becomes less sensitive the pressure can be increased.

Many suggest the use of a non scented lotion, oil or cream for scar massage. I would add that a good alternative might be a silicone scar gel such as Scarfade. There has been much published research that suggests these types of products are effective in the reduction of scars. If scar massage really is effective, coupling it with the use of a scar removal gel seems to be very good idea.

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The Importance of Silicone In Scar Treatment Products

April 13, 2010 at 10:58 pm · Filed under Uncategorized ·Tagged , , , , ,

Wow … I just did a Google search on the phrase “scar treatment products” and it came back with 891,000 results! Apparently there is a market for these products. As I clicked through several of the links it occurred to me how easy it would be for somebody that didn’t know any better to be impressed by some of the lofty claims offered on some of these sites.

One of the most amusing observations during this exercise was the array of different miracle ingredients some of these products contain … everything from honey to onion extract. Several of the sites claim that their miracle ingredient is clinically proven to reduce scarring. Most, however, fail to offer up evidence of any such clinical trials.

With so many scar treatment products out there, how does one go about picking the right product? I have spent a considerable amount of time researching this topic and in my opinion the first place you should look is at the ingredient list. To my knowledge the only ingredient proven effective in legitimate clinical trials is silicone. Sure, you will find other ingredients that are claimed to be proven effective but take a closer look. My experience is that these claims aren’t backed by actual study reports or that the study’s they do offer are sketchy at best. Look for study’s that have actually been accepted by and printed in professional medical trade journals. Again, the only ingredient I know of that is backed by such published studies is silicone.

Silicone scar products come in the form of either a sheet or a gel. Both can be very effective if used properly. Generally, the gel is preferred by more physicians and their patients because it is less cumbersome to use and not visible once applied. In addition, makeup or sunscreen can be worn over the top of it. There are numerous scar products containing silicone gel. They contain varying amounts of silicone from just a trace to 100% silicone. It is ok and possibly beneficial for these products to contain small amounts of other ingredients such as vitamin c or sunscreen.

One should also note that there are different types of silicone. It is best if the silicone used in the product is non volatile, meaning it will not evaporate once applied. Volatile gels are easier to apply and probably more comfortable but may potentially be less effective as a portion of the product applied evaporates, leaving less product on the skin. Non volatile gels can be sticky to the touch and slightly uncomfortable when first applied but if you massage them onto the skin thoroughly and gently wipe away the excess they aren’t so bad.

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Make The Application Of Sunscreen Part of Your Daily Routine

April 9, 2010 at 6:51 pm · Filed under Uncategorized ·Tagged , , ,

We have all heard the warnings about how important it is to use sunscreen, haven’t we? Apparently many of us aren’t listening. Research on the topic suggests that perhaps as much as 40% of us never use sunscreen even when we know we are going to be exposed to excessive sunlight.

For this reason, skin cancer is one of the leading forms of cancer in the United States. Over 100 million Americans each year get sunburns. In addition to skin cancer, overexposure to the sun can cause pre-mature aging of the skin, wrinkles, age spots and the proliferation of moles. Daily use of sunscreen will help reduce the chances of serious skin damage. Thus it will help keep the skin smooth and soft and help maintain its youthful appearance.

It is important to note that damage can be done even if you don’t get a sunburn. Sunscreen should be used when spending any length of time outdoors. Most experts recommend a sunscreen with an SPF15 rating or possibly higher depending on the conditions. It is important to make sure the sunscreen you choose protects against both Ultraviolet A (UVA) rays and Ultraviolet B (UVB) rays.

Part of the reason so many of us don’t properly protect ourselves from sunlight is that applying sunscreen is viewed as a hassle. This doesn’t have to be the case. It is easy to make the application of sunscreen part of your daily skincare routine. For example, if you are already using a daily moisturizer, consider using a moisturizer which includes a sunscreen. There are many available. However you do it, make protecting your skin from the sun a priority. Our skin is the organ that protects the rest of our body’s structures and it is very important that we take care of it.

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The Use Of Silicone Gels In The Treatment Of Scars

March 12, 2010 at 10:52 pm · Filed under Uncategorized ·Tagged , , , ,

While there are no formal studies I know of that would confirm the numbers, estimates from some in the medical community suggest that perhaps 100 million or more individuals throughout the world develop scars each year. Of course scars differ widely in their characteristics and thus their effects on individual patients. In some cases they pose no problems at all, while in others their effects can be more troubling. These effects may include pain, itching, anxiety, sleep disturbance, depression and diminished self esteem.

Despite all of this, there are limited viable options available for effectively treating scars. That is not to say there is a lack of products on the market claiming to heal scars. On the contrary, an internet search of the topic will reveal page after page of products claiming to heal any and all types of scars, regardless of their characteristics. But, most of these products offer no legitimate published studies to substantiate their claims. I have researched the topic extensively and as far as I can tell, the only scar treatment products proven effective in published medical studies are topical silicones in the form of sheets or spredeable gels.

Silicone sheets have long been an accepted form of effective scar treatment by the medical community, particularly by plastic and cosmetic surgeons. While medical studies confirm their effectiveness, there are some drawbacks to this form of treatment. Specifically, they are cumbersome to keep fixed to the scar site, they are unsightly when used on scars not covered by clothing, and in some cases they may cause irritation of the skin particularly in warmer climates where extreme perspiration may occur. Due to these drawbacks, patient compliance can become an issue. In other words, the sheets are not worn consistently throughout a course of treatment causing their benefits to not be fully realized.

The more recent development of silicone gel in a spreadable form is a viable answer to the problems mentioned above. These gels come in a tube and are applied like a cream. They are massaged onto the scar site a couple of times per day and once applied are generally invisible and more comfortable for the user. In addition, cosmetics or sunscreen can be applied on top of the gel. Studies have shown these gels to be effective on par with silicone sheets and patient compliance appears to be easier to achieve.

It should be noted that while several topical treatments are available on the market, they contain varying degrees of the key ingredient, silicone. Some have no silicone at all while others are nearly all silicone. One should be careful to check that the product they select is composed primarily of silicone. It is ok and perhaps good for there to be a small percentage of other ingredients such as Vitamins, Sunscreens or Co-Enzyme Q10 as well.

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THE IMPORTANCE OF TOPICAL VITAMIN C

February 23, 2010 at 5:27 pm · Filed under Uncategorized ·Tagged , , , ,

On an almost daily basis our skin is exposed to such damaging forces as stress, sunlight, cigarette smoke and pollution. Such exposure can damage the skin and lead to the presence of free radicals. Free radicals are unstable molecules that can cause cells to function poorly or die and thus can help lead to premature aging of the skin. Exercise, proper nutrition and enough sleep can help minimize these effects to some extent, but there are other things that can and should be done.

Current research indicates that using topical products containing vitamin c (L-Ascorbic Acid) on the skin can be an effective tool to enhance its health and vitality. Vitamin C is a powerful antioxidant, which means it can help inhibit free radical activity and therefore minimize their associated effects as mentioned above.

Vitamin C can also help maintain and promote the production of collagen in the skin. Collagen is an important protein that helps keep your skin firm and toned. As we age, our skin loses essential collagen, causing our skin to sag, droop and wrinkle. On the contrary, younger people with plenty of Collagen tend to have firmer, smoother looking skin.

With the popularity of Vitamin C skincare products, there is no surprise how many companies are selling Vitamin C Serums, creams and ointments. And why not? Professional strength Vitamin C can be very effective in providing your skin superior protection, helping fight off the onset of fine lines and wrinkles, making the skin appear brighter and more even, and promoting the production of Collagen in the skin. Buyers should beware though. Not all of these products are effective. It is important that the Vitamin C in the product one uses is in the form of stabilized ascorbic acid. Non stabilized Vitamin C will deteriorate quickly and won’t be properly absorbed by the skin.

Make sure that you include application of a good professional topical Vitamin C product in your daily routine. It is every bit as important as vitamins, exercise and proper nutrition.

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Healthy Skincare Tip from Hanson Skincare

December 22, 2009 at 12:18 am · Filed under Uncategorized ·Tagged , , , , , ,

Why should you include cleansing and toning as part of your daily facial skincare regime? Cleansing and toning are one of the least expensive yet most effective ways to help maintain healthy, vibrant skin.

CLEANSING: Cleansing is perhaps the easiest most important element of maintaining healthy skin. It is the basis for a healthy skincare regime. Cleansing removes excess oil and impurities from your skin and helps improve its health and radiance. Cleansing also helps prepare your skin for the other steps in your skincare program. You should consider using a professional facial cleansing product. Most of these products are designed to be gentle on your face’s delicate skin yet powerful enough to remove debris and impurities effectively. On the other hand, many all purpose soaps will end up being too harsh for your face, leaving the skin dry or irritated.

TONING: Toning is an important second step that completes the cleansing process yet many people choose to leave this step out. In reality, toning should be considered part of the cleansing process. A good toner will remove any remaining bits of oil, dirt and debris left behind by the cleanser. More importantly, toner will help soothe, nourish and hydrate the skin while restoring its delicate pH balance.

Cleansing and toning should be done twice daily for optimum results, however once a day is better than not at all. Cleansers and toners are relatively inexpensive and the cleansing/toning process takes only a few minutes. It makes sense to clean your skin daily just like you do your teeth and your hair. Doing so will help keep your skin looking good longer. And good looking skin will help make you feel better about yourself, which has the potential to benefit you in many other areas in life.

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Need a Tummy Tuck? Read This

November 30, 2009 at 7:37 pm · Filed under Uncategorized ·Tagged , , , , ,

A Tummy Tuck (also called Abdominoplasty) is a very popular procedure to remove excess skin from the abdominal area. According to the American Society of Plastic Surgeons (ASPS), there were approximately 148,410 Tummy Tuck procedures performed by member surgeons in 2007.

The majority of the time, this procedure results in a greatly improved appearance for the patient. The stomach becomes flatter and firmer and the waste narrower. Many patients may even show improved self esteem because they feel more confident and comfortable with their bodies after this procedure.

While the positives of this procedure are many, there are also a few drawbacks. To many the biggest of these is the fact that scars are unavoidable. The length and type of incision a surgeon uses will determine how extensive the scars will be. Many if not most Tummy Tuck surgeries result in a scar from hip to hip. The larger the amount of skin removed, the larger the scar is likely to be. These scars are very bothersome to many patients that have undergone Tummy Tuck procedures.

As is the case with other types of scars, there are options for treating Tummy Tuck scars that range from surgery to topical gels and creams.

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The Basics of Scars

November 10, 2009 at 4:51 am · Filed under Uncategorized ·Tagged , , , , , , , , ,

As part of the body’s process of healing itself, scars are a natural result of trauma to the skin. When the skin is broken, the body’s response is to produce collagen in the affected area. Collagen helps to heal the area which is a good thing, however often the body will overproduce collagen. When this happens, the result is a buildup or pile of excess collagen which results in a scar. Certain areas of the body may be more likely to form visible scars and certain skin types, such as darker skin are thought to be more prone to visible scarring.

In most cases, scars are not painful. For many, the problem with scars is in how they look rather than any associated discomfort. While smaller, narrower scars will often heal neatly and fade over time, larger more unsightly scars often form as a result of wider wounds.

To many, visible scars are not an issue. To others however, they may be an unwanted reminder of an unpleasant event. Scars generally only need to be treated if they are either painful (physically or emotionally) or if they are bothersome due to their appearance. The rare scar may pose problems with mobility, for example if they form on an area such as a knee or elbow. But this is normally not a problem. There are several available medical treatments for scars, including surgical excision, steroid injections, laser treatment and cryosurgery.

For those that would rather not go through one of the available medical treatments, there are several topical products (creams, gels, sheets) available for the treatment of scars. These types of treatments are generally available without prescription from a physician. For topical treatments to be very effective, the scar should be active, meaning no more than 1 ½ to 2 years old. As is the case with other treatments, not all topical products are created equally. Those with silicone in them tend to perform the best. There have been numerous published studies showing that silicone based products are effective in scar remodeling. Also important to note is that these products won’t have the same effect on all scars. Factors such as skin type, scar type, scar location and scar size all play a roll in how effective they will be. For example, pitted scars such as those often associated with acne or chicken pox, are not good candidates for treatment with topical products.

Scarfade Scar Gel from Hanson Medical is one of the leading silicone scar treatments available. It has been around for several years and is recommended by plastic surgeons and other physicians to their patients. Scarfade has been used in published studies substantiating the effectiveness of silicone based products. For more information, including copies of studies, visit www.scarfade.com

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