Atlas of Scar Treatment and Correction

Atlas of Scar Treatment and Correction

Igor Safonov Atlas of Scar Treatment and Correction

Author Igor Safonov Centre of Scars Treatment and Correction Dr. Bogomolets Institute of Dermatocosmetology Kiev Ukraine ISBN 978-3-642-29195-1 ISBN 978-3-642-29196-8 (ebook) DOI 10.1007/978-3-642-29196-8 Springer Heidelberg New York Dordrecht London Library of Congress Control Number: 2012949283 Springer-Verlag Berlin Heidelberg 2012 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)

Preface Cicatrices, often commonly referred to as scars, are an invariable companion of humans. There are few people in our imperfect world without a scar on the body. Our skin undergoes an endurance test on a day-to-day basis throughout our life. Common injuries, cuts, burns, accidents, surgeries and in fl ammatory skin diseases constitute an incomplete list of reasons for scarring. Supposing 1 of 1,000 residents across Europe and the United States has a 4-cm wound treated; the total length of these wounds would be more than 40,000 km, a value equivalent to the length of the equator. This is happening on a daily basis. Scar appearance varies depending on multiple factors: depth and mechanism of wound, localization, adequacy of treatment, and other factors. The common thing about scars is that they leave an imprint on the soul. Apart from physical pain, scars may cause an inferiority complex and undermine self-con fi dence to the extent psychological aid is required, with some neglected cases ending in suicide. Scar treatment and correction involve a lasting and assiduous process that does not always produce quick and expected results. This is why the scar issue does not receive suf fi cient interest. Even highly professional surgeons may often be heard saying, Let s just wait a year or so, and then we ll see! and after this time span, the same doctor says, It is hard to do anything about it. Scars can and should be treated within the fi rst hours after injury, and 95 % of cases do not require surgical treatment. I learned this by my own experience when treating over 3,500 patients with scars of different origin. Our goal is to make the scar unseeable or less conspicuous and erase the scar-related unpleasant memories. I would be happy to make my humble contribution to the development of scar treatment and correction with this book and help my colleagues and patients. v

Contents 1 Atrophic Scars and Stretch Marks.................................... 1 1.1 Atrophic Scars................................................. 3 Factors of Atrophic Scar Formation................................. 3 Types of Atrophic Scars.......................................... 12 Methods of Treatment for Fresh Scars............................... 14 Models of Fresh Scar Treatment................................... 31 Methods of Old Atrophic Scar Correction............................ 39 Models of Old Atrophic Scar Correction............................. 66 1.2 Treatment and Correction of Stretch Marks (Striae).................... 75 Prerequisites for Stretch Mark Formation............................ 75 Stretch Mark Correction Methods.................................. 83 References......................................................... 95 2 Pathological Scars (Keloid and Hypertrophic Scars)...................... 97 2.1 Definition of Keloids. Features.................................... 99 2.2 Definition of Hypertrophic Scars................................... 100 2.3 Factors of Pathological Scar Formation.............................. 101 2.4 Methods of Pathological Scar Treatment............................. 109 2.5 Ear Keloids. Treatment of Ear Keloids.............................. 129 2.6 Keloids on the Chest (Décolleté Zone). Chest Keloid Treatment.......... 135 2.7 Shoulder Keloids. Shoulder Keloid Treatment........................ 142 2.8 Pathological Scars of Mental Region. Treatment...................... 145 2.9 Back Keloids. Back Keloid Treatment............................... 149 2.10 Postburn Pathological Scars. Treatment............................. 152 References......................................................... 160 3 Normotrophic Scars................................................ 161 3.1 Factors of Normotrophic Scar Formation............................ 163 3.2 Stages of Normotrophic Scar Formation............................. 167 3.3 Fresh Normotrophic Scar Treatment................................ 169 Treatment During the Inflammation Stage............................ 169 Treatment During the Proliferation Stage............................ 172 Treatment During the Maturation Stage............................. 176 3.4 Old Normotrophic Scar Correction................................. 186 Encrusted Scars................................................ 186 Depigmented Scars............................................. 186 References......................................................... 188 4 Mixed Scars....................................................... 189 4.1 Mixed Scar Definition........................................... 191 4.2 Factors of Mixed Scar Formation.................................. 192 Intensity of Edema and Inflammation............................... 192 Inflammation of Phase 1 Cicatrization............................... 193 vii

viii Contents 4.3 Mixed Scar Treatment and Correction............................... 196 4.4 Some Example Models of Mixed Scar Treatment...................... 198 Details of Medical Companies and Products for Scars Treatment and Correction..................................................... 205 Index................................................................. 207