Scar Prevention Treatment: Is There a Golden Window of Time?

Hello. I am Kang Jin-moon, a dermatologist. All wounds, to varying degrees, leave traces after healing. If these traces are prominent, treatment is necessary, and today I would like to discuss scar prevention treatment. The most important thing to prevent scars from injuries or surgeries is the timing of scar treatment. In this article, I will explain why scar prevention treatment is necessary and when the appropriate time is.

Our skin plays two important roles. First, it protects the body from losing moisture and electrolytes to the outside. Second, it defends against external bacteria or pollutants entering the body. However, when the skin is damaged by trauma, these two important functions cannot operate properly.

The skin creates scars as a temporary measure to quickly restore its damaged functions, as part of a self-protective mechanism. This is the body's self-protective response to address the immediate problem. It usually takes about 6 months to 2 years for a scar to fully settle, during which time the skin may become somewhat raised or sunken, and pigmentation or depigmentation may occur. It may also be accompanied by itching or stinging.

In the past, it was taken for granted that scars would form after surgery or injury. Even when treating scars, the focus was on removing them only after they had fully formed, passing through the final stage of the scar formation process, the maturation phase. However, skin that has gone through the maturation phase after an injury often develops irregular shapes, hypertrophic scars, or keloids. Especially, the deeper the wound, the greater the likelihood of severe scarring. Once a scar has formed, it is difficult for it to return to its original state.

Furthermore, blood vessels that are essential for early wound healing and regeneration must disappear appropriately over time, but if this process does not occur properly, hypertrophic scars or keloids may appear due to excessive regeneration. Therefore, preventive scar treatment is necessary from the process of damaged skin regeneration.

Scar prevention treatment is better the sooner it is started. Scar treatment begins with proper treatment and management immediately after an injury occurs. When the skin is damaged, it regenerates with an emphasis on speed rather than perfection to quickly defend against bacterial invasion from the outside. Therefore, if an injury is not immediately treated and is exposed to external air, the skin may regenerate faster, leading to more severe scarring.

Generally, scar treatment is known to be possible only after 6 months have passed since the skin was damaged, but to minimize scarring, it is best to quickly block the wound from external air and maintain appropriate humidity and temperature as soon as it occurs. In that sense, early moist dressing is very important.

• Moist dressing maintains appropriate humidity and temperature for smooth cell regeneration.
• It enriches skin regeneration factors, enhancing the completeness of skin regeneration.

If you have undergone surgery, you can start treatment immediately after the stitches are removed. However, since the wound healing process continues for more than a year even after skin regeneration is complete, receiving appropriate treatment even after the initial period can further help prevent scars.

Even if you have missed the golden time, there is no need to give up on treatment. Even for old scars, patient satisfaction is reported to be higher when treatment is performed compared to not treating them.

Scars form differently depending on various factors such as the depth, length, direction, and blood circulation of the wound, as well as genetic factors, age, and UV exposure. It can be said that all wounds expected to result in scars.

Especially in young people, scars may remain in a more distinct form, and if the damage extends deep into the dermis below the epidermis, the probability of scarring increases. It is also affected by the direction and area of the damaged skin; areas with frequent movement like joints, areas with strong pulling forces like the chest, and thick-skinned areas like the back are prone to raised or widened scars. Also, if the wound occurs in a direction that does not align with the skin's natural wrinkle lines (e.g., vertically on the forehead instead of horizontally), the scar may be more noticeable.

For hypertrophic scars or keloids caused by excessive regeneration due to blood vessels, the scope can be significantly reduced with vascular lasers that suppress abnormal blood vessel proliferation.

I have discussed the importance of scar prevention treatment. As mentioned above, the most important point for effective scar treatment is the timing of treatment. And please remember that the sooner, the better. Thank you.