Scar wars
UNDER YOUR SKIN - Grace Carole Beltran, MD (The Philippine Star) - December 11, 2017 - 4:00pm

Perfect skin is defined as a seamless organ, like fine cloth. But imagine how just a small tear on a silk cloth can destroy the way it looks. It’s the same with skin. Any injury, such as a burn or a trauma like a dog bite, infection (abscess), severe acne, or even surgery, can cause a visible imperfection that takes away the skin’s allure.

However, an imperceptible scar isn’t bad if it’s in a location that’s easy to conceal. But when it’s not, one often wonders if there’s a way to treat it, other than hiding it under thick cosmetic cream and powder or hair or a piece of clothing like a hat or scarf, that will make it disappear or at least change how it looks.

The truth is, a scar will never completely go away. But hold on, this statement no longer applies. Because there now exist methods that can help not only reduce scar size and change its appearance but make it totally disappear.  That is the magic of aesthetic medicine and surgery.

First, here is a brief background on how we scar.  Scarring is a by-product of our body’s natural healing. Rather than try to reproduce the skin exactly as it was previous to the wound, our body closes up a wound as fast as possible to prevent infection so that we can heal very quickly. This is believed to have been an evolutionary advantage; however, now it also means that it can leave undesirable marks on our skin. Once the skin has been disrupted, it cannot grow back in an exact identical fashion as it was before. Instead, your body makes a new form of skin.  Scars are composed of collagen and other proteins that would normally be thought of as just your skin although slightly altered.

A variety of treatments can make scars less visible and improve their appearance. But the options available to you may depend on the type of scar that you have.  Over time, normal scars and hypertrophic scars will fade and become much paler.

Depending on how large or deep your wound is, your scar will form accordingly. Skin will be affected differently based on ethnicity, age, and heredity. Thankfully, there are many ways to reduce the size and appearance of scars.

Case #1: Marissa, on her first visit, was diagnosed with severe pustular acne.  She used a cream with very strong steroid for almost five months. This triggered the appearance of multiple bumps with pus especially on the sides of her face and by the time she visited me, it had spread towards the center of her face, even including the neck area.  Some keloids were also noted by this time.  I put her on a package so that I could closely watch her facial skin and also treat her as often as necessary.  At first, I was really terrified as every time I tried to remove pus from her skin, it was like punching a hole in her skin, too.  Marissa’s skin was so fragile, as a result of prolonged steroid use, that even  gentle pressure on it would cause a tear. So I did acne surgery with special precaution, which took me more time to prick than usual, but thinking about it, it was actually worth the patience.  Luckily, Marissa was that type of patient who was resilient and really dedicated.  After two months, her face was normal except for the pinkish discoloration in the areas where the pustules were located.  Then, she visited me after two months for a scar treatment.  When the top layer of the skin becomes inflamed by acne, the skin produces too much collagen in an attempt to heal itself, forming acne scars. In Marissa’s case, she developed numerous minute angular and wave-like scars that were shiny and silvery like colored lines that are slightly elevated.  I started her on injections with a very tiny needle that is almost painless.  After three sessions, the marks were indiscernible. Still remaining are a few hypertrophic scars, which have improved almost 50 percent as of this writing.

Case # 2:  Textural scar changes are the hardest to modify and the longest to heal.  Benjamin is a charismatic leader who lives in the US.  He visited my clinic a long time ago for multiple scars on his legs.  As of this consult, I already had the technology from Australia about stem cells.  In fact, I was the first one to popularize this idea about stem cells improving skin imperfections like melasma, vitiligo, scars, etc. So, he was one of my very first few patients to avail of this treatment. For the procedure to become successful, we needed to be in a sterile environment as a simple infection could kill all the stem cells that had been harvested and transplanted.   So, I processed his skin on the kit, collected all  the stem cells I could collect and then prepared the site where the transplants were supposed to take place.  The whole process was uneventful. What was difficult was the post-operative technique of caring for the wounds, which took me at least a week.  Once healed, Benjamin headed back to USA but came back after five months.  Scars improved by 70 percent.  It was difficult but worth it, according to him.  Now, he could walk on the beach wearing short shorts without getting embarrassed.

Case # 3:  Stretch marks are definitely obnoxious.  And Tita was not spared of these after giving birth three times. Her once unblemished skin is now tarnished by the pains of giving birth.  Only in her early 30s, Tita is  gifted with a good height and a fashion model frame she could pass for a single woman.  Unfortunately, stretch marks are etched on the lower part of her abdomen, preventing her from wearing sexy dresses and showing off her figure.  She is into fashion shows so she needs to dress up. I suggested a little liposuction and lipectomy, which she did.  We got rid of all her stretch marks in an instant!

Case # 4:  This is the most difficult case I have handled so far.  This little girl was referred to me as a charity case.  Let us call her Desiree.  If I remember right, Desiree was left in the care of her aunt when her parents died.  Her aunt was so pissed one day that she poured gasoline all over Desiree, then 12, and set her on fire.  Desiree suffered second and third-degree burns so that when she was brought to me, she had scars over 70 percent of her body, including her face, neck, torso, and both arms, plus some wounds that were still fresh.  I really was so overwhelmed by the severity of the injury that I accepted to treat her for free.  At the time of her visit, there was severe itching and a little pain all over her, with her neck tilted on the left, which she could not really move normally because of the contracture that had settled in.  She was also unable to lift her arms to their complete range.  Well, to make the story short, Desiree has fully recovered.  She could move her limbs normally and her neck can now also move freely as we prevented the progression of her contractures.  I am happy I was able to help her with what I can.  The scars are flatter now, the color almost normal, but of course, no amount of treatment can bring her back to what she was before.

* * * 

For inquiries, call 0917-4976261, 0999-8834802 or 263-4094; email gc_beltran@yahoo.com.

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