After the wound has healed

After the wound has healed you can use slightly more emollient products with antioxi­dants to keep free-radical damage to a minimum. Sunscreens in a light, moisturizing base are essential, not only to keep the skin moist but also to allow the skin to continue heal­ing. There is some evidence that AHAs, BHA, and tretinoins (such as Retin-A, Renova, Tazorac, Avita, and generic tretinoin) can significantly reduce the appearance of scarring by exfoliating the surface skin (using AHAs) and by stimulating normal cell production (using tretinoin). Exfoliation can reduce the thick, discolored appearance of scar tissue. Tretinoins, over time, may help generate collagen production to possibly shore up some of what was lost from the injury.

Exfoliation, antioxidants, and sunscreens can all help minimize scarring after the skin has healed. None of them will get rid of a scar, but the possibility of greatly reducing the appearance of a scar is not to be ignored. Basically, there are no miracle skin-care ingredients or products when it comes to healing skin or reducing the appearance of scars.

Instead, practice good skin care: Don’t overmanipulate the site, protect it from the sun, keep the area disinfected, keep heavy emollients off the skin, and, as much as possible, let the skin handle its own healing process.

As to nutritional issues, research shows that these definitely play a factor in healing wounds and scars. A diet high in antioxidants and omega-3 and omega-6 fatty acids can have an overall significant benefit. For a list and description of oral supplements that have been shown to help heal wounds and scars, visit the Web site www. drweil. com.

The following list describes topical factors to enhance healing wounds and scars. The most important thing, both for healing a wound and trying to improve the scar’s appear­ance, is patience. It can take up to two years or longer depending on the depth of the lesion or wound, and it can depend on how diligent you are about caring for your skin with the following steps:

1. Once the skin has healed completely and the scab is gone, you can use nonfragrant plant oils or a lightweight moisturizer to keep the skin moist. The point here is to keep skin pliant and soft to help the skin’s healing process (dry skin can fissure and tear, which can cause further skin damage). Topically applied vitamin E has not been shown to be of any special help in healing wounds or scars and may make matters worse.

2. Now that the skin is healed, it is helpful to remove the surface layers of skin where scar tissue may be forming. It is also helpful to improve skin-cell production, which may have been damaged from the wound. The damage, if any, is completely depen­dent on the depth of the lesion—meaning how many layers of skin were affected and how well you have left the scab alone. For gently removing the surface layers of skin, consider using an effective salicylic acid product (BHA is preferred over AHAs because BHA is composed of salicylic acid, which has anti-inflammatory properties, and reducing or preventing inflammation is essential for the healing process) as well as tretinoin (Retin-A, Renova, Tazorac, Avita) for improving cell production.

3. Once the wound or lesion is completely healed (this can take several months and up to two years), there are several options for dealing with the resulting scar. For surface discolorations and minor irregularities, microdermabrasion is an option. Acid peels (including AHA peels or trichloroacetic acid peels) as well as laser resurfacing are also significant options for reducing or eliminating scars.

4. If you have any concern about impaired healing or how the scar looks, it is important to see a dermatologist.

Updated: September 26, 2015 — 5:44 pm