Week 3: Scar & Skin Lesions

What are the different types of scars?

Flat & pale, hypertropic, keloid, acne, sunken, stretched.

What is a flat & pale scar?

A scar that is initially red or dark and raised but later pales and flattens over time.

How are hypertropic and keloid scars characterized?

These are raised overgrowths of scar tissue at the injury site that grow indefinitely and may not improve in appearance over time.

What differentiates hypertropic scars from keloid scars?

Hypertropic scars enlarge within the original size of the wound, while keloid scars enlarge beyond the wound size and do not improve over time.

What type of scars do acne leave?

Acne scars can have post-inflammatory pigmentation and are different from flat, red macules which disappear over time.

What is the healing time for macules?

They remain for up to 6 months after the inflamed acne lesions flatten.

What are rolling acne scars?

Broad depressions with sloping edges.

What characterizes boxcar acne scars?

Broad depressions with sharp edges.

Describe ice-pick acne scars.

Deep, narrow, pitted scars.

What are sunken scars?

Recessed scars in the skin, often resulting from chicken pox or ice-pick scarring from acne.

What causes stretched scars?

They occur when there is tension on a healing wound or poor healing due to health conditions or malnutrition.

What factors affect scar treatment?

PATH: Predisposing & Causative Factors, Age of Scar, Anatomic Location, Type of Scar, family History.

When should prescription treatment be considered for scars?

For severe scarring cases, patients should be referred to a physician for personalized treatment.

What is Mederma used for?

An OTC product that helps to improve both new and existing scars.

How long should Mederma be applied for new scars?

3-4 times daily for 8 weeks after healing. For existing/old scars is 6 months minimum.

What is important to do before using a silicone gel sheet?

Wash hands and gently clean the scar with mild soap and warm water while drying thoroughly afterwards.

How long should silicone gel sheets be worn initially?

4 hours on the first day, increasing to 24 hours if possible.

What does Centella Asiatica extract do?

• improves wound repair

• reduces inflammation over time

• modulates or slows down production of collagen on scars/in the skin,

What is the purpose of Vitamin E in scar treatment? — available in oil/cream/oil capsule form

It speeds up healing processes and lightens scars. (90% report either no effect or worsening scars)

What should be avoided when applying Hydroquinone?

Normal surrounding skin; it should only be applied to dark spots.

What is the main action of Arbutin?

It acts as a tyrosinase inhibitor to prevent the formation of melanin.

What is the role of Kojic acid in scar treatment?

It is a tyrosinase inhibitor used to remove or reduce epidermal hyperpigmentation.

Where are old acne marks typically found on the body?

Cheeks.

What skin condition is associated with sun damage?

Freckles on the shoulders.

What is Hydroquinone’s mechanism of action?

It interferes with melanin production by inhibiting tyrosinase.

What are some potential side effects of Hydroquinone?

Ochronosis and potential pigmentation changes.

What does Kojic acid specifically inhibit?

The formation of melanin.

What should be done with a scar under treatment if irritation occurs?

Reduce treatment duration or discontinue if irritation persists.

What is the visualization method linked to skin discoloration?

The Visual 'Body Map' Method.

What skin issues might be visualized on the forehead?

Melasma.

Which OTC product is often recommended for scar treatment due to its efficacy?

Mederma.

How can Vitamin E negatively impact scars?

In some cases, it may worsen the cosmetic appearance of scars.

What kind of scars are primarily caused by chicken pox?

Sunken scars.

How does a hypertropic scar differ from a regular scar?

It represents abnormal growth of scar tissue at the injury site.

What effect does the aging of a scar have on its appearance?

Scars may become less noticeable and improve in appearance over time.

How does skin health affect scar formation?

Poor health or malnutrition can lead to poor healing and stretched scars.

What type of acne scars can be deep and narrow?

Ice-pick scars.

What treatments help alleviate raised scars?

Using products like silicone gel sheets or corticosteroid injections.

How long can post-inflammatory pigmentation from acne last?

Up to 18 months.

What role does collagen play in scar formation?

Imbalance in collagen production during healing can lead to raised or abnormal scars.

What is the ideal way to measure the effectiveness of scar treatments?

By observing the improvement in scar appearance over time.

What is a common misconception about Vitamin E?

That it always has beneficial effects on scars.

What type of scar usually requires professional treatment?

Severe scarring or scars that do not improve over time.

What is the preferred duration for wearing a silicone gel sheet to see best results?

24 hours a day, if possible.

What is the difference between macules and acne scars?

Macules are flat red spots that typically disappear, while acne scars are pitted or raised.

What should be used with Hydroquinone to protect against sun damage?

Sun protection higher than SPF 15.

What is recommended for treating acne scars with inflammation?

Using anti-inflammatory products like Centella Asiatica.

What are the benefits of using Silicone Gel Sheets/ Why do we use them?/ What do we use them for?

• prevent of new scar formation

• reduce inflammation

• reduce proliferation of fibroblast cells

• used to manage old and new scars (apply for either 8 weeks or 6 months)

Describe the healing timeline for keloid scars.

They tend to take longer to improve and may remain raised.

What dietary considerations are important for preventing poor scar healing?

Adequate nutrition to support healing processes.

Which body region is most affected by skin trauma in children?

Knees.

What type of treatment can be used for acne scars with pigmentation?

Tyrosinase inhibitors such as Hydroquinone or Arbutin.

Why might someone choose a product like Mederma over others?

For its specific formulation aimed at improving scar appearance and less severe side effects compared to medication like hydroquinone. It is also easy to apply just by massaging it into the skin after cleansing

What is the usual recommendation for treating minor scars?

OTC products unless the scars are severe.

How does the body respond to injuries in terms of scar formation?

Through a healing process that can lead to various types of scarring depending on the factors involved.

How can sun damage be recognized on the body?

By the presence of freckles, especially on the shoulders.

What might be a sign of poor hygiene related to the use of silicone gel sheets?

Development of rashes or irritation.

How is the effectiveness of scar treatments typically assessed?

By observing changes in scar texture and color over time.

Why is it important to avoid normal skin when applying Hydroquinone?

To prevent damage to healthy skin surrounding dark spots.

What happens to the collagen during the healing processes that can affect scar appearance?

Imbalances in collagen production can lead to excessive scar formation.

What might cause stretched scars to form?

Tension on a healing wound or poor healing due to health issues.

How is the age of a scar relevant to its treatment?

Older scars may require different treatments and treatment duration compared to new scars.

What does the acronym PATH represent in relation to scarring?

Predisposing & Causative Factors, Age of Scar, Anatomic Location, Type of Scar, family History.

How can medications like Arbutin help with skin issues?

By inhibiting melanin production, they help reduce pigmentation.

What actions may need to be taken if a silicone gel sheet is found to be too irritating to the skin?

Reduce treatment time to 12 hours, then rest for 12 hours.

What types of scars are characterized as raised?

Hypertropic and keloid scars.

What is the ideal daily usage frequency for Centella Asiatica extract on scars?

Once or twice daily.

What should be included in a treatment plan for scar management?

Consideration of the type of scar and the individual’s health history.