What to do if scars are itchy

Scars require patience

Atrophic scars are primarily the result of poorly healing wounds in which local and immigrating cells were not able to produce sufficient amounts of connective tissue fibers. Often such scars appear immediately after a period of acne.


Since some scarred skin area contains less collagen and water than normal skin, it can pull itself inwards for this reason alone. As the tissue shrinks, it hardens and sclerotic scars develop. Large areas of scalded or burned skin are particularly affected.


Therapy goals


The goals of scar therapy can be very different. The aim is to relieve itching, redness and pain, to make scars softer and more elastic, to plump them up, to sand them down or to let them become smaller. For reasons of movement, it can even make sense to lengthen a scar.


There is no standard procedure in scar therapy. Methods of first choice cannot be assigned to the individual treatment goals either, because too many factors influence the development and regression of scars. Therefore, the nature and stage of a scar are crucial for the selection of a suitable treatment method.


Local therapy for young scars


You can do something about the later appearance of a skin defect at an early stage and current symptoms of a young scar can often be alleviated with simple measures. If there are no complications, massage the fresh tissue several times a day under moderate pressure for at least five minutes for at least two to three weeks after an operation (4). It is important not to work the scar across, but only along its length.


Mild skin creams, such as children's face creams, can be used as a support. Scar cosmetics and topical scar gels are particularly suitable for alleviating symptoms and counteracting increased tissue formation.


For the prophylaxis and treatment of hypertrophic, keloid-shaped and movement-restricting scars as well as for scar shrinkage, a gel with the components Extractum Cepae, Allantoin and Heparin Sodium is approved (example: Contractubex®). It is said to have an anti-proliferative, anti-inflammatory and smoothing effect on scar tissue. Occasional itching is interpreted as a sign of tissue remodeling and does not constitute a reason to discontinue therapy. However, you need patience until the result is visible. The gel should be gently massaged in several times a day for about half a year. An ointment bandage overnight is also possible.


A scar gel from the anthroposophical direction of therapy is intended to stimulate the structuring forces of tissue formation (example: Wala scar gel®).


Numerous cosmetics are available for the care of scars. Preparations with allium cepa, allantoin, evening primrose oil, panthenol and chondroitin-hyaluronic acid complex are intended to inhibit connective tissue growth, counteract skin irritation, increase moisture and improve suppleness (example: Mederma®). According to case reports, regular massage should reduce tension, pain and itching and improve the appearance of the scars. Creams with heparin, camphor and urea (example: kelofibrase®) or with N-acetyl-D-glucosamine, prolinoleate, glucopeptides and asiatic acid (example: Terproline®) are supposed to improve the moisture balance of the skin and make scars more elastic. The cosmetic with asiatic acid is also used in clinics for severely burned people (1). In a pilot study, burn-related hypertrophic scars became less noticeable after ten months of use (8).


It should be noted that the topical preparations do not help all patients equally well. The right remedy must be found for each patient (4).


Foils curb growths


After surgical interventions, injuries or burns, topical silicone gel as well as silicone and polyurethane films are used to prevent excessive scarring. Prophylaxis can begin as soon as the skin over the wound area has closed and is presented as an intact surface.


All silicone or polyurethane products form an air-permeable but water-impermeable protective film over the scar. Above all, this has a positive effect on the hydration of the new skin. While healthy skin is about 8.5 g / m2 Releases water vapor per hour, hypertrophic scars only achieve values ​​of around 4.5 g / m due to their connective tissue structure2 (1). The occlusion increases the skin's moisture and temperature significantly, and the scar tissue becomes softer and more elastic. In addition, physiological remodeling processes in the tissue are promoted. Silicone is said to halve the risk of keloids or hypertrophic scars and to relieve itching and pain.


Topical silicone gel made from polysiloxane and silicon dioxide (example: Dermatix®) can be used on all parts of the body with the exception of the mucous membranes and eye areas. Even heavily used parts of the body such as joints, shoulders and back can be treated due to the elasticity and stretchability of the product. The gel is applied thinly to the cleaned scar twice a day. After a few minutes it solidifies so that no further fixation is necessary. Treatment should last at least two months. In the case of particularly pronounced scars, however, a much longer application may be necessary.


Silicone films are also used on young scars that tend to grow. Bandages made of polyurethane film, non-woven fabric and silicone coating are self-adhesive and skin-colored available in various sizes (e.g. Mepiform®). A film can be used for up to seven days because it can be removed and reattached for daily washing. Ideally, silicone bandages are worn 24 hours a day. An improvement in the complexion of the skin can usually be expected after two to six months.