Rehabilitation of patients with scarred skin lesions

Kristina (Novak) Musikhina , plastic surgeon, specialist in contour plastic surgery, graduate student of the Department of Otolaryngology at the Aleksandrovskaya Clinical Hospital, specialist in the field of aesthetic surgery and cosmetology

In essence, a person cannot adequately exist in the world. This is extremely dangerous for mental health, and some people in this situation - especially if we are talking about patients with deep facial scars - seriously consider suicide. As a doctor, I always recommend that people with such scars work through this situation with a professional psychotherapist. After all, even the best plastic surgeon is powerless to help a person get rid of internal problems and complexes. It all starts with a change in mindset and healthy self-love. Otherwise, no matter how you “sculpt” the patient’s appearance, he, alas, will not become happier. But an adequate attitude towards oneself, a healthy, constructive desire to change something, combined with the surgeon’s skill, always leads to successful results and positive changes in the patient’s life.

In addition to the aesthetic side of the issue, scars can cause other troubles to their owners. For example, keloid scars often cause physical pain and, more problematically, can grow larger. This situation is a direct indication for therapy. However, it is vitally important to carry it out under the supervision of a specialized specialist so as not to worsen the situation.

I am often asked about the effectiveness of non-invasive (that is, non-surgical and non-injection) scar treatments - such as silicone-based creams and gels. And here it is important to understand: yes, these remedies are effective, but if used in a timely manner. That is, in the first three months after the scar appears. This is the period when the scar is just forming and cannot yet be corrected. It is at this stage that such medications are effective. Their later use will be useless, no matter what the commercials promise us.

There is a widespread belief that invasive methods of treating scars are only surgical correction. Against. These include laser dermabrasion, mechanical skin resurfacing, and injection methods for treating scars. All these methods are very effective, but these procedures, in principle, cannot be too cheap. And it’s not just that the doctor invests a lot of time and money in his training and professional growth. The acquisition and high-quality maintenance of equipment necessary for carrying out procedures requires large financial costs.

It is important to understand what drugs and what equipment the specialist uses, whether he has the appropriate education and experience in treating this pathology. I recommend to my patients, if they decide to undergo the procedure, to have it performed in a trusted clinic with a good reputation. Fortunately, we live in the age of the Internet, when you can read reviews about any doctor, as well as see real examples of his work.

Modern approaches to the treatment and prevention of scar deformities

The patient must understand that he should not choose the method of scar treatment on his own. He can choose a specialist who will select the most suitable therapy for your situation. After all, it is the surgeon’s experience and his ability to work with various types of scars that is the main factor influencing the outcome of treatment. In addition, comorbidities and patient age may influence the outcome. We should not forget about the financial side of the issue, as well as a person’s pain threshold and his lifestyle.

For example, if we are talking about different types of dermabrasion , then mechanical dermabrasion is a procedure that is affordable from a financial point of view and very effective, its results can be very impressive. However, it is also extremely painful, and the recovery period after it is quite long.

Laser dermabrasion, on the other hand, is not a painful procedure and the recovery period after it is short, but this method is very expensive from a financial point of view. When indicated and when the patient is able to do so, I try to combine methods to obtain the best result. In this situation, the attending physician can be compared to a conductor who selects the appropriate “musical instruments” (that is, treatment methods) or a combination of them.

“Internet 'treatment' can be deadly”

Often, as a doctor, I am faced with the sad consequences of self-medication by the parents of their children. A striking example is the “treatment” of burns at home instead of competent first aid and contacting specialized specialists - combustiologists. I can say without exaggeration that “treatment” over the Internet can be deadly. It is important to choose specialists that patients can trust and contact when necessary.

Another important piece of advice I give to parents is: don't rush to correct your children's scars just because you don't like them. The most advantageous tactic, as we have already said, is to be in touch with the attending physician and in time - in the first three months after the injury - to use non-invasive methods of wound healing. Skin regeneration in children occurs faster, so they have a greater chance of normal healing and normotrophic scars. If we are talking about teenagers, then if we use aggressive methods of scar correction, we risk getting a keloid scar.

Therefore, in general, as a specialist, I do not recommend the use of such methods in children. If desired, a young person will be able to independently contact a specialist for scar correction upon reaching the age of 18, if he considers it necessary.

What conclusions can we draw?

• The number of patients with scars and cicatricial deformities is extremely high and there is no tendency to decrease
• Treatment of such patients requires the use of various methods of conservative and surgical treatment, monitoring the effectiveness of prescribed medications, and long periods of rehabilitation.
• The success of treating patients with scars and cicatricial deformities depends on the qualifications of specialists and knowledge of surgical and conservative rehabilitation methods

Have you already learned to love yourself?

I often ask my patients this question. No matter how trite it sounds, you are alone in your home, so you must learn to take proper care of yourself in order to preserve youth, beauty and good spirits for many years to come. And full self-care is impossible without interaction with competent specialists.

I constantly tell my patients: “Do not trust your treatment to advisers from forums, neighbors or graduates of two-week courses. Contact professionals to solve your problems. They will be able to choose the path that suits you best to solve these problems.”

Almost any issue can be resolved when an experienced specialist meets with a positive-minded patient who trusts the doctor, is open to his suggestions and is ready to follow his recommendations. Such cooperation between doctor and patient always leads to excellent results.