A better understanding of scarring
Nast and colleagues recently wrote about how silicone products can improve a scar’s presentation, along with reducing the risk of hypertrophic scar formation or helping accelerate its resolution. This of course has relevance for those individuals with a predisposition to abnormal scarring such as those : of a young age (< 30yrs); experiencing hormonal peaks (puberty and pregnancy); with a genetic tendency; with a wound under high skin tension and/or infection; an inflammatory condition and delayed wound healing. The authors postulate that the greatest risk for hypertrophic scarring arises from delayed epithelialisation. Even when a wound is closed, the epidermis continues to play a role in inciting inflammation until such time as the stratum corneum water barrier is intact and functional. Nast et al states that … “after wound closure, water still evaporates more rapidly through scar tissue and may take over a year to return to pre-wound (water-loss) levels.” A dehydrated stratum corneum prolongs the inflammatory process and provides stimulus for hypertrophic scar development. Occlusive silicone products are barriers to transepidermal water loss. Maintaining the skin in a hydrated state has been demonstrated to reduce inflammation and excess collagen deposition, allowing scars to progress through healing with a more normal physiological outcome.
Nast,A Carreras,M Thompson,AR Edwards,J Yutshovskaya,Y Scar management: using silicone-based products in primary health care. Wounds Int 2016;7(4):23-27.