The best, and actually only proven effective, risk-free, treatment for raised scars is topical silicone gel sheeting. In this study, published in Dermatologic Surgery in 2001 researchers conclude:

Topical silicone gel sheeting, with a 20-year history of satisfaction in dermatology, now appears to be useful in the prevention of hypertrophic scars and keloids in patients undergoing scar revision.

Also other studies confirm such claims. This type of therapy has been used for a few decades now, initially in burn centers and hospitals.

Not only to prevent excessive scar formation but to improve cosmetic appearance as well. Some dermatologists and other medical professionals refer to silicone sheeting as ‘The Golden Standard in Scar Treatment’.

Steroid Injections
Another treatment for raised scars that works is the, more invasive, use of steroid injections. Generally multiple injections are required to get the desired effect.

Downside are the possible side effects. Such steroid injections (e.g. Kenalog) may deform the scar and surrounding skin by causing dents (skin atrophy). Other complications include; lightening of the skin (hypopigmentation), and red spots on the skin (telangiectasia).

Because of these side effects and the non-invasive character of silicone gel sheeting it is often recommended to use these. Most scars improve upon using this modality.

Raised Scars
Raised scars can be white, red, purple, or even darker colored. The most common types of raised scars are keloids and hypertrophic scars. Hypertrophic scars are more common then keloids. The elevation of scar tissue is a result of excessive fibroblast creation. Fibroblasts are connective tissue cells the body creates to repair the wound.

• Keloids
  Keloids only occur in 10% of people. They look like mounds growing above the skin surface. Sometimes they are mistaken for benign tumors. Their symptoms are itchiness, pain, unusual sensations, redness and skin pigmentation. They grow out of the normal boundaries and can be triggered by wounds, pimples, insect bites, tattoos, and even simple scratches. Keloids are hard to treat effectively and recurrence is typical. These scars are often treated with combinations of laser therapy, steroid injections, and silicone sheets. As a last resort surgery can be performed but more scar tissue may form afterwards.
• Hypertrophic Scars
  Hypertrophic scars have a slightly similar appearance but do not grow as big as keloids. They may restrict movement when located close to a joint. They are more likely to fade in time, generally within 1 or 2 years. This type of scar tissue may develop into keloid scar tissue in some people. Therefore preventive treatment is recommended. (Surgical) wounds are commonly covered with paper tape to reduce wound tension and thus minimize scar tissue creation. (and the risk on keloid development) Scars (wounds that have closed) can be treated effectively by pressure therapy (garments) and silicone gel sheets.

How Do Silicones Work?
Silicones are thought to act by downregulating fibroblast creation thus reducing the amount of collagen deposit in the tissue. They are theorized (their precise method of action isn’t clear yet) to mimic the occlusive barrier function of healthy skin thus increasing hydration.

Hydration seems to be essential in improving (raised) scars therefore it is recommended to keep the scar and surrounding skin hydrated.

They can also improve the appearance of burn and contracture scars.

My Experiences With Silicones for Scars.
I have used silicone sheets myself on the several scars I had when I had been stabbed and needed surgery to safe my life. The sheets made my scars smoother, less itchy, flat, and more skin colored. I therefore recommend ScarAway .

You can also use a silicone gel cream such as ScarAway Serum or Kelo-cote scar gel. A gel is more convenient and once applied is less obvious which makes it more useful to wear during the day. (in case your scar is not covered by clothes.)

Sheets, also known as pads or patches seem to be slightly more effective though. I myself used both. Sheets at night and the gel during daytime.

What should I eat to promote healing and reduce scarring? That’s what I asked the medical personnel when I was in the hospital a few years ago.

Because I had various cuts and surgical wounds on my face and body I was anxious to know but they couldn’t tell me anything useful.

Later on I learned that there are certain foods that can help promote wound healing and even reduce scar tissue creation. Also certain vitamin and mineral supplements are known to be beneficial. Different studies confirm such claims.

So, What To Eat and Which Vitamins and Minerals To Take?

Most obviously, and probably needless to point out but for the sake of completeness mentioned anyway, is the importance of a healthy, well balanced diet. Make sure to eat a varied diet. Also, smoking should be avoided at all costs.

One particular nutrient to keep in mind is protein because studies indicate that protein deficiency delays wound (and possibly scar) healing. Proteins provide the body with the building blocks that are required to repair and rebuild. They also help fighting infections.

Other proven effective nutrients are those containing zinc. Animal studies show that zinc deficiency resulted in less quick healing wounds and when dietary zinc was supplemented wound healing times decreased. According to one study report:

“Oral zinc supplementation may be beneficial in treating zinc-deficient leg ulcer patients, but its therapeutic place in surgical patients needs further clarification.” Note: topical zinc application seems to be more efficient.

Studies show that most prominent results are achieved in patients or individuals who have deficiencies of certain nutrients. When a balanced diet without deficiencies is maintained eating these foods in addition might not lead to substantial benefits. An exception is vitamin C:

Clinical studies provide evidence that wound healing in subjects judged not deficient in vitamin C can be significantly accelerated with supplements of this nutrient above the recommended daily allowance (RDA).

This was the conclusion from a study titled Vitamin C and Human Wound Healing conducted on the Department of Oral Diagnosis, University of Alabama School of Dentistry, Birmingham, Ala., USA. Read the abstract here.

There are also indications that certain oral supplements can help heal wounds and reduce scarring. Bromelain, grapefruit seed extract, glutamine, and vitamin A are a few of them. Read this page; Do Vitamin and Mineral Supplements Promote Wound & Scar Tissue Healing? for more info.

There’s a huge, worldwide demand for a post-surgery scar reducing drug. Scar revision surgery is the third most common reconstructive procedure performed in the USA according to the American Society for Aesthetic and Plastic Surgeons. Will the new, soon to be launched Juvista fill this gap in the market?

Juvista is a drug that would be injected intradermally into the margins of wounds created by cosmetic and reconstructive plastic surgeons during scar revision surgery.
The manufacturer of Juvista, pharmaceutical company Renovo said that the phase III trial for scar revision drug Juvista is nearly complete.

As scars to be revised occur at all sites within the body (head, neck, limbs, chest, abdomen, back), in all races, sexes and in a wide age range, Renovo will seek to generate safety and efficacy data for Juvista across a wide range of body sites and patients.

Juvista has currently been tested on more than 1,500 patients. As for now the clinical trials have brought to light two failures of Juvista – in mole removal and breast augmentation. Juvista is the commercial name for the drug Avotermin – an injectable solution of human active recombinant transforming growth factor beta 3 (TGFβ3).

Apart from scar revision there are all sorts of other potential uses, from varicose vein treatment to cosmetic surgery.

“Juvista has the potential to become standard of care to reduce scaring after surgery work the high sales potential validated by Shire’s interest in the North American rights.”

Its main focus is to continue developing its scar-reduction treatments Juvista and Prevascar, with the results of clinical trials expected in the first half of this year.

Update: Failure Juvista Clinical Trial

Too bad but the clinical trial for anti-scarring drug Juvista did not meet primary or secondary endpoints. The Renovo companay is completing trials of two other treatments, Prevascar and Adaprev.

More info on the Renovo website.

Question: How to regrow a severed finger in 4 weeks? (as seen on the Oprah Winfrey show.)
Answer: by using Matristem Wound Powder and a Band-Aid.

What is Matristem Wound Powder?
Matristem wound powder is an innovative regenerative medicine. It is made from the extracellular matrix (ECM) material that naturally occurs in pig bladders (pigs tissue has a collagen structure that is nearly identical to that of human tissue). Which is why this new product is sometimes popularly called pig powder.

What is this Extracellular Matrix?
Extracellular matrix is a network of biomolecules (mostly proteins) which hold the cells together. It is sometimes compared with a scaffold because it supports construction and repair on a cellular level.

Instead of the normal healing process which involves scabbing and scarring it stimulates cellular regeneration (promotes rapid donor site remodeling). This means that thanks to this medical innovation we can now grow back fingers (and possibly other body parts). There’s also no, or far less, scarring involved.

How Does Matristem Wound Powder Work?
The powder keeps the wound from healing and as a result the body focuses on creating new cells. Its main mechanism has to do with the fact that the body doesn’t have to regenerate so much extracellular matrix on its own.

Because the wound is covered in extracellular matrix there’s an increase of regenerative cells which are able to regrow the tissue. I’d like to compare it with a collapsed brick house of which the presence of the steel framework determines whether or not it can be rebuild the way it was.

The patient’s own cells and blood vessels grow into the material; it is completely absorbed, leaving behind new tissue instead of scar tissue. Source: Acell.

MatriStem Wound Powder vs. MatriStem Wound Care Matrix
Matristem is currently available in sheet and micronized particle form (powder). Ask your surgeon, dermatologist, or other health care professional about. This product is exclusively available commercially by keepers of a pharmacy license.

Is MatriStem™ Powder Safe?
For these and answers to other questions, on for example side effects and how to use instructions, visit this Finger Amputation Patient pdf file.

More news such as;

ACell’s MatriStem® Wound Powder heals toddler’s severed thumb
ACell’s MatriStem Wound Powder featured on the Oprah Winfrey Show
ACell’s MatriStem MicroMatrix® regenerates woman’s severed fingertip

on the Acell website.

Especially keloid scars have a tendency to grow back. Even after they have been removed surgically. But soon a new medicine for the prevention and reduction of scarring following scar revision surgery may end the problem of recurrent keloids.

The UK based biopharmaceutical product company Renovo is currently developing a first‐in‐class pharmaceutical scar reduction drug called Juvista. This scar preventing medicine, which has to be injected in the skin just before surgery will soon be marketed in the US and Europe. (it’s currently in its research and development phase.)

Professor Mark Ferguson, CEO, Renovo Group commented:

“It was important to establish the safety of Juvista® when given to patients who develop keloids, as one can not necessarily predict which patients will go on to develop them.

This series of safety trials achieved the primary objective across a range of Juvista® doses and provided valuable new information on the natural history of keloid scar development to inform future trial design.

The main Juvista® Phase III programme in disfiguring scars remains on track as a potential first‐in‐class pharmaceutical for the prevention and reduction of scarring following scar revision surgery.” Source: Renovo.com (.pdf)

More research results will become available in 2011. The company is also working on a new formulation of Juvista that is specifically designed for children.

Design Veronique compression garment

Before silicone sheeting became widespread, pressure therapy has been the appropriate method to treat (burn) scars.

During the nineteenth century the use of pressure in the treatment and prevention of hypertrophic scars or keloids became popular.

Compression garments, made from elasticized fabric shaped as sleeves, gloves, or masks, became standard treatment modalities in burn centers and other health care institutions.

Nowadays compression garments are still commonly used. For example after (cosmetic) surgery. This because of the specific benefits of these garments.

Benefits of the pressure applied are;

• improved blood circulation,
• minimized swelling after the procedure,
• drainage of potentially harmful fluids,
• acceleration of the healing process,
• and prevention of problematic scar development.

So How Do Compression Garments Work?

• The mechanism of pressure therapy has to do with the fact that in case of (burn) scars the top layer of the skin is missing. Therefore it can’t put pressure on the skin as healthy skin would do and this is what may lead to hypertrophic and keloid scarring.
• Another probable benefit of post surgery compression garments is that the pressure applied on the scar protects the tissue from overstretching. This reduced tension on the healing tissue prevents scars from widening (or thickening).  For the same reason scar taping is sometimes administered.
• Furthermore, pressure may theoretically break up excessive scar tissue (collagen bundles) and soften the keloid mass however, therapy must be instituted for long periods (>23 h/d for 6 mo) before significant effects can be achieved.
• When used following a facial procedure, the compression garment also provides support to surgical areas for more comfort and helps the skin fit better to it new contours.

Used When?
Plastic surgery compression garments are available for most  types of cosmetic surgery and for every part of the body (face, upper body, mid body, lower body, chest, abdomen, arms, back, shoulders, thighs, legs, calves, and all other body areas).

There are several online stores who offer these garments.

Makemeheal for example, offers a wide range of medical grade garments for various procedures. (The term medical grade refers to the fact that these are high quality post-operative, medical compression garments which are specifically designed to be worn for long time periods during the recovery process from a cosmetic surgery.)

Examples of cosmetic surgeries after which pressure garments are used are; breast surgery, face lifts, buttock surgery, arm, thigh lift, liposuction and other weight loss procedures.

Photo by Howcheng

This may sound unbelievable but just like salamanders are able to grow back their tails medical science is now capable of growing back fingertips and other tissue. Several cases have demonstrated tissue regeneration in human beings.

Here’s a short Youtube video about how doctors were able to regrow the severed top part of a little boy’s thumb with the use of wound tissue regeneration.

Acell, the manufacturer of innovative tissue regeneration products (MatriStem) states that their products “promote cell development and regeneration of site specific tissue, may recruit adult progenitor cells, and reduce scarring and restore tissue to its normal state and function.”

Progenitor cells (like stem cells) have a tendency to differentiate into a specific type of cell. In contrast to stem cells, however, they are already far more specific because they have the ability to differentiate into site specific tissues such as muscle, skin, tendons, and bone.

Commonly two types of tissue regenerative agents are used. Wound powder and biodegradable scaffolds which are matrix structured dressings which foster the regeneration of new tissue that resembles the original tissue in structure and function.

According to the wound healing page on Wikipedia: “biodegradable scaffolds inhibit wound contraction, thereby allowing the healing process to proceed towards a more-regenerative/less-scarring pathway.”

Problematic wounds such as diabetic, venous, arterial, and pressure ulcers, traumatic wounds, first and second degree burns, and surgical wounds can benefit from this fairly new type of treatment.

Since they are said to reduce scarring and even prevent scars from developing, as impossible as it sounds, patients might want to ask their surgeon, dermatologist, or other health care professional about this treatment. MatriStem Wound Matrix is available on Amazon but can only be purchased by keepers of a pharmacy license.

Read more about the miraculous opportunities modern medical science has to offer in this CNN article: Woman’s persistence pays off in regenerated fingertip. There are some tips on how to be a proactive patient and how to contribute to getting the most optimal treatment available today. Or as stated in the article; realize your doctor doesn’t know everything.