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2014/15 EDITION SCARS AND STRETCH MARKS

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may occur on any part of the body, but the upper chest SCARS AND STRETCH MARKS and shoulders are the most common sites. Unfortunately, keloid scars do not disappear over time. Scars form when the skin recovers from an injury. They do not generally pose any medical problem, but may be a Possible triggers of keloid scarring: cause of distress for some people. • Surgery • Injury Not all injuries result in a conspicuous scar. Whether or • Acne not a disfiguring scar will form is influenced by a number • Body piercings of factors including the severity of injury to the skin and its • Burns location on the body. Your age and ethnicity also affect the • Spontaneous formation in some people likelihood of scar formation. WHAT CAUSES SCARS? Hypertrophic scars Keloids Raised scars Enlarged scars that grow beyond Scars are areas of fibrous tissue that replace normal skin the size of the original injury as a result of the natural process of wound healing. Scars Affect around 40–70% Affect around 10–15% of are made up of collagen, the same protein found in healthy of surgical scars wounds skin. In healthy skin, collagen fibres are arranged in a basket Remain stable or may Do not reduce over time weave formation, whereas collagen fibres inside scar tissue reduce over time tend to align in one direction creating a dense, inelastic Occur at any age Tend to occur in people aged structure. Scar tissue differs from normal skin in a number 10–30 years of ways including its altered texture and appearance, and More common in people with the absence of sweat glands and hair follicles. darker skin DIFFERENT TYPES OF SCARS More prevalent in some families Hypertrophic scars Prevention of keloids Wound healing usually leaves a pale, flat scar on the skin. You have a greater risk of keloid scarring if: However, hypertrophic scars arise from overproduction • you have developed a keloid before of collagen, producing a thick scar that is raised above • members of your family have developed keloids the level of surrounding skin. The processes that initiate • you have dark skin. hypertrophic scar formation are not fully understood. If you are at risk, avoid deliberate wounds to the skin such Hypertrophic scars are more likely to develop if the wound as tattoos, piercings, unnecessary elective or cosmetic gets infected or if there is a lot of tension on the healing surgery, and seek effective treatment for acne to minimise wound. These types of scars may subside over time. inflammation. Keloids TREATMENT OF HYPERTROPHIC SCARS AND KELOIDS Keloids are raised, hyper-pigmented scars that grow beyond the confines of the original injury and are considered a While there is no cure for hypertrophic scars and keloids, more serious form of hypertrophic scarring. Keloids appear a range of treatment options are available aimed at as firm hard growths and although they are completely improving the appearance of the scar tissue and reducing harmless, they can be a cosmetic problem and may be itchy itchiness. These measures are helpful in at least some or painful in some people. While most people never develop patients, though treatment success may vary depending keloids, some get them after only minor injuries. Keloids on a number of factors, including the type and severity of

Bio-Oil® is a specialist skincare product formulated to help improve the appearance of scars and stretch marks. It contains the breakthrough ingredient PurCellin OilTM so that it can be absorbed easily, ensuring the targeted delivery of its key ingredients. It is important to apply Bio-Oil® twice a day, massaging gently in a circular motion to achieve the best results. Use for a minimum of3 months. Do not use on broken skin. Bio-Oil® is non-greasy, suitable for sensitive skin and formulated for use on the face and the body. For further information please visit bio-oil.com Bio-Oil® is the product most recommended by Doctors for scars and stretch marks Colmar( Brunton 2014). This resource provided to you by Dr. Grabiel Ng

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scarring. A combination of treatments may be needed. Talk Cushing’s syndrome. Stretch marks do not pose any with your doctor about which options may be best for you. medical concern, but may be a cause of embarrassment or even psychological distress to some people. • Silicone gel sheets and silicone-based ointments • Pressure dressings PREVENTION OF STRETCH MARKS - Requires long-term treatment • Stretch marks are a very common condition and it may • Corticosteroid injections into the scar not be possible to completely prevent them - Aims to flatten and soften the appearance of the scar • Maintain a healthy weight and avoid rapid weight gain - Treatment is repeated at 4 to 6-week intervals or loss • Laser treatment • Eat a healthy and balanced diet, and include vitamins - Requires multiple treatment sessions E and C and the minerals zinc and silicon to maintain • Cryotherapy healthy skin - Freezing with liquid nitrogen to stop keloid growth • During pregnancy, aim for steady, gradual weight gain • Radiotherapy • Topical creams, lotions and ointments may help to - Only suitable for treatment of severe scarring prevent stretch marks - Possible long-term side effects • Surgical removal TREATMENT OF STRETCH MARKS - There is a risk of keloids growing back after surgery, Treatment of stretch marks is most likely to be effective in possibly larger than the original one the early stages. Once stretch marks have faded to white STRETCH MARKS (striae alba), they may become more difficult to treat. Currently, there is no product that can be applied to the Stretch marks are narrow streaks or lines on the skin. skin that will eliminate stretch marks, but moisturising oils They are initially red or purple in colour (striae rubra) but and lotions can reduce their severity. eventually fade to white or silver (striae alba) and become considerably less noticeable. A variety of treatments have been advocated to improve the appearance of stretch marks, including laser therapy, The most well-known type of stretch marks are the ones topical retinoids and exfoliation, as well as regular use of that may occur on a woman’s body during pregnancy moisturizing oils, ointments and creams. (striae gravidum), but stretch marks actually affect a wide variety of people and can occur in any situation where Moisturisers provide an emollient, skin softening effect, as the skin is continuously and progressively stretched. The well as increasing the water holding capacity of the skin’s exact mechanisms by which stretch marks develop are outer layer, and an occlusive action that provides a layer likely to involve hormonal changes, physical stretch, and of oil on the surface to prevent water loss and thereby structural changes to the skin. improve skin hydration. Improved skin hydration through the use of moisturizers provides some benefit in reducing Stretch marks may develop as a result of: the appearance of scars and stretch marks. Choose • Pregnancy a moisturising lotion or oil that contains skin-repairing • Rapid weight gain ingredients (e.g. calendula, vitamin A) and/or anti-oxidant • Overweight and obesity vitamins (e.g. vitamins E and C). • Adolescent growth spurts • Body building FURTHER INFORMATION AND SUPPORT Stretch marks may also occur from prolonged use of oral or topical corticosteroids and in association with DermNet NZ http://www.dermnetnz.org

Bio-Oil® is a specialist skincare product formulated to help improve the appearance of scars and stretch marks. It contains the breakthrough ingredient PurCellin OilTM so that it can be absorbed easily, ensuring the targeted delivery of its key ingredients. It is important to apply Bio-Oil® twice a day, massaging gently in a circular motion to achieve the best results. Use for a minimum of3 months. Do not use on broken skin. Bio-Oil® is non-greasy, suitable for sensitive skin and formulated for use on the face and the body. For further information please visit bio-oil.com Bio-Oil® is the product most recommended by Doctors for scars and stretch marks Colmar( Brunton 2014).