Can cure scar tissue cancer
Removal is not possible
People with hypertrophic scars or keloids suffer greatly from this condition, as large studies have shown. The quality of life is severely limited and people have a high burden of disease.
Treatment of normal scars
Normal scars do not require medical treatment. Because scars remain lifelong, removal can never be achieved. At most, a cosmetic improvement can be sought, the costs of such procedures must be borne by yourself. Scar removal is often promised, but this is not possible for the biological reasons described.
For cosmetic improvement, lasers are used that remove the surface of scars or cause tissue changes (for example Fraxel lasers). Microdermabrasion and the use of scar plasters are also offered.
Scar creams or gels can be tried to improve the cosmetic appearance, but are limited in their effectiveness.
Hypertrophic scars and keloids
Diseased scars usually require medical therapy. However, there are no patent remedies for the treatment of pathological scarring. The therapy is individually tailored to the patient. Nevertheless, there are international recommendations as to which procedures should be used at which point in time. Basically, the best results are achieved through a combined application of different methods.
If pathological scars are clinically suspected, therapy with pressure bandages or corsets should be sought as early as possible. Usually such bandages are made to measure and should be at least compression class 2. These pressure bandages are usually worn for more than six months and have proven their worth especially for burn patients.
An important basic therapy are silicone gel sheets or silicone gels that are placed or applied to the scars. It is recommended to wear the slides all day, to apply the gels twice a day. The therapy lasts months and longer.
Corticoid injection not too often
Often, corticoid crystals are injected into the scar tissue. This slowly reduces the thickness of the scar and suppresses itching. However, this therapy should not be carried out more than three to five times at longer intervals.
The application of extreme cold (mostly liquid nitrogen, -196 ° C) leads to a slow remodeling of the scar, making it flatter and softer. However, such an icing treatment (cryotherapy) can also lead to scabs and wounds, which can then reactivate the scar growth.
Various non-ablative laser systems have proven themselves in the treatment of pathological scars. Especially with the dye laser, good results can be achieved in terms of reducing pain and itching.
X-ray irradiation of fresh scars to prevent keloids is now only carried out in selected individual cases, but it is a well-documented and effective therapy.
In all plastic surgery procedures, the aim is not to remove the keloids, but rather to try to eliminate problems associated with the keloid formation. For example, strands of scarring in burn scars or keloids that lead to restricted mobility or severe pain can be treated using techniques such as "Z" plastic surgery.
Since strong scarring promotes the active growth of keloids, such measures can often stop growth. In individual cases, surgical reduction in the size of the keloid can also be achieved, with the removal of scar tissue within the confines of the keloid. However, a cure cannot be achieved through these measures.
Since keloids arise on the basis of an innate genetic disposition, every time the skin is damaged, keloids are formed again. Therefore, normal surgical removal inevitably leads to the creation of a new, larger keloid. The frequent introduction of corticoid crystals into the wound immediately before the final suture is without any effect.
Are hypertrophic scars or keloids removed with lasers (e.g. CO2Laser, Er-YAG laser), as with surgical removal, a relapse inevitably occurs.
Scar creams or gels applied to the surface have no detectable influence on hypertrophic scars and keloids. Since the disease process lies deep in the skin, the substances contained in these preparations do not reach the target tissue. It is assumed that the massaging recommended during the application is subjectively perceived as pleasant.
A cream with the active ingredient imiquimod developed for other skin diseases can also be used off-label to prevent the development of keloid. However, there are only a few reports on this in the scientific literature. Imiquimod-containing cream is applied so often immediately after the wound has healed (for example after the threads have been removed) that there is always a slight reddening / inflammation reaction. The therapy must be carried out for at least one year.
Developments in the field of biotechnological substances include antibodies against a growth factor (TGFβ1-transforming growth factor beta 1), which is of great importance in the development of pathological scars. The messenger substance interleukin-10 can also suppress the formation of keloids. A corresponding drug is also in clinical development./
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