Paragon Press – July 2013

Treating Scars

Look in the “skin care” aisle of your local store and you will find several offerings for scar treatment. Many of us have scars from mishaps or surgeries and when they appear in noticeable places, we want them to be gone. For most people, it’s difficult to know which remedies might be quack cures and which produce real results. Here is some information to help you understand scarring better and available treatments.

WHY DOES SKIN SCAR?
Scars are the result of abnormal formation of collagen in the skin after an injury.

WHAT IS THE BEST WAY TO AVOID A SCAR?
Keeping the wound moist is key. Letting the wound form a scab will cause a worse-looking scar. Using plain old Vaseline under a BandAid is an easy and inexpensive way to keep it moist. If you are looking to use moisturizers, know that the more ingredients they have, the higher the chance of an allergic reaction. Also, keep the wound covered. Exposure to sun will worsen any discoloration of the wounded area and cause the tissue to thicken. Scars are very sensitive, so they brown quickly. This discoloration and tissue thickening make any sort of treatment more difficult. If the area is on your face, liberally apply sunscreen with an SPF of at least 50.

DO DRUGSTORE REMEDIES WORK?
Most drugstore remedies do not have any effect on scars. Vitamin E is an ingredient in some scar-healing products. It’s known for properties that lessen inflammation, but it hasn’t been proven to do much for scars. When it works, it is likely the result of the moisturizing effect that simply keeps the skin hydrated. Some people develop allergic reactions or skin irritations to Vitamin E, thus making healing more difficult.
Onion extract is another ingredient found in drug store creams, but is not scientifically proven to help.
One over-the-counter product known to help is silicone. It is often found as an adhesive sheet that sticks to the scar. Some experts think this works on scars because of the pressure that is applied to the skin through the bandage. It’s a slow process when you use this product and can be very expensive, with estimates at $40/month. Silicone can require up to two full years of use for full healing, requiring patience and diligence.

ARE ANY HOME REMEDIES USEFUL?
None is a guaranteed cure. Stay away from folksy home remedies, such as rubbing lemons or onions on the scar. These can be irritating and kill the healthy cells. Honey is one home remedy that might be useful. It promotes healing, yet kills off other bacteria and fungi. This shouldn’t be considered superior to keeping the wound moist, however.

MASSAGE THERAPY
You can try massaging the scar: 1-after stitches have been removed, 2-after the scab has fallen off, and 3-there is no risk of reopening the wound. Scar massage can prevent scar tissue buildup, puckering of the skin at its edges, and help range of motion. For lubrication, use a quality lotion without added scent, like Nivea or Eucerin. Additives can cause skin irritation. Ask for guidance from your healthcare provider. Note that massage will not help old scars.

ARE MEDICAL PROCEDURES WORTH THE COST?
Laser therapy has been shown to help thick or red scars. Cortisone injections are used to flatten thick or raised scars. A certified Dermatologist can determine if either of these would be helpful. These can be expensive, sometimes up to $500 a treatment, and require more than one procedure for optimal results. With some scars, you might be replacing one scar with another that looks better if it cannot be eliminated, which can happen in with acne damage.
If you try any scar treatment and the area shows signs of infection, such as pain, redness, bleeding, tenderness, or drainage, consult your healthcare professional immediately.

HAPPY INDEPENDENCE DAY
TO ALL OUR PATIENTS AND A BIG THANK YOU TO ALL WHO HAVE SERVED OR ARE SERVING OUR COUNTRY!
WE ARE PROUD OF YOU!

The following articles were referenced for this newsletter:
http://articles.latimes.com/2011/apr/17/health/la-he-scars-20110417

Paragon Press – August 2013

Aspirin vs. Warfarin

By definition, a thromboembolism is the formation of a clot (thrombus) in a blood vessel that breaks loose and is carried by the blood stream to plug another vessel. Clots are potentially fatal risks of surgery, with the severity of the problem depending on where the thrombus travels. If you have had total joint surgery in the past 40 years, then you probably know what warfarin is. As the drug surgeons have used to prevent postoperative thromboembolism/clots, warfarin is effective, but has many side effects. The most notable side effect is bleeding, since warfarin interferes with your body’s ability to clot. It can be difficult to determine the proper amount for each patient because dosing is individualized. A recent study following 28,923 patients showed that aspirin may be a more effective prevention for clots than warfarin.

The study showed patients who were treated with aspirin had:

  • A lower incidence of pulmonary embolism (clot to the lungs)
  • A significantly lower DVT rate (clots)
  • Fewer wound-related problems
  • Shorter hospitalization time

The patients who received warfarin were more than six times more likely to develop an embolism to the lungs than one on aspirin. It is also important to note that using aspirin would be less expensive because there is less monitoring of your blood clotting. Regular clinic visits to monitor clotting are necessary while a patient is on warfarin, but not for aspirin. This research shows clear advantages to aspirin, but more study is needed for a definitive answer as to which drug is safest and best. Dr. Van Horne and Dr. Bents keep up with the most recent studies and will review what is best for you and your surgery.


Did you know that because of genetics, some people metabolize caffeine slowly, needing 8 hours to rid half of it from the body, while others need just 2 hours?

Quitting caffeine usually brings withdrawal symptoms that can last 2 to 9 days and doctors recommend you taper off gradually over 2 to 4 weeks to kick the habit.

The following articles were referenced for this newsletter:
http://www.medterms.com/script/main/art.asp?articlekey=25032
http://www.hindawi.com/journals/thromb/2012/837896/
http://www.aahks.org/patients/documentary/inside_look.asp
Wall Street Journal: Tuesday, June 11, 2013, D1