SCIENCE OF SCARRING


Every wound on human skin results in a scar.  It is the final stage of the healing process. The appearance of a scar depends on many variables beyond our control including body site, depth of injury and genetics.  It also depends on some factors that we can control, most importantly proper wound care throughout the various stages of healing.  

This is where X•SCAR comes in. 

 

 

Wound healing occurs in 3 stages:

the inflammatory stage, the proliferative phase and the remodeling phase


The inflammatory stage occurs during the first 5-6 days, followed by the proliferative stage lasting up to 4 weeks and then scar remodeling which spans from 4 weeks and takes years.

Immediately after an injury, the initial response is bleeding.  The body’s response to bleeding, called hemostasis, stops the bleeding and starts the healing by attracting an army of inflammatory cells.  These cells begin to build the framework for new blood vessels, collagen and skin formation.

The inflammatory phase leads to the proliferative phase.  In the proliferative stage, cells called fibroblasts lay down the foundation for new skin.  Blood vessels are built and then new skin cells migrate in to rebuild.  

After the proliferative stage, the wound undergoes constant alterations, known as remodeling.  In remodeling, collagen is broken down and rebuilt.  The wound may contract and tighten. Remodeling is an ongoing, long-term process that ultimately determines how a scar looks and feels.  The best scars have an abundance of collagen type-1 over collagen type-3.  

 

HOW DO XSCAR, XSCAR KIDS, AND XSCAR HQ WORK?

X•SCAR products were created by physicians based on extensive scar management data and research.   As silicone based lotions, they are purposefully designed to be massaged into scars.   

 

SILICONE

Silicone forms an ultra thin sheet over a scar and works 24 hours per day. It has been reported to improve scars by an 86% reduction in texture, 84% in color and 68% in height of scars. 

Silicone gel exerts several scar repairing actions including:

  1. It increases hydration of stratum corneum and thereby facilitates regulation of fibroblast production and reduction in collagen production. It results into softer and flatter scar. It allows skin to "breathe".
  2. It protects the scarred tissue from bacterial invasion and prevents bacteria-induced excessive collagen production in the scar tissue.
  3. It modulates the expression of growth factors, fibroblast growth factor (FGF) and tumor growth factor (TGF). TGF stimulates fibroblasts to synthesize collagen and fibronectin. FGF normalizes the collagen synthesis in an abnormal scar and increases the level of collagenases which breaks down the excess collagen. Balance of fibrogenesis and fibrolysis is ultimately restored.
  4. Silicone gel reduces itching and discomfort associated with scars, leading to less trauma from rubbing or scratching.

 

MASSAGE

Scar formation and maturation happens over 12 to 18 months after injury.  After full healing of a wound, massage is often recommended to soften scar tissue build up, prevent stiffness, and improve the appearance of scars.  

  1. Massage therapy is standard in rehabilitation centers specializing in the treatment of scars and burns.
  2. In a review of 258 patients who received scar massage after burns, the data showed that massage effectively decreased scar height, redness, pain, itch, flexibility, and depression.
  3. A study of patients who had thyroid surgery showed that who underwent scar massage recovered faster, had better mobility, and experienced less discomfort than those who did not.
  4. A review of 30 surgical scars treated with massage showed that 90% improved appearance according to the Patient Observer Scar Assessment Scale.

 

References: 

Wound Repair Regen. 2002 Mar-Apr; 10(2):126-8. Massage applied to scars. Roques C Burns. 2018 Feb;44(1):24-38. doi: 10.1016/j.burns.2017.05.006. Epub 2017 Jun 29.Scar massage for hypertrophic burns scarring-A systematic review. Ault P1, Plaza A2, Paratz J3.

Dermatol Surg. 2012 Mar;38(3):414-23. doi: 10.1111/j.1524-4725.2011.02201.x. Epub 2011 Nov 7. The role of massage in scar management: a literature review.Shin TM1, Bordeaux JS.

Surgery. 2018 Nov;164(5):965-971. doi: 10.1016/j.surg.2018.05.029. Epub 2018 Jul 24. Effect of wound massage on neck discomfort and voice changes after thyroidectomy.Lee JS, Kim JP, Ryu JS, Woo SH.

 

INSTRUCTIONS FOR USE

 

Directions:

After cleared and instructed by your doctor, (usually 1-2 weeks after suture removal), begin by applying a generous coat of X•SCAR lotion to the affected area.  Gently massage into the area and repeat this process for a total of 3x a day.   After 1 month, increase the strength of the massage and apply a circular motion with your finger or applicator.  Ideally, you would apply and massage the gel in 3x a day for 3 minutes each time.   This may help reduce the thickness and the red color of your scar over the course of the scar maturation (typically 6-12 months after injury).  We recommend you continue using X•SCAR consistently for one year to maximize your results.  
 

Recommendations:

We recommend using a sunblock (spf 30 with Zinc) when outside for a prolonged time or to wear protective clothing.  Make sure to reapply after excessive sweating or swimming. 

 

Warnings:

For external use only.  Keep out of eyes.  Rinse with water to remove.  Stop use and ask a doctor if rash occurs.  Keep out of reach of children.