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Wednesday, September 1, 2010

Ointment after Surgery to Reduce Scars: Best to Prevent Scarring?


Many company's ointments and creams claim to reduce scarring after plastic surgery, injury, scratches, or cuts. Unfortunately, there isn't much well-done scientific research to support those claims. So how does one pick the best ointment to prevent scars? First, speak with your Washington DC facial plastic surgeon or dermatologist and follow their advice.

Several studies have suggested that any occlusive dressing on an incision or surgical site will improve the final scar by about 33%. Redness, swelling, and cosmetic appearance of the incision generally looks better by merely covering up the surgical site with something. Years ago, the general idea was to keep the wound open and let wounds scab to help prevent infection. However, plastic surgeons better understand wound healing and no longer recommend letting wound dry out. Covering the wound or incision with ointment may prevent the need for future scar revision procedure.

The occlusive skin dressing should be a bland, non-allergic material such as petrolatum jelly or silicone. Vaseline®, Aquaphor®, and Mederma® are products with varying degrees of petrolatum. Petrolatum jelly, however, should not be used in the following areas:
  • Recent Burns, including sunburn. Petrolatum traps heat inside tissue, which worsens heat damage. Only once the heat has dissipated, it may used for specific burns.
  • Nasal congestion or dryness: petrolatum stuns the natural cleaning ability of the nose by immobilizing the cilia (small wipers) in the nose. Also, petrolatum may form deposits in the lungs and lead to pneumonia.

Studies have also shown that some topical ointments may cause a skin allergy or contact dermatitis after prolonged use, such as vitamin E, triple antibiotic, Neosporin®, or Bacitracin. Other topical antibiotic ointments have much less risk of skin allergy such as polymyxin B or muporicin.

Other methods to help reduce scarring after surgery include:
  • Avoid direct sunlight on the area
  • Treat infections immediately
  • Massage
For my Maryland face lift patients, they use an antibiotic ointment & avoid getting the incisions wet for the first two days after cosmetic surgery. Once the incisions are healed, patients resume using their sunblock. Topical petrolatum jelly or silicone gel (patient's choice) is used on the incision for approximately 2 months daily.

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