Dermatologist Debriefs

Scar Treatment Secrets: 9 Essential Supportive Measures for Atrophic Scarring

• Stefanie Williams

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What really makes the difference when treating those frustrating depressed scars? Dr. Stefanie  cuts through the noise to deliver a comprehensive framework of supportive measures for anyone undergoing atrophic scar treatment.

Forget the one-dimensional approach. While professional treatments like lasers and microneedling form the foundation of effective scar management, Dr. Williams reveals nine complementary strategies that can dramatically enhance your results. From the strategic application of anti-pigment serums and vitamin C to prevent discoloration, to the surprising impact of stress management on collagen production – this episode delivers actionable guidance for optimizing healing.

Whether you're currently undergoing professional scar treatment or preparing for future procedures, these evidence-based supportive measures provide a holistic framework to maximize your skin's healing potential. Ready to transform your approach to scar management? This episode delivers the expert guidance you need.

Speaker 1:

Dermatologist debriefs. Join no-nonsense dermatologist Dr Stephanie Williams as she debunks myths and shares her professional treatment of scarring for one of her patients.

Speaker 2:

And apart from the actual scarring treatment, which may involve lasers or some form of medical needling in combination with exokine or exosomes or platelet-rich plasma, or maybe carboxytherapy or platelet-rich plasma or maybe carboxytherapy, anyway, that made me think about what additional measures, maybe even lifestyle choices, may be important to consider as well when we are treating scarring in our patients. And to be clear, I'm talking about atrophic scarring here, so the scarring that leaves a dip in the skin surface rather than raised, so-called hypertrophic scars. So that's a different discussion. Anyway, I came up with a list of nine supportive measures that would be really beneficial for anybody undergoing treatment of atrophic scarring, and I'd like to talk you through these now. So point number one is an anti-pigment serum. The reason is that if you have a relatively fresh scar, there is a risk of developing post-inflammatory hyperpigmentation, or PIH, in addition to the textural change of the skin. So discoloration in addition to the dip in the skin, and using anti-pigment topicals before that can develop is a really good idea for anybody who has a fresh scar, whether they are going to have treatment for that scar or whether they just want to prevent PIH and let it heal as well as possible. And this is, of course, when the surface of the skin is already fully healed and not when the wound is still open. Number two connected to this is a vitamin C serum. So vitamin C is an antioxidant that can brighten the skin and also support the treatment of irregular pigmentation support the treatment of irregular pigmentation, but in addition to that it also supports collagen synthesis, which is of course very important for anybody who's treating atrophic scarring. So suggestion number two is a vitamin C serum, so you could, for example, use that in the morning and use the anti-pigment serum in the evening. And that brings me to point number three. So if you already have quite activated melanocytes and in this case activated by the inflammation of the wound healing and the scar formation, then you want to avoid any additional triggers that will drive even more melanin formation in those pigment cell building cells, the so-called melanocytes, and for that reason it's a good idea to avoid UV exposure and also wear a daily SPF of 30 to 50 minimum so that we're not getting an additional trigger for pigment formation.

Speaker 2:

Adjunct treatment number four are topical retinoids. These are vitamin A derivatives that enhance skin remodeling by boosting collagen production and cell turnover. So they can really nicely help to improve skin texture and appearing of atrophic scars. However, we have to be a little bit mindful about the strength of the product that we are using, because if we are talking about a fresh scar, then the skin is still very sensitive and delicate and we don't want to use something too strong. So while later we may change to a prescription strength retinoid like tretinoin, I would recommend starting with a much milder version, something that's available over the counter but of course, still very effective version, something that's available over the counter but of course, still very effective, for example, the DeloRx Youth Matrix Activator. But if even a gentle retinoid at the initial stage might still be too strong, then an alternative matrix activator might be a topical containing peptides, collagen stimulating peptides. So that's another useful topical ingredient to use to support scarring treatment.

Speaker 2:

So that was the topicals, and now I'd like to continue with oral adjunct treatment, and this is not prescription, but I'm talking about supplements here. So the first one I'd like to mention and that's 0.5 on our list is a collagen supplement. So these collagen supplements, they provide the building blocks of collagen that your skin can then use to remodel the skin. So they are typical amino acids for collagen, or peptides, which are short chains of amino acids and your skin will really well come to be supplied with these building blocks when it is in the process of remodel a scar. These building blocks, when it is in the process of remodel a scar, the best ones with regards to efficiency are bovine collagen supplements and unless, of course, you're a vegetarian or vegan, I'd recommend to choose a bovine one. And with regards to the dose, I would recommend to take maybe 25 grams per day, so that's 25,000 milligram per day. So it's a really high dose, and you could even, for a few weeks, double that and take 25 grams in the morning and 25 grams in the evening. So you really want to boost that, the collagen building block storage levels in your skin when you are treating scarring.

Speaker 2:

Point number six are anti-inflammatory supplements and of course, we need a certain degree of inflammation for scar formation. However, that has to be very balanced, so any type of too much inflammation is certainly not good either. So for that reason, I often give my scarring patients a supplement containing turmeric. This contains curcumin, which is an anti-inflammatory, and that may help to regulate and prevent excessive inflammation while we are treating the scarring. The next point, point number seven on my list, are general dietary changes. And of course, any one of these on its own is not a miracle cure for scarring, there's no doubt about that. But every little helps and if you are bringing in quite a few of these different adjunct measures, that's certainly a good idea. And if you're thinking about diet, then think about a balanced diet, obviously, and one that is rich in omega-3 fatty acids, rich in zinc and vitamin c, as all of those support skin health and healing.

Speaker 2:

And one thing I forgot to mention earlier so it's kind of like a negative point on my list which a lot of you will probably think of first, but I don't actually advise, is to wear silicone sheets or silicone gel on the scar.

Speaker 2:

So those can be really useful for hypertrophic scarring, so for the raised type of scarring, and it can help those raised scars to flatten and soften. But for atrophic scarring it doesn't really do very much in my experience, and maybe apart from reducing redness, but other than that, I think silicone sheets and silicone scar gels are really overrated in my opinion. That brings me to the last point, point number nine, and again, on its own it's not going to make a massive difference, but in addition, with all the other things, it's something to think about, and that's about stress management. And the reason I'm mentioning this is because high stress levels, especially chronic stress, can really significantly increase cortisol levels, and cortisol is definitely not supportive of beautiful scarring. In fact, cortisol is known to accelerate collagen breakdown rather than to support its production, which is, of course, crucial for effective scarring treatment, and something and um something in our system that accelerates breakdown we want to minimize as much as we can. So, with that in mind, try to moderate your cortisol levels by, um, looking at your stress levels and maybe thinking about something to help with the stress level. So, whether this is things like meditation or mindfulness or yoga, whatever works for you, just something to think about.

Speaker 2:

And with that I'd like to conclude today's session. So, a few things you could consider while you're having your scarring treatment, and I just want to reiterate that this is in addition to actual in-clinic scarring treatment. And I just want to reiterate that this is in addition to actual in-clinic scarring treatment, not instead of scarring treatment. This is just supportive. I hope this makes sense and I speak to you again very soon. You.