Emerging scar therapies can help treat and prevent painful, unsightly scars. At the surface, a wound from trauma or surgery may leave a scar that is raised and discolored; at a deeper level, blood vessel and nerve damage can result in associated pain and itching. Therefore, the best therapies involve a multi-prong approach to help smooth and lighten the physical appearance of the scar, while controlling or eliminating associated discomfort.

Individually compounded scar therapy preparations may contain caffeine; vitamin A; avocado, coconut, and other tree oils; and medications including corticosteroids, antihistamines, as well as other agents such as verapamil that promote healing. Verapamil exhibits anti-proliferative properties that reduce collagen deposits and promotes scar tissue breakdown by increasing collagenase production. Another often used drug is pentoxifylline. In vitro, pentoxifylline inhibits the production of collagen; topical application improves blood flow and elasticity of scar tissue. Other agents used in scar therapy include: imiquimod 5% (immune-response modifier and Toll-like receptor (TLR) agonist), hyaluronic acid (corporal lubricant), and tranilast (suppresses collagen synthesis by fibroblasts). With so many options available, the key is to work closely our compounding pharmacist to find the preparation that will work best for your patient’s skin type, scar location, and stage of healing.

Medications may be compounded into a cream, ointment, or gel base. Several studies show the benefits of a silicone gel base in the treatment of scars. The mechanism by which silicone aids in scar healing is not well understood. One possible role is the creation of a physical barrier to prevent water loss through damaged scar tissue. It is thought that promoting hydration and proper temperature and oxygen transmission creates an environment conducive to healing. In one study, a total of 36 post-operative patients applied silicone gel twice daily resulting in statistically significant improvements in scar height, pain, pigmentation, pliability, pruritus and vascularity.

TAKING AN INDIVIDUALIZED APPROACH TO TREATING SCARS WITH COMPOUNDED TOPICAL SCAR THERAPY CAN BE AN IMPORTANT ADJUNCT IN THE TREATMENT OF WOUNDS AND SCARS.

References:

Dermatol Ther (Heidelb) 2013;3:157-67. Natl Med Assoc 2004;96:108-16.
J Am Coll Clin Wound Spec 2013;4:23-31. Jpn J Pharmacol 1992;60:91-6.
J Am Acad Dermatol 2006;55:1024-31.

Burns 2014;40:1255-66.