Inevitably, we will encounter some burns or trauma in our life, such as scars left by cesarean section (academically called “scar”), scars after boiling water burns, etc. Here are some general knowledge and experience of scar prevention and treatment. After a serious trauma or burn, the process of scarring (scarring) usually lasts for 2 years. During the first 6-9 months after healing, the scar will continue to thicken and harden, become congested and itchy. After 6 months to a year, it will gradually flatten out, but generally, it will not return to its pre-injury state. The color and texture will be different than before. After 2 years, the scar will not change significantly. The final shape is difficult to predict. It is related to the patient’s genetics and constitution, as well as to the healing process. Even the same person with the same area of scarring may show different changes, as shown below: this casualty has the same depth of flame burn on the back and the same treatment. However, after healing, there are three different states of pigmentation, normal, and loss of pigmentation (more typical in the rectangular box). What we have to do is to make the scar as light and flat as possible through various interventions during this process. The prevention and control of scarring does not only rely on a particular drug or material. It also requires proper application and a little patience if you want to achieve more desirable results. The following are the specific methods of scar prevention and control: 1. Treatment before healing 1) Minimizing the tension of the incision can be done by using no-sew tape. It takes three weeks for the incision to heal completely, but in order to prevent the sutures from cutting the skin and bacteria from entering the subcutis through the sutures, the sutures are usually removed after one to two weeks. Therefore, the remaining time is likely to be spent with a misalignment or separation of the dermis, resulting in scarring. It is recommended to continue to use no-sew tape to secure the incision and reduce tension for 2 weeks after stitch removal. (2) Regular dressing changes and timely drainage of exudate are beneficial to the healing of the incision and the prevention of infection. Generally, the incision is changed once at 24 hours and once at 72 hours after surgery, depending on the situation afterwards. The trauma surface is changed according to the amount of exudation and the degree of contamination, generally once in 1 to 2 days. (3) Appropriate pressure dressing can prevent the accumulation of fluid under the incision; for the trauma, it is conducive to the adequate contact between the dressing and the trauma to avoid the possible infection. 2. Treatment after healing 1) Irradiation of superficial X-rays 24 hours after surgery to inhibit incision scar proliferation through the action of rays. 2) Subcutaneous injection of hormone (tretinoin or Depo-Provera), or 5FU, or botulinum toxin, etc., usually once every 3 weeks for 4 months. 3) Use of silicone dressings (Xanax, Mepivox or scar dressing) for a total course of 1 to 1.5 years, preferably adhered to for 2 years, for best results. Cut to the size of the wound and apply externally. Wash daily and can be repeated for 1 month. If contamination is large and the dressing loses adhesion it should be washed or replaced immediately. Try to insist on using it for a longer time every day, 20 hours are recommended, and in summer when sweating is high, it can be used at night while sleeping. During the time when the dressing is not used daily, the scarred skin and the dressing should be cleaned, possibly with soap, and the dressing washed and dried. When not using the dressing, other non-silicone medications can be used on the scar. When using the dressing again, the previously applied medication should be washed well. It is inevitable to encounter some burns or traumas in life, such as scars left by cesarean section (academically called “keloid”), scars after boiling water burns, etc. Here are some general knowledge and experience of scar prevention. (4) The elastic sleeve can be used with silicone dressing to reduce congestion and scar proliferation by physical compression. Use it for the same time as the silicone dressing, and try to wear it for more time every day. In general, the elastic sleeve should be replaced with a new one every three months. Once the elasticity is reduced or lost, it should be replaced promptly. (5) Silicone gel (Barker, Schiffer, Betsy) has the same composition as silicone dressing, but the anti-scar effect is slightly inferior to that of the dressing. It is suitable for use on the face, hands, perineum and other parts of the body that are not convenient to use the dressing; or for patients who cannot cooperate, such as children. Apply once a day in the morning and once in the evening, the dosage should not be too large, a thin layer is sufficient, and the previous medication must be fully washed when applying again. (6) Non-silicone drugs (Centella asiatica cream, Conradipine, Eloson, Urea cream V.E., Cytoxan) play an auxiliary role, such as reducing hyperpigmentation, relieving itching and keeping the skin moist. Multiple medications can be used daily, but they should be spaced apart and not applied two at a time. Before each use, the previous medication should be fully washed. (7) Massage and functional exercise are active and passive local exercises that help to loosen and flatten the scar. The joint area should be strengthened with exercise. At the same time, massage can also promote local blood circulation when using medication, which facilitates the full absorption of medication. 8) For old scars that are more than 2 years old, surgery is recommended. The more superficial scars can be treated with laser to remove itching and to loosen the contracted scar to some extent, but nothing can be done for scar striae and hypertrophic scars. 9) Oral anti-scar medication (Centrosine tablets) For patients with multiple scar growths all over the body after large burns, oral Centrosine tablets are generally recommended as an adjunctive treatment. For patients with small areas, the local anti-scar effect can also be increased by taking oral tablets. 3. Precautions: 1) The cleaning of scars is very important because the uneven surface of scars can easily hide dirt and breed bacteria. Bacteria will in turn stimulate scar proliferation. Therefore, careful daily cleaning of the scar area is an essential part of the treatment process that is easy to ignore. 2) If eczema or blisters appear, stop using elastic sleeves, silicone drugs and silicone patches, and continue treatment when it gets better. Eczema can be treated with our skin cleansing cream or Elocon which can be purchased for topical application. It is important to note that the form of eczema is often very similar to an unhealed trauma and can be easily confused. In general, breakouts and rashes that reappear after a wound has healed are associated with eczema.