As a dermatologist, I am often asked “how do you reduce the risk of scarring?“
After having treated many, many wounds over the course of my career, and having seen the healing process for my own cuts and scrapes, I have a few recommendations.
Overall, there are a few guiding principles that you can use to help your own cut, scrape, or wound heal while minimizing scarring. In this blog post, I’ll review some of these principles.
I also wanted to point out one important item: the skin's healing properties are truly amazing, so hang in there if you're dealing with a new injury.
How to help the healing process for an open wound or scrape
If you have a scrape or a small cut or an open wound, one of the key principles that we talk about is moist wound healing. Before I go into the specifics, though, you need to make sure you have done a few things first.
For any cut or scrape where you have contacted a foreign object, like gravel or metal, it is important to make sure that you are up-to-date on your tetanus shot.
In those cases, it is important to see your doctor. You may also need to see your doctor for stitches (sutures), depending on the location of the wound and the size of the injury
Once your cut has been thoroughly cleansed and rinsed out, you can focus on moist wound healing.
You can apply either Pure Vaseline petroleum jelly (make sure there’s no added fragrance), or 100% coconut oil to the surface of the wound.
Then, cover the wound with a nonstick dressing. Some brand names are Telfa or Opsite.
I prefer a wound dressing that has no adhesive at all. Instead, I recommend that you buy medical paper tape to hold the dressing in place.
Do NOT just use regular gauze. There’s an important reason for this: open wounds will produce drainage, and as the gauze absorbs that drainage, it will stick to the surface of the wound. Then, when you change the dressing, you may have to rip off the dressing. That's painful, and it will take the top layer of skin off with it, ultimately slowing down the healing process.
That’s why it’s so important to do a nonstick dressing.
Repeat the dressing change twice a day until the skin surface has healed over.
How long will it take for my skin to heal over?
For small wounds, the surface may heal in a few days or a few weeks.
For larger wounds, it can take up to six weeks for the surface to heal over.
Should I use antibiotic ointment to help my skin heal faster?
I do not recommend using antibiotic ointment for an open wound, unless that wound is known to be infected.
Research has looked at the use of bacitracin, a common antibiotic ointment that is sold over-the-counter. Researchers compared wounds that were treated with bacitracin to wounds that were treated with just pure Vaseline petroleum jelly.
They found that the rate of wound healing was almost identical in the two groups.
However, the group that used the antibiotic ointment had a much higher risk of developing an allergic skin reaction.
If you are developing signs of skin infection, then it's important to see your doctor. In some cases, they will prescribe antibiotics by mouth.
What are signs of a wound infection?
Healing cuts and scrapes are often very tender, but if you start to see pus, warmth, redness that extends out from the edge of the wound, or an increase in pain (as compared to what it was at the beginning), then you should see your doctor. These are potential signs of a wound infection.
What to do with a healed cut or scrape
Once the skin heals over, it’s important to continue to be very gentle with the skin. This new layer of skin that has developed is still fragile, so you don’t want to damage it.
Try to limit sun exposure to the area, since that can increase pigmentation.
How to treat a healed wound that is now a scar
Research has shown that continuing to keep the wound slightly moist can continue to help in the healing process.
You don’t want your skin to stay wet and damp, but a little bit of moisture with Vaseline petroleum jelly or coconut oil can continue to help the healing process.
Many scars develop something known as post-inflammatory hyperpigmentation, where the color of the scar is darker. At this point, it is important to make sure the scar is protected from sun exposure, since that can make the pigmentation worse.
Once the skin is completely sealed over, your dermatologist may be able to prescribe you a prescription medication if you have developed post-inflammatory hyperpigmentation. However, the healing properties of skin are amazing, and just giving it sufficient time will help to reduce the pigmentation.
If the scar is raised, then you may be developing what is known as a hypertrophic scar or even a keloid. In these cases, we recommend seeing your dermatologist to discuss potential treatments.
Are there any over-the-counter products that can help improve the appearance of a scar?
There has been research on different products, such as vitamin E, cocoa butter, or a product called Mederma that uses an onion skin extract.
However, there have only been small studies on these, and I haven't found the evidence to be definitive.
Personally, I have not been convinced that any of these products are more powerful than moisturizers. I use a bland moisturizer and massage it gently into the skin twice a day while protecting the area from sun exposure.
It's also important to be careful with scar products. There are a lot of different over-the-counter products that advertise that they can help reduce the appearance of scars, but some of these products can trigger allergic reactions.
Personally, I use 100% coconut oil or pure Vaseline petroleum jelly for my own scars, but I keep an open mind, and I continue to keep an eye out for further research studies.
If you take a look at the progression of the photos above, you can see how amazingly the skin can regenerate-within just a week this wound has almost healed. From there, the process of healing continues, but take note of how the scar continues to improve over the next several months. If you're dealing with your own cut, scrape, or wound, please hang in there. Remember--your skin has amazing abilities to heal!