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Author: slowlythere Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 884911  
Subject: Face cut - prevent scarring? Date: 4/21/2008 12:29 PM
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Tips please on preventing long-term scarring for a facial cut.

An acquaintance's cat accidentally gave her a prominent scratch on her face last night. Seems the cat was leaping to a shelf above her reading chair, slipped, and landed on her face.

If it was anywhere else, this could be quite forgettable, but it is prominently on her face.

She's not insured and would rather treat this herself. It is too shallow and narrow of a cut to require stitches.

This is a shallow cut is top to bottom. The top part is slightly jagged (presumably where the cat first snagged her face) and the bottom is fairly straight, and thins out. It was cleaned with soap and water, topical antibacterial applied, not using a bandage. She has very mild tenderness since it is still healing and I think since facial skin is more sensitive, but otherwise fine. Today the redness from clotting makes it stand out quite a bit. She is not particularly susceptible to keloids usually. She's had cat scratches before on hands or feet and usually most have healed well when she kept them clean and didn't pick at scabs.

How can she help prevent scarring? She's read about using fresh Aloe Vera gel from leaves, Vitamin E oil capsules, Mederma, but not sure what else.

Meanwhile she's just keeping it clean, applying a dab of topical antibacterial ointment after each cleaning. She is not wearing any make-up, lotion, or related.

Thanks,
ST
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Author: 2gifts Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797086 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 12:35 PM
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How can she help prevent scarring? She's read about using fresh Aloe Vera gel from leaves, Vitamin E oil capsules, Mederma, but not sure what else.



I recommend Vitamin E cream. It comes in a tub, and you can pick it up at places like CVS or Wal-mart.

This is what was suggested to me when DH was 5 and had cosmetic surgery on his abdomen to remove some old scar tissue and stitches that were popping by the dermatologist. He told me to put it on the scar area twice a day for a good 6 months, and the scar would fade. It did fade, so I'd recommend that your friend try that.

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Author: Synergism Two stars, 250 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797089 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 1:23 PM
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I recommend Vitamin E cream.

I'll second that emotion. Cream or gel caps.

It really does work best when applied immediately after the wound occurs.

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Author: slowlythere Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797090 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 1:23 PM
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I recommend Vitamin E cream. It comes in a tub, and you can pick it up at places like CVS or Wal-mart.

Thank you! Glad your DH's scars faded.

Just wondering: do you think she should start using this cream right away (she was scratched last night), or wait until the cut has healed over (won't re-open, or re-bleed) perhaps in a few days? If wait until it is healed, she'll keep using the antibacterial ointment.

ST

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Author: slowlythere Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797091 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 1:30 PM
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I recommend Vitamin E cream.

I'll second that emotion. Cream or gel caps.

It really does work best when applied immediately after the wound occurs.


Just saw your response. Great, thanks!

I'm passing on any tips to her as I can.

Thanks,
ST

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Author: Ringfinger Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797093 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 1:38 PM
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That is one to remember.

Now, do you apply after scabbing has occurred? It would seem that would be the most effective way to prevent infection.

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Author: AngelMay Big funky green star, 20000 posts Top Favorite Fools Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797094 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 1:46 PM
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I recommend Vitamin E cream.

I'll second that emotion. Cream or gel caps.

It really does work best when applied immediately after the wound occurs.

-------------------------


Also, don't forget: Harrison Ford has a facial scar and he's a hunk ;o)

Sometimes it's best to just go with the flow in life rather than worrying about it too much. Beauty comes from inside anyway. But the vitamin E cream sounds like it surely could not hurt.

AM

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Author: montecfo Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797097 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 2:29 PM
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A key element to prevent scarring is to avoid sun on the new skin for a season. Use sunblock. Otherwise you get burns and scars then tend to worsen and not fade. Really inportant.

Otherwise the antibacterial creme as others have suggested, keep it moist.

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Author: Synergism Two stars, 250 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797124 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 6:32 PM
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Sometimes it's best to just go with the flow in life rather than worrying about it too much. Beauty comes from inside anyway.

Very true. It's not always cosmetic, though. Without knowing the patient, one never knows how the new cells will grow.

But the vitamin E cream sounds like it surely could not hurt.

To borrow from an old commercial, "a little dab will do ya". A little Vitamin E goes a very, very long way.

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Author: WendyBG Big gold star, 5000 posts Top Favorite Fools Top Recommended Fools Feste Award Winner! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797131 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 8:16 PM
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DH got a very serious cut on his forehead, when the crowbar he was using to pry linoleum from a floor popped up and hit him.

I washed the cut, and brought the edges together with butterfly bandages.

Then, I covered the cut with a moist burn dressing (developed for burns). This is a special hydrogel bandage that keeps the cells on the edges of the wound growing, because they don't dry out. At the same time, it is important to let the wound breathe (oxygen to the cells). The dressing comes with an impermeable plastic cover that must be removed before it is applied. Bacteria cannot penetrate the gel, as they can penetrate a woven cotton bandage.

DH's wound healed without a trace of a scar.

http://findarticles.com/p/articles/mi_m0GER/is_2002_Winter/ai_97116391
http://www.fda.gov/cdrh/pdf2/k022995.pdf

Wendy

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Author: FromAllOver Three stars, 500 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797144 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/21/2008 11:11 PM
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I had the identical cut many years ago--cat tried to climb a curtain, failed, and bounced off my face on the way down. My tear was from the corner of my left eye down the cheekbone. Lucky it didn't touch the eye!

I heal "too" well, with quick and prominent scarring. I already knew of the benefit of vitamin E, having used it to greatly minimize surgery scar tissue, so I had some on hand. I broke a capsule of vitamin E oil and applied twice a day, not caring how oily I looked for a few days. There was absolutely no scar, not even a faint line.

Vitamin E oil has no other ingredients which could block the vitamin from bathing the wound. Get oil, not cream, with the highest I.U. of vitamin you can find, and use it topically. I use it religiously on every scrape and cut my sons get; they know it works.


A. Simpatico

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Author: slowlythere Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797175 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/22/2008 9:24 AM
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I have forwarded all these tips to my acquaintance meanwhile, but I saw her earlier this morning.

She asked me to thank everyone very much for your input.

Last night, she started the topical Vitamin E (oil capsules) treatment. She has been careful to clean it gently and not touch it especially since yesterday it was still slightly tender to the touch. Overnight, she covered it with a large bandaid to protect it in case she slept on it, but otherwise she has kept it open.

This morning, the cut looks like it is healing surprisingly extremely well, no signs of complications (no swelling, etc.). She's very happy with how it seems to be healing within 48 hours now.

ST

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Author: Ringfinger Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797177 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/22/2008 9:46 AM
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A new use for an ingesible vitamin!!

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Author: slowlythere Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797178 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/22/2008 9:48 AM
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Wendy,

Glad your DH is alright now! That crowbar sounded painful, but glad you were there to take care of it immediately and adeptly.

Then, I covered the cut with a moist burn dressing (developed for burns). This is a special hydrogel bandage that keeps the cells on the edges of the wound growing, because they don't dry out. At the same time, it is important to let the wound breathe (oxygen to the cells). The dressing comes with an impermeable plastic cover that must be removed before it is applied. Bacteria cannot penetrate the gel, as they can penetrate a woven cotton bandage.

Thank you for the links and this information.

Perhaps this is otherwise obvious, but I wonder what the difference is between using a fabric bandage, which has it's built in cotton gauze and a bit of topical ointment (often in a petroleum jelly base)?

For something minor like cuts and scratches I wonder if there's much of a difference, but I realize for more severe lacerations (and obviously burns in which fluid loss and other damage are significant), the simple common home methods wouldn't apply. Based on your information, my assumption is perhaps the home method and bandaids don't work since perhaps the usual petroleum jelly base ointments 'smother' the cells (no oxygen), even if they can keep the moisture level higher. Also the tiny gauze in the bandage may not provide enough circulation, or in some cases, it becomes saturated too quickly with fluid/moisture (from the wound, or from the topical ointment).

From your links, I suspect that the hydrogel bandages are rather expensive, but now I'm curious to know what they are like (in both design and effectiveness) for minor wounds.

Two weeks ago, I had an abrasion on my knee from a clumsy trip and fall on the street. The first 24 hours I kept changing bandages for it (mostly to prevent irritating the raw abrasion), but thereafter left it uncovered. It quickly developed a sizeable scab which I left until about 5-6 days later when I accidentally broke it. At that point, I gently peeled it off, using the regular bandages again since it seems to result in the scab edges softening. It is leaving some scarring now, but not a real concern since it's on my knee. I wonder if even two weeks later, if the hydrogel can still work. I'm mostly interested in it to try a new concept, but not a big issue obviously.

Thanks,
ST

- - - - - - - - -
A. Simpatico,

Thanks for your story, also. Her scratch is also just below her eye, which is why the scratch is so easily noticed and prominent.

If this scratch was less evident, I think she would have just ignored it. Some of her other little scratches heal up incredibly well, some leave a bit of a scar. Not sure if it's because of either the location or the treatment, but probably paying extra attention helps.

Thanks,
ST

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Author: GreatVintage1965 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797197 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/22/2008 11:09 AM
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I have found liquid bandage (both topical and spray) work very well at wound care. My daughter has received some severe scrapes on her foot (beach, sand, salt), knee and elbows (high flex zones), and stomach and back (more tender skin). The liquid bandage seems to keep the wound from oozing, keeps that which is outside from getting in, and locks in moisture. I type moisture just because it looks like the skin and wound underneath look normal and not on the dry side.

This product was especially impressive at the beach. She was able to continue playing without a concern for the sand or salt.

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Author: WendyBG Big gold star, 5000 posts Top Favorite Fools Top Recommended Fools Feste Award Winner! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797204 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/22/2008 11:14 AM
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I'm glad that your wound and your friend's wound are minor.

I worked in the field of medical devices for 9 years. One of our smaller products was a breathable wound dressing that was impermeable to bacteria. However, this was not a moist wound dressing. Because I had a product in this line, I did some research about wound healing.

For major wounds, especially burns, infection is the most important issue. An infected wound, even if every other healing factor is ideal, can kill the patient.

The second important issue is providing an environment which is conducive to healing. Burn patients who are missing large areas of skin have two issues. One life-threatening issue is evaporation of moisture from the body. (People take their skin for granted -- it is an essential organ for maintaining the body's moisture, among many other important functions.) The other life-threatening issue is infection.

The third issue is absorption of fluids, such as blood. A bleeding wound should not be covered by a dressing that won't absorb fluid.

Traditional wound dressings (fabric) have two functions. They absorb fluid and protect from major contamination (such as dust that might carry bacteria). They are breathable, when they are dry. If they are wet, oxygen can diffuse through the water (or blood).

An impermeable wound dressing (e.g. Saran wrap) would be unacceptable, because oxygen is essential.

You wrote: "my assumption is perhaps the home method and bandaids don't work since perhaps the usual petroleum jelly base ointments 'smother' the cells (no oxygen), even if they can keep the moisture level higher. Also the tiny gauze in the bandage may not provide enough circulation, or in some cases, it becomes saturated too quickly with fluid/moisture (from the wound, or from the topical ointment)."

Yes, you are correct. However, if the wound is exuding blood or fluid, an absorbent pad must be used. Thin, non-absorbent wound dressings wouldn't work, in that situation.

In the situation of your knee, it would have been better to leave the scab in place, if removing it exposed a fresh wound (i.e. if it began to bleed again). If you exposed a fresh wound to air, it might scar more.

The choice of bandage depends upon the type and seriousness of the wound. As you said, the hydrogel wound dressing is more expensive than a conventional gauze dressing. However, it's not extravagantly expensive (I think it was less than $10 for a package of 4). Since the hydrogel minimizes scarring, it's worth considering for home use.

For serious wounds, such as large wounds or burns, I would go for the hydrogel.

Another type of wound, the pressure sore, which is troublesome to bedridden patients and diabetics, can be treated by a breathable clear polyurethane film (such as Tegaderm by 3M Company). There are now even spray-on bandage solutions of polyurethane. Polyurethane films have the benefit of maintaining their ability to block bacteria, even if the patient bathes right over them, so the dressing doesn't have to be changed daily. Breathable polyurethane is also good for covering cuts and I.V. sites.

The body is well-adapted to heal from wounds. However, the new types of wound dressings help when the wound is extensive, to protect from infection, and to minimize scarring.
Wendy

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Author: slowlythere Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797212 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/22/2008 12:21 PM
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Thank you again, Wendy, for the reply and additional information. :)

I was thinking to myself just now that we underestimate the use and application of the bandage (or more properly any wound dressing), in terms of immediate first aid and ongoing care and treatment until it is considered fully healed. Both our understanding and treatment options have improved a lot in just a few decades. It's nice that we have more possibilities to deal with injuries, improving both the recuperation process and the aftermath.

For now, I'll skip the fancy (hydrogel) bandage for myself, but I'll look for it locally for future reference.

Thank you,
ST

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Author: MoneyPenny07 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797217 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/22/2008 1:13 PM
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I had some surgery late last year and my surgeon recommended that once the wound had stopped draining, the placement of special silicone "anti-scarring" sheets over the area. I purchased some at drugstore.com (they can be cleaned and re-used) and they have worked like a charm. At first the incision mark was bright purple, but now it has faded very quickly.

I tend to be vain about my face, so I would definitely look into something like this.

MP

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Author: markr33 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 797374 of 884911
Subject: Re: Face cut - prevent scarring? Date: 4/23/2008 5:58 PM
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I've heard that this - http://www.mederma.com/ - works well. We used it for a cut that one of our kids got, but didn't use it quite as recommended (started late and didn't always apply it regularly).

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Author: slowlythere Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 798239 of 884911
Subject: Re: Face cut - prevent scarring? Date: 5/5/2008 8:24 PM
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Update.

This vitamin E oil capsule treatment really works

(1) Scratch on the face. saw the friend with the cat scratch today, 15 days since she had the scratch and 14 days after she starting using vitamin E oil capsules, twice a day (in the morning before leaving and in the evening). The scratch has completely healed and is already virtually invisible, almost completely gone. I had to look very closely to find traces of original scratch.

She said that even 7 days afterwards, it was just barely detectable at a casual glance and had closed over completely within the first 4 days. If you looked closely you would see the redness from the scratch, but nothing that had people doing a double-take as they had in the first 2-3 days. Normally she does heal well, but not this quickly and perfectly. She definitely credits the vitamin

(2) My knee scrape. Before the above, I already had a 2-3 week old scrape on my knee that was still oozing occasionally and had partially scabbed, but I had accidentally broken it during cleaning or other activities. I decided to try this vitamin E oil idea as well to test the concept though I'm not concerned about minor scarring on my knee. As for the above facial scratch, I committed to twice daily applications for the last 14 days, dabbing the oil around the hardened scab itself. I also used a simple adhesive bandage to cover the area to keep the oil from smearing off too quickly. I applied it around the little bit of scab that was still on it. As of today, the scab itself has completely fallen off and the new skin is completely smooth and covered, though healing. This was much better than I had expected and I will continue this treatment for another week. I suspect there will be very minor, if any, visible scarring when it is completely healed over.

ST

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