- Best Results1-2 sessions
- Treatment Recovery3-8 days
- Procedure Time5 min
- Skin SpecialistGP, family physician
- Duration of ResultsNA
- Back to Work0-3 days
- Cost$ Medicare
Self-Harm / Cutting Scars - Immediate treatment
Early management of self-harm scars can markedly reduce permanent scars. Correct wound dressings, silicone sheeting, coupled with low energy lasers & LED lights are indicated. It is much easier to remodel early scars compared to treating old hypopigmented & wide scars.
FactsFacts on Self Harm -Cutting Scars, Acute Management
- Prevention of infection is paramount
- Appropriate wound approximation or apposition can prevent scars
- Acute dressings should be in a moist & sterile environment
- Silicone & compression is the next step
- Microneedling, LED & vascular lasers are useful in early scar treatment
How to look after wounds?
The first step in wound management is to prevent infection. Correct disinfection & wound care is required. The second step is to determine if wound closure, via sutures, tape or glue is required. This is determined by your family physician or GP.
I understand that some patients do not want to visit their doctor. In this case clean your wounds with chlorhexidine, & dress them daily with an appropriately sized dressing such as Melolin.
Disclaimer: I do not manage acute wounds. Your general practitioner will guide you. Acute wounds require frequent follow ups & management, including dressing changes by nurses.
Who to see?
For acute wounds, your GP is the first point of contact. You may want to discuss issues with them when you are ready. It is important to find someone whom you can talk to, as well as someone to help you in the early stages of cutting.
How to prevent scarring?
My work is focused on repairing old scars, however with immediate action, most scars can be prevented or reduced. Dressings & appropriate wound closure early is super important. Be guided by your GP-family physician.
What does silicone do?
Silicone tape & gel can reduce or prevent hypertrophic & keloid scars. Tape & products such as Dermatix or Strataderm can be purchased in most pharmacies. They should be started as soon as possible, as early as 7 to 10 days post injury.
Ideally a silicone sheet should be applied 24/7 for 10 to 16 weeks. Gel should be applied twice a day, for the same duration.
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What does compression do, & how to do it?
Wound compression can reduce hypertrophic & keloid scarring. Simple silicone tape is a form of compression, micropore tape is useful to hide scars & provide pressure.
Another simple form of compression that dermatologists & plastic surgeons use is double fold Tubigrip. This can be purchased in most pharmacies. You do need proper fitment as Tubigrip comes in different sizes. Compression should be done daily for 3 to 6 months. If you find it difficult to do so, nightly compression is a compromise. In summary-
- Use silicone tape on the cuts.
- Compress tape with Tubigrip aiming for at least 12 hours per day.
- Do this for at least 3 months.
*Risk factors for hypertrophic & keloid scars include female sex, young patients, ethnicity (Asian), family history of scars, high tension areas (thighs, forarms, arms, shoulders) as well as thermal injury .
What lasers can improve early scars?
If you have red scars, I suggest you see a dermatologist to have laser treatment. Lasers such as vascular V Beam or pulse dye laser can make a huge impact on scar mitigation.
If you have red scars, you can book an appointment with my nurses– this will save you time & a consult fee. They are well versed in the management of red scars.
Can LED lights - Healite help with scars?
Yes, yellow light, diode lights in the 820-840 nm range can help. Red light in the 620-640 nm range is also an option. Light or more accurately light emitting diodes (LED) are most effective in early wounds (day 1-day 20). Vascular lasers (around 600 nm) are much better at treating red scars. If you do not have access to lasers, IPL or BBL with a red filter can be used.
Who to talk to?
You may want to discuss your situation with someone. There are plenty of resources online, including tips on YouTube to help you through this process. Cutting & self-harm scars are more common than what is perceived.
I do think that support groups are very helpful, as mentors have been through what you are going through now. Finding a psychologist who is passionate about helping people with this condition can make a huge difference.
Disclaimer: My work is procedural, namely I surgically revise scars. I have no experience in counselling.
What is a simple DIY wound care tip for cutting scars?
Hopefully these tips will help you, at least in the early stages of wound care &, in most cases can reduce long term scarring.
- Acute care, day 0-7. Clean wounds with chlorhexidine or iodine, don’t use alcohol as it stings. Dress with Melolin, apply Vaseline over the wound. A moist & sterile wound environment can prevent scars.
- Sub acute stage, day 7 to day 100. Scar prevention with silicone. My preference is silicone tape. You can source this online. Protect your scars from UV, otherwise you may end up with prolonged redness or hyperpigmentation.
- Scar repair; as described above using simple, sensible microneedling. You can add skin care active such as retinol post needling to help repair collagen. If you have scars that are hyperpigmented, pigment inhibitors can be used.
*If you have persistent red scars, lasers can help remodel & repair. Old scars can be treated with a combination of lasers & surgery. Book an appointment with my clinical team for more information & a treatment plan.
How to get an appointment?
Acute scars are best managed by a family physician as wound dressing reviews are required. They will determine if sutures are needed or in most cases wound tapes.
My team of nurses will work closely with your physician. They provide subacute wound management, namely dressings & simple low level laser devices & vascular lasers.
I am the last line of management, namely my work focuses on revision of recalcitrant scars, including deep & wide hypopigment (late stage) scarring.
Davin’s Viewpoint on Cutting Scars; Acute management
The Golden Month is the month following acute cutting injuries. Good wound management early will mitigate scarring. This means prevention of infection & correct apposition of wound edges.
The anatomy of cutting scars varies with the depth. Shallow scars usually self heal, albeit some redness, then hypopigmentation. It is the deeper cuts that require urgent management. Correct wound closure will prevent spread scars. In some cases sutures are required, whilst in others simple steri-strips are sufficient.
A second window arises after the acute phase, namely, to prevent hypertrophic or keloidal scars. Simple wound dressings include silicone tape coupled with compression. The latter can be achieved with double Tubigrip, available from most pharmacies. Red scars should be treated with vascular lasers. Most patients undergo 3-6 sessions, spaced 2-4 weeks apart. My clinical team can assist.
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