Atlanta — A new therapy visibly improves the quality of hypertrophic scars without any surgical intervention, according to Wolfgang Meyer-Ingold, Ph.D., director, Wound Healing Research Unit at Beiersdorf AG, Hamburg, Germany.
Research conducted by Beiersdorf showed that "scars are accepted out of necessity," Dr. Meyer-Ingold says. "People do not know of effective self-medication, and they don't consider professional help such as surgery, laser or abrasion to be an option because it is risky and too expensive. Consequently, people simply tend to hide scars with make-up or clothing."Hypertrophic or keloidic scars can be treated at home using the scar therapy. Like similar silicone-based patches, the polyurethane clear pad is simple to use and can be applied without a doctor's supervision. However, unlike silicone-based pads, the polyurethane-based clear pad allows the skin to breathe and is permeable to water vapor.
"The polyurethane matrix does not lead to moisture accumulation under the patch, and therefore avoids side effects like itching or maceration," Dr. Meyer-Ingold says. In addition, the polyurethane matrix is hypoallergenic, reducing the likelihood of an adverse reaction at the site of application. After several weeks of use, the therapy softens the surface of the scar, flattens it and reduces redness.
The clear pad is available as a set of self-adhesive patches (2.75 in. x 1.5 in.) that the patient uses to cover the scar. Larger scars may be treated with two or more patches. Application of the patch is simple. The scar area is washed and dried, and the patch is applied and secured over the scar. For best results, a patch should remain on the skin at least 12 hours a day. The patch is changed daily for at least three weeks, after which results first become visible, with the therapy continued preferably until eight weeks.
The polyurethane clear pad was compared to a silicone-based adhesive pad (Mepiform, M�ycke Health Care, Helsinki, Finland) in a 12-week, open-label, observer-blind, intra-individual clinical trial evaluating the efficacy of both products for scar therapy. The polyurethane pad rated significantly higher in overall scar index at both four weeks (p<0.001) and eight weeks (p=0.012).
Kick start the remodeling "After wounding, nature has a higher need for fast healing than for cosmetic results," Dr. Meyer-Ingold says. "Remodeling takes place after wound closure, and the two factors that have been identified as essential to the remodeling process are temperature and pressure. CURAD Scar Therapy applies slight pressure upon the scar and raises the scar temperature." The pressure exerted on the scar by the clear pad is 15 to 20 mbar.
The surface temperature of a scar is slightly lower than the surface temperature of the surrounding skin. A slight increase in scar temperature increases the activity of collagenase and stimulates cells to produce more collagenase, a critical enzyme in the remodeling process.
"CURAD Scar Therapy provides a local thermal insulation of the scar, hindering the body's heat radiation from the skin into the environment," Dr. Meyer-Ingold says. Measurements have shown that CURAD Scar Therapy raises the temperature by approximately 1 degree Centigrade.
In addition, use of the polyurethane pad was shown to improve microcirculation in the scar tissue. The resulting increase in blood flow to the scar area further supports or activates the normal remodeling process.
"CURAD Scar Therapy works by physically stimulating the body's own remodeling mechanism," Dr. Meyer-Ingold says. Small-scale clinical studies in Europe have suggested that the therapy might also be effective when used prophylactically to prevent fresh hypertrophic scars after surgery.