Although I believe scars are
beautiful reminders of your life’s journey,
I also understand that you
may not want to be reminded of them every day.
Many people are incorrectly told that nothing can be done to improve their scar, or conversely that miracle treatments can get rid of their scars. Helen has over 27 years of experience working with scars and can help you sort out the myth from the facts. Regardless of the cause, the size, the age or the type of scar you have, Helen will provide you with honest advice regarding the potential for improvement.
Helen has just completed a Doctorate for her research in scarring, and continues to work closely with Professor Fiona Wood, the Fiona Wood Foundation, The Harry Perkins Institute for Medical Research and the University of Western Australia to develop a better understanding of scar formation to improve treatment techniques. The therapies used at Perth Scar and Pain Clinic aim to modify scars at a cellular level, with gentle stimulation to release the contractile cells that cause scarring
Scars form as a part of normal healing. Some scars heal and fade on their own, whilst others need a bit more help to minimize thickness, discolouration, tightness and pain or itch. The therapies used at Perth Scar and Pain Clinic are pain-free, effective and based on the latest evidence.
Over 100 million people each year are negatively affected by scars, so your not alone.
Scars Treated at Perth Scar and Pain Clinic:
- Burn injuries
- Radiation induced fibrosis following cancer treatments
- Surgical scars e.g. mastectomy and other cancer removal surgery, cesarean sections, abdominal surgery, orthopedic surgery, cardiac surgery etc.
- Multi trauma and minor trauma scarring
Therapies Offered at Perth Scar and Pain Clinic:
Treatments offered at Perth Scar and Pain Clinic are based on the latest evidence and recommendations from various global scar organisations and include:
Early scar (<3 months):
- Education regarding scar formation and pain
- Early, gentle scar mobilisation massage
- Pre and post surgery structural Integration
- Pressure garment prescription
- Silicone gel recommendations
- Sensory integration
- Movement education
Developing and mature Scars (3+ months):
- Scar mobilisation massage
- Chronic pain and itch management
- Meaningful movement
- Body issue counselling
- Cognitive Behaviour Therapy
- Acceptance and Commitment Therapy
- Somatic integration and trauma release.
Although scars are permanent, they are living tissues which means they can respond to various treatments throughout your entire life. Non-invasive, pain-free therapies offered at Perth Scar and Pain Clinic can improve scar colour, height, stretchiness/flexibility and texture. Additionally, treatments can improve sensation, itch and pain to enhance the way the scar looks, moves and feels. Although early treatments are more effective, scars 20 years old or over can still be improved.
Receive the best advice to optimise your healing
and return to those activities you love, sooner.
Pathological scars are more than skin deep.
Scars can affect every physiological system within your body, not just the skin. Pathological scars are now considered to be a chronic, systemic inflammatory disorder, which means it is essential to take a wholistic approach to therapy.
Some scars can be deceptive. A scar can be smooth and pale on the surface, but be stiff and tight below the visible scar. This is especially the case with abdominal scars, C-sections, mastectomy and radiation-induced scars. Scarring can lead to deep tissue and organ adhesion, which can contribute to chronic pain and organ dysfunction. Interventions offered at Perth Scar and Pain Clinic can release deep scar adhesion and reduce the risk of persistent pain and dysfunction following surgery and trauma.
Although treatments can maximize your potential to heal, and minimize both scarring and pain, scars will often remain. We can also help you through the process of embracing the beauty of your scars, and wear them with pride.
What Influences Scar Formation?
A number of factors can influence how your body heals and the type of scar you form. These can include the size and depth of your injury, how you were injured, the colour or your skin, your age, wound infections, your nutrition, generalised body inflammation, your stress levels, the topical creams or ointments placed on your skin, pregnancy and your fitness/ or degree of exercise you do. Different parts of you body also heal differently with an increased risk of scar formation around your joints. In addition the amount of physical tension placed on the developing scars also affects how they form.
The body is composed of four main tissue types (epithelium, muscle, nerves and connective tissues) which all heal and scar slightly differently. Therefore they all require different treatment techniques. The connective tissues, which make up the fascia network hold all the other tissue types together and plays an integral role in scar formation. Scarring also influences how the fascia network functions, influencing how your tissues glide and slide which then affects your posture and movement. An integrated approach to scarring is offered at Perth Scar and Pain Clinic.
What is Scar Tissue?
Scar tissue has a different composition to the tissue that it has replaced, but scar tissue is still a growing, living tissue within the body which has a purpose. The production of this new tissue begins directly after injury with the instigation of wound healing. The tissue is laid down rapidly in order to close a wound, reduce the risk of infection and allow a person to function in order to survive. Injury changes the distribution of mechanical tension through out the body. Scar formation is influenced by the degree and direction of tension within and around the site of injury. This tension is beneficial as it helps direct the repair process, however excessive levels of tension can result in excessive levels of tissue production resulting in stiff, thick, and dysfunctional scars.
Treating Scar Tissue
Various treatment modalities exist which can help to prevent or minimise the formation of scar tissue. Preventing or minimising the formation of scar tissue early is recommended over treating scars once they are formed.
Massage; Can be highly beneficial for improving the blood flow, sensory stimulation and providing a mechanical stimulation to the tissues to influence the formation of scar tissue at the site of injury.
Structural Integration: Helps to integrate the injured tissue and scar tissue into the functioning, moving human body. Treatment is focused on both the injured tissue as well as the entire body, helping to rebalance the distribution of tension.
Pressure therapy: Helps to modify the production of scar tissue. Custom-made garments or splints can be made to apply pressure to injury sites.
Silicon gels: Come in various forms. They help to soften scars and improve the cosmetic appearance of scars.
Sensory Integration: Damaged nerves and tissues benefit from sensory stimulation and sensory awareness techniques to ensure the body and brain continue to communicate throughout the healing process.
Movement Retraining: Injury can unconsciously modify movement habits, influencing the type of tension distributed throughout the healing tissue. Bringing awareness to your movements and how you hold your tension can help influence scar formation.
Scar Release: Scars tissue can often be mobile, flexible tissue which grows with you and adapts to your movements patterns. Other scars become tighter over time, restricting movement patterns leading to discomfort and pain. These tight scars and surrounding tissues can often be released with manual (hands-on) techniques.
Chronic pain and itch Management: Pain and itch can be a debilitating symptoms of scarring. Desensitisation techniques can offer some relief as well as some cognitive strategies to help cope with these symptoms.
Body Image and Stress Management: Scarring can alter your perception of yourself and affect self confidence. The trauma of injury or change in physical status can also have an impact on the recovery process and the development of both the physical and emotional scars. Both traditional forms of counselling are offered as well as somatic (body based) therapy.
Camouflage Cover Creams: Advice on camouflage products can be provided.
Professional advice is offered with the various treatment options provided. Come in for a consultation to get the right advice to manage or prevent your scar.
Types of Scarring:
Normotrophic scar: Following skin injury these scars are flat, often a slightly different colour to the non-injured skin but are flexible and function fairly similarly to the non-injured skin.
Atrophic scar: Forms below the surface of the skin, pitting scars often associated with acne or chicken pox. These are due to the destruction of collagen during an inflammatory phase of tissue injury.
Hypertrophic scar (HTS): These are red and thickened scars which develop within weeks or months of the injury or surgery. HTS can thicken up and become raised above the surface of the skin, or they can thicken below the surface of the skin. They can become itchy and painful. Hypertrophic scars progress through stages with an active phase beginning weeks after tissue damage, continuing for 6-12 months (depending on the injury type and size). The scar then progresses into a mature phase where the signs and symptoms of the HTS start to settle down. They can become paler and flatter. However permanent changes to the tissues structure and appearance is evident.
Keloid scar: Can look similar to hypertrophic scars, however keloids keep growing. They can be classified as benign tumours as they can grow much bigger than the initial injury or surgery and don’t tend to mature. They are not dangerous tumours, but they can become painful, itchy and can limit movement. There is a high genetic tendency for keloids, and they are more commonly seen in people with darker skin types. Keloids often form in areas of high tissue tension, such as the chest and shoulder regions. Caution needs to be taken when treating Keloids as some treatments can aggravate keloid growth.
Contracted scar: All the above categories of scars can occur with or without contracture. Contracture is a tightening of both the healing tissue and surrounding tissues which can limit the mobility of the scar as well as the movement of surrounding tissues. Scar contracture can be very debilitating restricting the normal balance and movement of tissues. Scar contraction can persist for years following injury and can lead to generalised tissue stiffness, adhesions and pain. The stiff tissues surrounding the contracted scar can be released, improving movement and reducing pain. Some scar contractures can be released with manual techniques whereas others can only be be released by surgical intervention, depending on the degree of adhesions.
Adhesions: Adhesions occur when layers of tissue stick together, either during the healing process or as a result of immobilisation. Adhesions limit the degree of gliding and sliding between tissue layers in the body. Once formed, adhesions are difficult to treat, but it is possible. Prevention is the best treatment, therefore early management of healing tissue is recommended.
Pigmentation: Discolouration of the skin can occur following tissue injury. Sometimes there is a loss of the skin pigment and sometimes there is an excessive amount of pigment. Unfortunately the scientific understanding of why this occurs is limited. Conservative treatment is difficult, however camouflage treatments are available.
Sensory Issues: Nerves within the injured tissue can be damaged as well as the nerve endings within the surrounding tissues. Nerves can also be affected by inflammation and changes in tissue tension. As a result people can experience altered sensation, numbness, hypersensitivity, pain and/or itch. Various techniques can be used to improve sensory functioning after tissue damage.