Scar Treatment

[charlieanne]

Hi Sarah,

Wow, this forum is amazing, thanks for providing the time to give us all advice on your products.

I have a scar on my arm from the removal of a suspicious freckle (which turned out to be fine, yay!). The freckle was removed in 2010 by my GP but it left a scar that was 5cm long and about 1.5cm wide. I had the scar revised by a plastic surgeon in November 2011 and am now left with a scar that is still 5cm long but less wide. I have attached a photo of the scar.

It is flat but still quite red/purple in colour. I was hoping you could provide some advice on which products would give it the best chance to improve.

I am currently breastfeeding and hoping to start trying for another baby in a few months time - just in case either breastfeeding or pregnancy affect treatment options.

Should I use the dermaroller or stamp? Which creams/products should be applied before and after rolling/stamping? How often should I roll/stamp?

Sorry for all the questions.  I had looked a lot on the internet about scar treatment and was so close to purchasing from White Lotus but happened to just put 'White Lotus forum' into Google search and found your forum...... am I glad that I did!!!!

Thanks, Julie

                     

Attached files

[SarahVaughter]

Thank you, Julie for your praise.

  I am surprised that a mole removal left you with such a long scar. I think you should use a 1.5 mm ONE LINER roller. It will be difficult to roll with your left hand (if you are right handed) but you will learn it.



  Roll the scar very densely every 20 days. Apply Infadolan afterwards.

  No pre-treatment is necessary in your case.

  Tretinoin cream, applied every second day on the scar would also be beneficial. Tretinoin is contraindicated in breastfeeding and pregnancy due to potential Tretinoin side effects to the fetus and the lack of studies determining its safe levels in pregnancy. In spite of this, you would apply it on such a small area of skin that the amount of Tretinoin is minuscule. I certainly do not advocate using Tretinoin in pregnancy, especially not after dermarolling, which greatly enhances its absorption.  Some experts suggest that topical Tretinoin does not increase the risk of malformations, while others recommend avoiding it in pregnancy.

 

 

  First trimester topical tretinoin and congenital disorders.

  Jick SS, Terris BZ, Jick H

  Boston Collaborative Drug Surveillance Program, Boston University Medical Center, Massachusetts 02173.

  Abstract

  We used information from the Group Health Cooperative of Puget Sound, Washington, USA, to evaluate the risk of birth defects in mothers exposed to topical tretinoin--a retinoid preparation used to treat acne--in the first trimester of pregnancy. We identified 215 women who delivered live or stillborn infants at Group Health Cooperative hospitals and who were exposed to topical tretinoin early in pregnancy, and 430 age-matched nonexposed women who delivered live or stillborn infants at the same hospitals. The prevalence of major anomalies among babies born to the exposed women was 1.9% and among babies born to the nonexposed women was 2.6%. The relative risk estimate for having a baby with a major congenital anomaly for exposed versus nonexposed women was 0.7 (95% CI 0.2-2.3). We conclude that topical tretinoin is not associated with an increased risk for major congenital disorders.

 

 

Minor malformations characteristic of the retinoic acid embryopathy and other birth outcomes in children of women exposed to topical tretinoin during early pregnancy.



  Loureiro KD, Kao KK, Jones KL, Alvarado S, Chavez C, Dick L, Felix R, Johnson D, Chambers CD

  Abstract

  ..........................First-trimester topical tretinoin exposure in this study was not associated with an increased risk of any adverse pregnancy outcome evaluated. Specifically, there was no indication that topical tretinoin is associated with an increased risk for minor malformations that are consistent with the retinoic acid embryopathy. Although it is impossible to exclude the possibility that some women/infants may be uniquely susceptible to topical tretinoin exposure, this study provides further reassurance for women who are inadvertently exposed early in pregnancy.

 

   

   

Concerning Tretinoin safety in non-pregnant individuals:

   

  In the study below, a person took 1000 mg Tretinoin orally with no serious consequences.

   

  For comparison:

   

  A 30g tube of 0.05 % Tretinoin contains a total 15 mg of Tretinoin.

  (You would have to eat 66 tubes in one go to reach 1000 mg).

   

  Our 18g jar of 0.025 % Tretinoin contains a total 4.5 mg of Tretinoin.

  (You would have to eat 222 jars in one go to reach 1000 mg)

   

   

  Tretinoin overdose: a first case report.

   

  CASE REPORT:

  A 31-year-old man ingested 1000 mg of tretinoin (100 pills of Vesanoid 10 mg) in a suicide attempt. He developed nonbloody diarrhea, but otherwise had no complaints. Clinical examination was normal. The patient was treated with activated charcoal and was hydrated. The patient's blood results did not show any deterioration on the third consecutive day. He was discharged well on the third day, but was subsequently lost to follow-up.

  DISCUSSION:

  Although there has been no reported experience with acute tretinoin overdose in humans, our patient took a dose approximately 3 times the recommended maximum tolerated daily dose in patients with myelodysplastic syndrome or solid tumors (195 mg/m2 per day). Overdose with other retinoids such as isotretinoin have been associated with only minor symptoms that resolved quickly. Our patient had diarrhea, which also resolved quickly with symptomatic treatment and hydration.

  https://http://www.ncbi.nlm.nih.gov/pubmed/19415591

[charlieanne]

Hi Sarah,

Thanks so much for your reply.  I have just ordered the dermaroller and the Infadolan cream and look forward to starting treatment.

Thanks also for the info on Tretinoin cream, I will read up on it.

Yes, it certainly is a large scar for a mole removal.  I have had about 8 removed over the last 10 years by a plastic surgeon on the advice of a dermatologist and they are all quite small scars. This latest one was so small the dermatologist suggested just getting my GP to remove it to save the hassle of booking in to the plastic surgeon. I was all anaethesitized in my arm and the GP was about to cut it out when he told me that it would be a 5cm scar. I couldn't believe it but felt too bad to cancel out so was left with the big scar. His theory was that if it was suspect then he had to take a large margin around the mole. Oh well, my plastic surgeon revised it about a year later (in November 2011) and it is already looking so much better, just still very long and red.