How to Care for Wounds to Minimize Scarring


Photo courtesy of Angela Marklew/ The Licensing Project

How to Care for Wounds to
Minimize Scarring

Whether you’re tending to a recent wound or preparing for future ones, getting familiar with the healing process can help you care for your skin and minimize scarring.

Our skin is a complex organ made up of three main layers: the epidermis, the dermis, and the hypodermis.

The epidermis is the outer layer of skin that we see, touch, and interact with every day, and its main function is to protect the body from things in the environment, like pathogens, UV light, and environmental toxins.

Below the epidermis is the dermis, with its sublayers and skin “accessories”—blood vessels, lymph vessels, hair follicles, sebaceous glands, sweat glands, nerve endings, collagen, and elastin. The dermis helps regulate our body temperature and provides nutrients to the epidermis.

The hypodermis is the deepest layer of skin: fat, nerve endings, hair follicles, and blood vessels provide insulation and shock absorption to prevent damage to muscles and bones.

When our skin is cut, burned, or damaged in some way, it goes through phases to heal the wound: First it stops any bleeding and calms inflammation and pain, then it creates cells and tissue to repair skin damage. And with the right amount of nutrients and proper wound protocol to support the natural healing process, it’s possible for it to heal with minimal scar tissue.

The 4 Phases of Wound Healing

Healing can be explained generally within four stages, yet the process is very complex and interconnected. Each phase is important for the wound to heal properly with minimal scarring.

Blood clotting: Minimizing blood loss with blood clotting is the first step. Immediately after an injury, platelets and fibrin (a fibrous protein) begin to stick together at the site of the injury to form a clot that stops the bleeding and protects the wound from the outside environment. At the same time, inflammatory molecules from the damaged cells trigger blood vessels to narrow (vasoconstriction) to also help slow the bleeding. This process lasts for 5 to 15 minutes. Then blood vessels widen (vasodilation) to help a variety of inflammatory and immune cells come to the injured site and start the healing process. The entire clotting process can last for up to three hours.

Inflammation: While blood clotting occurs, immune and inflammatory cells—neutrophils and macrophages—cleanse the wound by removing debris and bacteria so the healing process can take place. This is the time, about three to four days, when the wound becomes swollen, inflamed, warm, and sometimes painful as part of the process.

Proliferation: During the proliferation stage, new skin, connective tissue, and blood vessels are formed, and the edges of the wound close. Depending upon the size of the wound, this stage can last for 3 to 21 days.

Remodeling: Fibroblasts, cells that make up connective tissue, secrete collagen protein to restructure the collagen matrix. Scar tissue develops during this stage, which can last for years—it’s the process most responsible for scars fading over time.

Nutrition and Care for Wound Healing

NUTRIENTS

Our skin needs nutrients, ingestible and topical, to function normally and repair itself well, especially these:

  • Vitamin C and zinc are particularly important for wound healing. Vitamin C is involved in all phases of healing, and zinc helps with the inflammation and proliferation phases.

  • Vitamin A may support the proliferation phase and collagen production during the remodeling phase.

  • Collagen supplementation can help to rebuild skin elasticity, hydration, and density during the remodeling phase.

  • Probiotics and prebiotics may help during the inflammation phase because of their role in immune regulation via the gut-immune axis.

  • A note on vitamin E: It’s often thought that topical vitamin E is helpful for scars, but there’s little evidence to support this belief. Research, although limited, shows it can be helpful for some and irritate the skin of others.

WOUND CARE

Proper wound care can promote healing and minimize scar tissue. A few other rules to live by, according to London-based dermatologist Unnati Desai:

  1. It’s important to clean wounds of infection or debris and then allow your skin to clot. “Antiseptics should be used only on intact skin, not on open wounds—they will slow down the healing process by killing proliferation cells,” Desai says. “Generally, avoid steroid creams and tablets (unless recommended by your doctor) because their anti-inflammatory actions can interfere with the healing process, too.”

  2. Keep the wound covered. “Adequate levels of skin hydration help the healing process,” Desai says. “Because wound dressings keep moisture in the wound and surrounding tissues, using them can help accelerate healing and minimize scarring.”

  3. Sunscreen will be critical: After the wound has closed, a high-SPF sunscreen is essential to prevent cellular damage and post-inflammatory hyperpigmentation.

This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. To the extent that this article features the advice of physicians or medical practitioners, the views expressed are the views of the cited expert and do not necessarily represent the views of goop.



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