*Sponsored Post by Fagron South Africa*
Scars are an undesirable, yet normal and inevitable outcome of wound healing. The incidence of scarring in the developed world is about 100 million patients per year, because of 55 million elective operations and 25 million operations after trauma. It is estimated in the developed world, that there are 11 million keloid scars and 4 million burn scars, of which 70% occur in children, global incidence is unknown but considered to be much higher. (1).
The male-to-female ratio for hypertrophic scars and keloids is 1:1. However, the incidence varies with age, race, anatomical location, trauma type and body mass index (BMI). Injuries in young people (<30 years, risk peaking between 10-20 years) generally produce worse scarring compared to elderly people (2), (3). Non-Caucasian (especially African and Asian) pigmented skin seems to contain pro-inflammatory and pro-proliferative properties, that make the skin more prone to hypertrophic scar formation (2), (4).
Having an ethnic background is also an important risk factor for keloids, with a 15- to 20-fold increased risk. Both hypertrophic scars and keloids occur more frequently in regions of the body that are subjected to motion and stretching tension (5).
Certain types of trauma are associated with a slower wound healing process (> 3 weeks) and show an increase in keloid-formation risk, with burn wounds having the highest risk (2). Anatomically at highest risk for keloid formation, are the sternal, chest, back, shoulder and neck area, moreover, the ears, abdomen and cheek area are susceptible (2), (5).
In contrast, hypertrophic scars seem to be less susceptible to regional predisposition (2). A high BMI has been positively associated with hypertrophic scar formation, probably due to the prolonged inflammatory phase during wound healing observed in overweight patients and due to the increased stretch of the skin compared to non-obese patients (4).
When skin injury occurs, the dermal barrier is disrupted and the stratum corneum will no longer be able to retain its water gradient. The epidermis will start to regenerate and once formed, this new and immature stratum corneum will have an abnormally high level of trans-epidermal water loss (6), (7). After the injury, it can take up to 1 year before water levels have returned to basal levels (7).
The decreased water level in the stratum corneum is a signal for keratinocytes to produce cytokines, which leads to changes in the dermis and will stimulate fibroblasts to synthesize collagen (6). This excessive collagen production at the scar site causes undesirable physical and aesthetic properties associated with scars.
Studies have shown that silicone gel sheeting decreases water loss from the skin and increases the hydration of the stratum corneum (8). The silicone gel sheet that is formed on the skin after the application of silicone gel has beneficial effects on the hydration level of the skin (9). Occlusion is an important factor that hydrates the keratinocytes in the epidermis, which results in a decreased synthesis of pro-inflammatory cytokines (such as IL-1) and an increase in the expression of anti-fibrotic cytokines (such as TNF-α) (6).
These signalling alterations are correlated with changes in the activation state of the fibroblasts in the dermis, resulting in reduced extracellular matrix synthesis (reduced collagen synthesis by fibroblasts) and less scarring (10). Silicone gel appears to be an effective and non-irritating way to restore the hydration balance, by providing a sufficient (but not excessive) occlusive environment.
Introducing Nourisil™ MD – an advanced scar treatment
Nourisil™ MD is a transparent, self-drying silicone gel, which has been developed for the management and prevention of keloids and hypertrophic scars, resulting from general surgical procedures, wounds, trauma and burns. It contains a unique blend of silicones (mainly polysiloxanes) and tocopheryl acetate (Vitamin E) to maintain the skin’s moisture balance while improving the appearance of the scar.
Nourisil™ MD gel has an elegant silky skin feel and is easily applied to scars on all areas of the skin, including the face and body parts subjected to motion and stretching tension. Moreover, after the application of Nourisil™ MD, a practically invisible sheet will be formed, offering a patient-friendly solution for application on visible areas such as the neck and facial area.
Nourisil™ MD helps to flatten, soften and smooth scars, relieve the itching and discomfort of the skin caused by scars, as well as reduce any associated pain and redness.
What can it be applied for?
- Post-surgery such as C-Section, cardiac surgery or skin biopsies
- Cosmetic surgery such as breast augmentation or tummy tuck etc…
- Wounds and trauma
- Burns, acne scars, cuts
Nourisil™ MD helps to:
- Flatten, soften, and smooth raised scars
- Relieve itching associated with scars
- Reduce redness and discolouration
- Prevent abnormal and excessive scar formation
Benefits of Nourisil™ MD
- Forms an invisible layer that hydrates and protects scars
- Sunblocks and cosmetics can be applied afterwards
- Easy to apply onto scars on all areas of the skin, including the face and joints, once the skin is intact
- Suitable for use on all skin types and on children
How to use?
Nourisil™ MD should be applied twice daily once the wound has closed.
The recommended duration of treatment is 60-90 days. For larger or older scars, longer treatment may be required.
Who is it for?
Nourisil™ MD contains safe ingredients and is suitable for use on skin types of all ethnic backgrounds and on children.
Nourisil™ MD should be applied only after the wound has healed (or sutures are removed) and the skin surface is intact. Nourisil™ MD should not be brought in contact with mucous membranes or applied too close to the eyes.
Price and where to buy?
R550.00 (as at June 2021)
Contact Fagron South Africa for more information
- Skin scarring. Bayat A, McGrouther DA, Ferguson MW. s.l.: BMJ, 2003, Vol. 326, pp. 88-92.
- Management of keloids and hypertrophic scars. Juckett G, Hartman-Adams H. 3, s.l.: Am Fam Physician, 2009, Vol. 80, pp. 253-60.
- Aging alters the inflammatory and endothelial cell adhesion molecule profiles during human cutaneous wound healing. Ashcroft GS, Horan MA, Ferguson MW. 1, s.l.: Lab Invest., 1998, Vol. 78, pp. 47-58.
- Going into surgery: Risk factors for hypertrophic scarring. Butzelaar L, Soykan EA, Galindo Garre F, Beelen RH, Ulrich MM, Niessen FB, Mink van der Molen AB. 4, s.l.: Wound Repair Regen., 2015, Vol. 23, pp. 531-7.
- Management of scars: updated practical guidelines and use of silicones. Meaume S, Le Pillouer-Prost A, Richert B, Roseeuw D, Vadoud J. Jul-Aug 2014, Eur J Dermatol, pp. 435-43.
- Occlusion regulates epidermal cytokine production and inhibits scar formation. Gallant-Behm CL, Mustoe TA. 2010, Wound Repair Regen., pp. 235-44.
- Functional analyses of the stratum corneum in scars. Sequential studies after injury and comparison among keloids, hypertrophic scars, and atrophic scars. Suetake T, Sasai S, Zhen YX, Ohi T, Tagami H. 12, s.l. : Arch Dermatol, 1998, Vol. 132, pp. 1453-8.
- Silicone sheet for treatment and prevention of hypertrophic scar: a new proposal for the mechanism of efficacy. Gilman TH. 2003, Wound Repair Regen., pp. 235-6.
- Scar management by means of occlusion and hydration: a comparative study of silicones versus a hydrating gel-cream. Hoeksema H, De Vos M, Verbelen J, Pirayesh A, Monstrey S. 2013, Burns, pp. 1437-48.
- Evolution of silicone therapy and mechanism of action in scar management. Mustoe, TA. 2008, Aesthetic Plast Surg., pp. 82-92.