Scar Management

It has been 9 months ago since the hot water burn accident happened. The badly hurt areas are now leaving down bad scarring and the others are still in white patches which yet to turn into skin colour soon. Till today, I still having hard time to get over the incident. Those horrible scenes are still on and off playing in my mind if I get to look at those scars and grafted area a bit longer.

The scars started to form at the wounds area during the 3rd month (Sept'08). Currently the scar is the only thing I very concern and worried as it grows thicker, hard and red, especially on the chest part, big big patch. It cause lots of itchiness on him especially when hot and sweating. At night, he doesn't have good sleep too due to the itchiness. Sometimes he can scratch till bleeding. Doctor did gave a tube of Elomet cream to soothe and eliminates itchy, but it doesn't works on him. I have stop using it before finish a tube as the instruction there also stated it will cause side effect for long term using, so better still ban it and use other natural and mild solution.

I then try using Cell Food diluted into water and spray on him when needed. He feels much better with that. Really, I can't bear any longer to see him suffer on the itchiness and trying to use whatever is good. The compression garment that tailor made for him from hospital is not wearing that often too due the garment cutting; it keeps pushing up when the boy moving and active around. It is not tight fitting on him entirely and stay in place. So I have the idea not to let him wear since the garment not stay in place and for sure it won't give much compression on the scar. Later on, when I got to know about the Teviron clothing, he was fully on that for 24 hours. Teviron did show lots of effect on his health improvement, but to scar flattening it is not much visible yet.

During the last skin check up before CNY, doctor even scolded me for not put on the compression garment on him for 24 hours, thats why the scar form thicker. He said, if the scar not given compression to flatten, after a year more later, the forming scar will become hard, and later when his body grow, it will pull him down on the chest part. I really so worried and scared after hearing that. I did ask for other solutions on flatten the scar, besides garment and cream, but nothing except to wear the compression garment on 24 hours for 2-3 years time.

In following of that, we got another new garment for him (RM90 each, last for 3 months). Back to the hospital rehab the next day for taking measurements and the new garment ready and collected after CNY. During the measurement, the rehab nurse did ask me, why not let him try using Cica Care Scar Gel. I said I don't know got such thing. Later, she roughly explain to me how the thing is and how it use. Back home, I immediatedly online and Google search more info about it. Wow, I'm impress on the fading result, the evidence shows that the appearance of scar also improve a lot and some almost invisible. It was so amazing, it even works for those old scar. Many more pics I found with proven result of use on Before and After.

Here are some brief info on Cica Care Scar Gel Sheet:

CICA-CARE◊ is a self-adhesive gel sheet that is medically proven to be up to 90% effective in the improvement of red, dark or raised scars.

> Description
CICA-CARE◊ Gel Sheet is a patented technically advanced form of silicone gel sheet for scar care.

> Features

• Self-adhesive silicone gel layer
• Reusable
• Non-adherent outer silicone membrane

> Benefits

• Improves the appearance of scars
  Widely used by hospitals, dermatologists, and surgeons for the management of hypertrophic and keloid scars.


• Easy to use
  The CICA-CARE◊ adhesive gel sheet is soft, comfortable and simple to apply. It can be cut to size to fit most scars. Durable and reusable, it can be used day or night.


• Self adhesive
  The skin contact side of CICA-CARE◊ is self adhesive, while the upper side is a strengthening non-adhesive silicone membrane. Therefore secondary fixation may not be required, making the product more user friendly, and can lead to higher patient compliance.


• Durable
  The silicone membrane and gel combination make CICA-CARE◊ more durable and less likely to "crumble" in comparison to other silicone gel sheets.


• Conformable
  CICA-CARE◊ is a very conformable silicone gel sheet. Because it is self-adhesive, CICA-CARE◊ can be easily used in many awkward anatomical locations, including earlobes and sternal areas.


• Reusable
  One piece of CICA-CARE◊ can be easily washed and reused. Once it becomes difficult to clean, a new piece should be used. This usually occurs after 14 to 28 day intervals.


• Cost effective
  CICA-CARE◊ is durable and reusable. Each cut piece lasts up to 28 days in use, making it a cost effective regime.

> Indications
CICA-CARE◊ is intended for use as follows:

• For the management of hypertrophic and keloid scars.
• May prevent the formation of hypertrophic and keloid scars.
• For use only on intact skin.
• For covering hypertrophic and Keloid scars as a means of reducing the size and erythema of scars resulting from burns, trauma and surgery.

While the nurse told me about Cica Care Gel, I was wondering how come the skin doctor not recommended it to us as another option for better recovery, could he be don't know about it? I don’t think so. You see, sometimes we also can’t rely too much on doctor's words. But, when I throw back my thought to the nurse she dare not to stress too much on using it (may be she afraid I'm not going to use the garment and only use the Cica Care Gel). She just said you can try Cica Care Gel, but better follow the hospital one, use the garment is better. Since I know the Scar Gel Sheet can help, I don’t want to miss it too. I combine both to use at the same time.

Without wait any longer, that time was almost CNY, I called up Caring Pharmacy and ask for the selling price for the size I want. Caring was always my trusted pharmacy with good price in medical products. But, I found that it was still a lil bit pricey, for the size of 12cmx6cm, it costs RM 170+ (the cheapest compare to other pharma). Luckily I got my friend, her sis (Jean) work in other pharmacy who can get me the Gel Sheet in Staff Price. On the 6th day of CNY (31/1), I manage to get the first piece of that size for RM159.80. Follow the instructions, I tried to put it on for 4 hours on first and second day. I’m glad that his skin can tolerate it well and I don’t find any irritation on his skin.

From 3rd day onwards till today, I let him put on the Cica Care Gel all day long together with the compression garment. The garment now works to hold the gel stay in place and at the same time give compression. Just nice. If were only put the gel on without any support, the gel can easily fall (although it is stick on the skin, as he moves and rubs around, it will still fall) or he will peel it away sometimes.

Daytime, he wears scar gel - compression garment - his own top the last. At night, scar gel - Teviron (contact to skin for recovery on white patches) - compression garment put the last as support. Before bathing, upon removing the gel sheet, I will also give a little bit massage on the scar in help to loosen the scar tissues for a better flattening result. After bathing him (twice a day), I will clean the gel sheet with mild soup, dry it then put it on again. Those scar gel were at least put on for 20-22 hours everyday on his scar area. Sometimes when found his skin and scarring area shows redness or dry after wearing it long, I will stop putting the scar gel for longer hours (like half a day) and apply some lotion to moisture it.

To my understanding, the earlier to put that on the scar the faster can see the fading and flattening result, for it reduce the chance on the scar continue to form and grow. Once the scar is soft, the skin area will get flexible to stretch up and as he grows gradually the scar will become invisible and won't find a hard patch there later. I really hope to see that's the final result in future.
The gel sheet can cut into the different sizes to fit the scar area
On using the first piece of scar gel, after putting it on for 2 weeks, I started to see the scar on his shoulder got flatten bit by bit. Now after 1.5 months using, the scar on shoulder and chest is flatten up to 40%. The scar on chest part no longer hard when touch on. It is much more softer and the redness is gradually reducing too. For the arm, it is not that flatten yet, only 20% as the scar there started to form hard, it may take longer to works. Overall, I can say that the scar gel is very effective and working good on him. I decided to let him continue to use it until the scar faded and looks better. Nowadays, the scar area no longer that itchy like last time and since he wearing the garment with scar gel on, he got no chance to scratch it too.

Every month, we need to spare RM500+ (with discount) for the Scar Gel in size of 12cm x 6cm and 12cm x 15cm each. The selling price for 12x6 is at average RM175 - the cheapest (Guardian sell it at RM203+, the most expansive) and for 12x15 is RM409.80. So far, I'm still getting it from Jean and Caring Pharmacy. The bigger piece I managed to get it at RM345, staff price from Jean. Last month, I bought 2 in size 12x6 for RM163 each from Caring Pharma.

I was still searching around for the cheapest as he may needs it for a year or two. I even ask people from Facebook (within my network, not my friend) who work in Smith & Nephew, see if I get any chance to buy directly in lower price. So far, no one get back any news to me yet. If any of you know someone who works in Smith & Nephew Healthcare or Zuellig Pharma, please, I really need your help to get me the contact.

As for now, Terry is overall ok and only left this scar management to do in next 2-3 years time.