The problem of scars may be universal but its management requires area-specific protocol, especially in an ethnically-diverse country like India.
It is for this reason Indian Scar Forum — a recently-formed group of dermatologists and plastic surgeons — is coming up with a protocol for management of scars in the Indian scenario. Till now, there has been no standard protocol for scar management here.
“There are protocols in western literature and recently, a protocol for Asia Scar Forum too was brought out. But these may not necessarily suit the needs of people in India due to differences in skin colour. Pigmentation/de-pigmentation of hypertrophic and keloid scars are common in the country,” said K. Sridhar, chairman of the forum.
The protocol is likely to be published in a few months in the Indian Journal of Plastic Surgery.
This, according to him, will serve as a tool for further study.
“It is based on case studies and analysis of published papers. We will see if our protocol is right,” he said.
The experts met twice last year to discuss prevention of scars, especially those caused by surgical wounds, and ways to assess and grade scars.
Globally, about 100 million individuals have some type of scar, and 55 million have problematic scars due to elective surgeries.
“In India, injuries alone do not cause scars; surgeries, acne and burns too are likely causes. Caesarean surgeries and laparoscopic procedures could also leave behind scars. Of late, I am seeing more cases of keloid, a thick scar that goes into the surrounding normal skin and is highly itchy and painful, on the pinna due to accessory piercings,” he said.
For this, doctors have been prescribing custom-made compression devices to be worn on the ears like earrings. “There are goldsmiths who make these devices. Once the scars are removed, we ask them to wear these devices for six months,” he said.
Some of the treatment modalities for scars are compression, silicon-gel sheeting, silicon gel, steroid injection and small doses of radiation, said Dr. Sridhar.
