Therefore, the best therapies involve a multi-prong approach to help smooth and lighten the physical appearance of the scar, while controlling or eliminating associated discomfort.
Individually compounded scar therapy preparations may contain caffeine; vitamin A; avocado, coconut, and other tree oils; and medications including corticosteroids, antihistamines, as well as other agents such as verapamil that promote healing. Verapamil, a vasodilator in the class of drugs known as calcium channel blockers, is often prescribed orally to control high blood pressure, chest pain, and irregular heart rhythm. When compounded into a topical scar preparation, verapamil exhibits anti-proliferative properties that reduce collagen deposits and promotes scar tissue breakdown by increasing production of collagenase (an enzyme responsible for the breakdown of collagen). Another often used drug is pentoxifylline which also inhibits the production of collagen; topical application of pentoxifylline can improve blood flow and elasticity of scar tissue.
With so many options available, the key is to work closely with doctor and compounding pharmacist to find the preparation that will work best for your skin type, scar location, and stage of healing.
As patient, prescriber, and pharmacist work together to tailor therapy, the compounding pharmacist may focus on what dosage form and base to use for your particular preparation. Medications may be compounded into a cream, ointment, or gel base. Several studies show the benefits of a silicone gel base in the treatment of scars. The mechanism by which silicone aids in scar healing is not well understood. One possible role is the creation of a physical barrier to prevent water loss through damaged scar tissue. It is thought that promoting hydration and proper temperature and oxygen transmission creates an environment conducive to healing. In one study, a total of 36 post-operative patients applied silicone gel twice daily resulting in statistically significant improvements in scar height, pain, pigmentation, pliability, pruritus and vascularity.
Time heals all wounds, however, taking an individualized approach to treating scars with compounded topical scar therapy can help time heal. Ask our pharmacist for more information.