1 / 4 H Neuro #159 - How to Work with Scars with Margot Sintes

Introduction to Scars

Hello and welcome to this episode where we will discuss scars. To talk about this topic, I have Margot, a physiotherapist in private practice since 2019, specializing in sports physiotherapy.

Margot practices between Lyon and Grenoble and has a general approach focused on musculoskeletal and orthotrauma issues. Today, we will explore the impact of scars on the body and how they can lead to various problems.

Pathological Scars

Margot explains that there are several types of pathological scars, which can have very different treatments. It is crucial to understand the structure of the skin, including the epidermis, dermis, and hypodermis, to comprehend the issues that can arise during the healing process.

Phases of Healing

Healing is a complex process that includes five phases. It is essential to note that these phases can last between 16 and 24 months, and care must be taken even after the scabs fall off. Here is an overview of the healing phases:

• Closure Phase: If the scar struggles to close, this delays the overall process.
• Inflammatory Phase: This phase typically occurs between the 3rd and 4th day. It is marked by increased permeability of the vessels to vascularize the scar and eliminate cellular debris.
• Proliferation Phase: Fibroblasts begin to transform and play a crucial role in healing.
• Maturation Phase: This is the longest phase, where tissue reorganization occurs, lasting up to a year.
• Final Evaluation: A mature scar should resemble a fine, almost invisible line.

Consequences of Scars

Scars can have both aesthetic and functional consequences. It is important to note that if a scar is visible and bothersome to the patient, it deserves special attention. Additionally, a scar can create functional limitations, such as reduced range of motion.

Types of Scars

There are different types of scars, including:

• Hypertrophic Scars: These are often red, raised, and can be treated with non-surgical methods.
• Keloid Scars: These are more challenging to treat and often require surgical intervention.
• Retractile Scars: These limit mobility and require specific treatment.
• Adherent Scars: These can cause indentations and necessitate mobility work between layers.

Treatment and Prevention

Margot emphasizes the importance of a tailored approach for each type of scar. Treatments may include manual techniques, specific care, and regular assessment of the scars' progress. It is crucial not to use pro-inflammatory creams without prior evaluation.

Sun Protection

Another essential recommendation is sun protection. Scars must be protected from UV rays for at least two years after they appear, with regular application of high SPF sunscreen.

Conclusion

In conclusion, it is essential to consider scars in rehabilitation and treatment. Margot insists that it is never too late to treat a scar, as long as it is done appropriately. For those not trained to work on scars, it is better to refer patients to qualified professionals.

Thank you for following this episode, and feel free to ask Margot your questions or contact us for more information!