Guest blog by Emma Holly at Restore Therapy Clinic.

I was delighted when Vanessa Jane Davies invited me to offer Scar Therapy at Skin Camouflage Services flagship clinic at 10 Harley Street, London. It has been a challenging time to set up a new service, but we are pleased to be open for business with new clients booking in for the specialised treatments developed to promote healing and reduce discomfort.
 
I am a leading specialist in Scar Therapy, developing new scar massage techniques and teaching alongside my clinical practice. My specialism - Scar Therapy - is the treatment of scar tissue after an injury or surgery. Many people are unfamiliar with Scar Therapy, although routinely people are instructed to massage their scar by their consultant. Within post-operative recovery, Scar Therapy is still emerging as a way to promote better patient outcomes.
 
Scar tissue that forms following a surgery or a traumatic accident is different from the pre-injury tissue in its cellular structure and function. Scar tissue, fibrosis and adhesions are terms to describe the internal complications that can occur. The surface scar is the skin scarring, but underneath the fascia, muscles and ligaments can be impacted. Externally there are not always visual abnormalities on the superficial scar line to indicate a dysfunctional scar, but they may be symptomatic. 
 
Symptoms of dysfunctional scars may include pain, sensitivity, oedema (swelling), reduction in flexibility, palpable bulky fibrous tissue and scar adhesions. Scar Tissue may be so tight, uncomfortable and restrictive the patient may not be able to complete rehabilitation exercises, their gait or movement patterns may be altered – leading to other longer-term problems. They may be dissatisfied with puckering, tightness or pain in the scar. As a therapist, creating positive improvements and reducing these symptoms is hugely rewarding.
 
Not everyone has a problem with their scar. The likelihood of problematic scar formation increases when a patient:

• Suffers an infection as the scar is healing
• Has chronic or slow wound healing or tissue necrosis
• Is genetically disposed to problematic scar formation
• Has suffered traumatic injury
• Reacts strongly to radiotherapy treatment

If the scar remains numb, painful or has altered sensation there may be a dislike of touch for the patient or a feeling of disconnection from that part of the body. It is our belief that a gentle approach is paramount to create the best outcomes and a positive therapeutic touch that promotes healing emotionally as well as physically.
           
When I have a new client booked in the first treatment includes a short discussion to understand my client’s priorities. The remainder of the appointment is spent delivering physical therapy. The 10 Harley Street basic appointment lasts around 50 minutes or for clients wanting a longer treatment to allow for more hands-on work a premium appointment is up to 1 hour 10 minutes. Single appointments are very useful to kick start come tissue changes, but often clients choose to come for a series of treatments over a number of months.
 
The Scar Therapy techniques that I use in the appointment feel like a gentle massage around the area impacted by the trauma. Treatment starts very gently and progresses deeper as the area softens and releases. By stimulating improvement in the health of the skin and improvement to underlying scar adhesions and fibrosis, we expect to create an observable change in symptoms presenting.  The scar appearance may also improve, but this is not guaranteed.
 
BIO
Emma Holly has been a therapist for 27 years, she began specialising in Scar Treatment since 2015. Emma has trained therapists at the UK’s leading cancer support centres including Macmillan and Marie Curie, cancer centres based at Royal Marsden, Guy’s and St Thomas’ and Christie Hospitals and also worked with Invictus Games via Help for Heroes since 2017, British Athletics elite sports, as well as trained therapists working in NHS, HCA and Spire Hospitals.
 
website www.restoretherapyclinic.co.uk
email emma.holly@restoretherapy.co.uk

Crave magazine has featured Vanessa’s top tips of how to manage scar management and skin camouflage at the same time. Read Skin Camouflage for skin confidence. 

Vanessa explains that for areas of scarring that are exposed to the sun, e.g. face and hands, that Kelo-Cote UV Gel which contains an SPF30 sunscreen is particularly useful and for hard-to-reach areas, joints, hairy areas, skin creases and larger wounds such as those caused by burns and trauma silicone sprays are very worthwhile. 

​For the last 5 years Vanessa has been in the fortunate position to work with silicone gels alongside skin camouflage and has developed a technique to further reduce scar height with the camouflage pigments and silicone to create a flattened appearance. This development of this application is unique to Skin Camouflage Services and has taken the traditional base layer of silicone application with skin camouflage to the next aesthetic level.

Since 2015 we have been using silicone therapy products for scarring alongside our skin camouflage applications to try and understand how this product partnership could practically work.

Over time these products have improved, and we have evolved our own expert techniques for incorporating their use into our skin camouflage practice. Our aim was to ensure that our patients can still reap the benefits of silicone therapy for their scars without compromising the quality of their skin camouflage effect.

We are now ready to offer advice and practical guidance on the choices available within our scar management programme in conjunction with our prescribed skin camouflage regime. This is part of our clinical practice for all our patients: Military, Rehabilitation, Expert Witness Referrals, International and Clinician or Self-referring patients.

Silicone Gel Therapy - Where a scar has healed but is still in the process of maturing, silicone gel therapy is something you may wish to consider.
Silicone gel therapy has been shown to help soften and flatten raised scars, and reduce redness and discolouration associated with them. Easy to apply and suitable for use by all age groups, silicone gel therapy can be used under the skin camouflage products prescribed for you.

Topical Silicone Dermal Filler - If you have indented or recessed scars or even ‘pock marks’ on your skin (e.g. old acne or chicken pox scars) a topical silicone dermal filler may be suitable for you, whatever your gender or skin tone. This easy to apply non-invasive skin camouflage technique evens out indented scars or recessed areas creating a natural, more even skin texture.

Topical dermal filler can be used on the face or body and once applied is durable and waterproof, withstanding the rigours of a normal day or sporting activity and will stay in place until you wish to remove it (up to 36 hours). Topical dermal fillers are compatible with your prescribed skin camouflage products and cosmetic make-up.

Specialist Scar Massage - You may have been advised by your medical/healthcare practitioner to moisturise and massage your scars after your injury or surgery as it is now well accepted that this helps repair the skin and reduce scarring.
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The specific scar massage technique that we advocate is a very gentle but an effective approach to scar management. The technique can be used on scars large or small, anywhere on the face and body and is equally suitable for children. Scar massage also aims to soften and flatten raised areas of scarring which not only improves comfort but can also improve the overall effect of your prescribed skin camouflage creams.
Depending on your particular needs and with guidance from us, you may be able to continue the recommended scar massage techniques yourself.
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​Vanessa Jane Davies: Skin Camouflage Consultant MEWI, MFHT, LCGI