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.

Skin Camouflage Services understand that the complexity of scarring can for some people be of great concern. We know from our 25 years of practical assessments what can realistically be achieved with scars, pigmentation and colour difference. This has led us to form the opinion that the majority of scars benefit from skin camouflage  “as long as there’s a colour difference, but this has to include the patient’s ability to manage the application”.

Over the decades skin camouflage has become well known for its support for private patients, NHS patients, rehabilitation and for those that wish to pursue skin camouflage personal injury claims. For those of us that work in this field we know that it is a well-respected recognised profession that stands apart the make-up arena and what we also know, is that self-gratification and claims of covering scars for the benefit of the practitioner is not helpful. Suggestions that all scars can be camouflaged is questionable when the patient is unable to mirror the results themselves furthermore, we also know from the number of skin camouflage assessments that we carry out that some scars simply cannot be concealed for example due to location, the type and formation of the scar and in the absence of scar management.

The expert assessment below involved complex scarring in multiple locations. The focus of the skin camouflage appointment was for the patient to be able to choose which clothes she wanted to wear rather than having to wear a particular style of clothes that covered her scars.  In addition, it was essential that she could manage her appearance independently.

The scarring to the right shoulder displayed multiple colours with particles of black grit which had embedded as the wound healed.

Surprisingly the results achieved were relatively quick and easy using the criss-cross technique, however the challenge was for this lady who was right handed was to apply the cover creams to her right shoulder by herself.

Whilst the skin camouflage application was successful to all the sites of injury, we concluded on reflection that the help required to assist with the shoulder would likely limit the frequency of use and therefore its effectiveness would be restricted. Therefore, not all medico legal skin camouflage reports can claim that full cost recovery is fair and reasonable.

If you would like an opinion to clarify levels of skin camouflage quantum before dispatching legal instructions, please contact us at 10 Harley Street London.