One of the services offered here at NFM Health Inc by Dr. Sabin Gilman is scar injection therapy. 

The goals are to reduce adhesions, free up normal movement, and improve blood flow and nerve conduction. This may help reduce numbness and pain as well as flatten out scars, helping them blend in better. 

Some may notice an immediate effect, however, most neurovascular changes develop over 3-6 weeks post-injection(s). 

This typically involves using a needle to inject a formula (it varies, but can be procaine/lidocaine, saline and sometimes 5% dextrose). 

What are Scars:

Most people have or will experience a physical scar at some point in their life as a result of an acute or chronic injury, trauma, surgery, piercing, infection, etc. Scars are part of the body’s innate ability to heal, repair, and protect itself. 

The wound undergoes the following stages of healing: hemostasis, inflammation, epithelialization, fibroblasia, proliferation, and maturation. 

A scar forms, which has more collagen and is more fibrous than the surrounding skin. Scars will look different for every person depending on a variety of factors, including genetics, age, location, depth, size, direction, type of injury, recovery activities, nutrition, etc. 

Scar Concerns:

The process of skin healing itself can be imperfect; its main goal is to protect itself, not to look pretty. As the tissue heals sometimes it can trap blood vessels, nerves, other local tissue, and create adhesions. 

This often can cause symptoms for people such as numbness, tingling, pain, pulling, tugging, tightness of the skin/region, and reduction of movement. Some of this is normal, expected, and will improve naturally.  

However, there are also a variety of techniques that may help the process, such as but not limited to massage, topical applications, steroids, silicone, surgery, and injections. 

Scar Stories:

Many scars have a story or multiple stories attached to them for people. They can carry a lot of trapped emotions and the injections can sometimes help people release them. This is not true for all people and all scars, but it can happen unexpectedly for some. 

If a scar is particularly charged for someone, we may ask for a support person to come to the visit with them, or we may delay it until the person has the time and space to process the experience. 

Risks/Contraindications:

It is not a therapy for every person or every scar. There are of course some risks, which will be discussed in detail with each patient as well as some contraindications, which can be case dependent. Some examples are pregnancy, uncontrolled diabetes, excessive keloid formation, infection, etc. Procaine Contraindications: pseudocholinesterase deficiency, pregnancy, myasthenia gravis, lupus. The scar should be at least 4-6 weeks old for it to be considered for injection. 

What to Expect:

The first appointment will typically involve assessing the scar, reviewing contradictions, risks, benefits, and developing a plan. 

Depending on many factors the scar may not be injected until the second visit. And, depending on size and depth, it could take several sessions to break up all the scar adhesions. There may be some pain, bleeding, increased sensitivity, increased emotions, and bruising associated with the injections. If a second injection (in the same site) is needed, the typical wait is a minimum of 4 to 6 weeks to allow healing and changes to occur. 

Price/Insurance:

Scar injections are a separate charge outside of the visit cost. Insurances do not cover them but I can/will bill them for the visit portion. The cost is dependent on the time it takes for the actual procedure, and it is $60 for up to 15 minutes, $100 for 16-30 minutes, and $150 for 31-60 minutes.