References
Management options for self-harm scars: non-surgical and surgical modalities
Abstract
Deliberate self-harm scarring is an increasingly common presentation in dermatology and plastic surgery settings. Most patients seek help with requests to ameliorate the stigmatising pattern of scarring, which can have a detrimental effect on social and personal interactions. This article aims to provide a summary of different management approaches for scar resurfacing, with particular focus on non-surgical interventions.
Deliberate self-harm (DSH) scar management poses a complex and multifaceted challenge. Rates of DSH have been on the rise worldwide, with female adolescents among the most prevalent demographic, albeit with a notable rise among males (Carr et al, 2016). An understanding of the psychological aspects that underpin self-injury behaviour is a key starting point in tailoring a successful management plan within a multidisciplinary framework for patients seeking treatment.
DSH entails infliction of self-injury in the absence of suicidal intent for the large majority of patients. However, it is important to note that DSH is a recognised risk factor for suicide in a subset of individuals in whom the self-harm may carry an escalating pattern akin to rehearsal for suicide, especially if the underlying cause is left untreated or undetected (Singhal et al, 2014). For the vast majority of patients who self-harm with no intent to end their life, the underlying motives can be multifactorial; the severity of the self-harm is best viewed as a spectrum entailing minor injury on one end to severe and, on occasions, accidentally limb or life-threatening self-harm on the other (Greydanus and Apple, 2011). The most common form of DSH encountered in clinical practice involves skin injury with sharp objects affecting the non-dominant upper limb (Zahl and Hawton, 2004; Greydanus and Apple, 2011).
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