"Doctor, can't we just leave the scab alone?"

— A question I got yesterday too

I'll give you the conclusion first.

When a wound forms a scab,

it's actually a shortcut to scarring.

I'll explain why in this article.

What makes DuoDERM different from a regular bandage,

actually

DuoDERM is a hydrocolloid

moist wound dressing product.

Simply put, it absorbs the exudate

coming from the wound while also

keeping the area moist.

Unlike a regular bandage (gauze bandage),

DuoDERM absorbs the exudate

and turns into a gel, covering the wound surface.

So it doesn't form a scab.

That's the key.

Why do some people scar from the same wound,

while others don't?

"If you maintain moist wound dressing with DuoDERM,

re-epithelialization can proceed without scab formation,

greatly reducing the risk of depressed scars and

hyperpigmentation."

— Dr. Wi Young-jin (Beauty Stone Clinic, Hongdae)

A scab forming means

re-epithelialization is progressing in a dry environment

and having a hard time.

If you keep the environment moist,

re-epithelialization proceeds smoothly without a scab,

greatly lowering the risk of depressed scars

and hyperpigmentation.

I see this kind of case so often

that I wrote it down separately.

Last month, a 46-year-old woman came in,

and after squeezing a small boil on her face

she let it scab over and just left it alone.

She said, "My mom told me not to peel scabs,

so I left it as it was."

But when the scab came off,

there was a slightly sunken mark

with some dark pigmentation left behind.

The tricky part is,

the scab itself isn't bad.

The problem is that when re-epithelialization happens under a scab,

the cells avoid the dry surface

and burrow into deeper layers.

So it does heal,

but new skin forms one layer below

the original surface.

That's the beginning of a depressed scar.

On the other hand, if you create a moist environment with DuoDERM,

epithelial cells move quickly over a flat surface

at nearly 0.5 mm per hour.

There are differences depending on the study,

but compared with a dry environment, the speed of re-epithelialization

is reported to be about twice as fast.

Because it closes quickly and smoothly,

melanocytes are less stimulated,

and the risk of hyperpigmentation also decreases.

That 46-year-old patient I mentioned earlier

had another boil squeezed in a different area,

so this time I had her apply DuoDERM right away

within the first 24 hours.

She changed it once every 3 to 4 days,

and when I checked two weeks later, there was almost no mark left.

Even she said, "Is this really the same person's skin?"

Dr. Wi Young-jin's key summary

A scab is not a "sign of healing"

it's a "sign that healing is happening in a dry environment."

If you want to avoid scars,

starting moist wound dressing within the first 24 to 48 hours

after the wound appears is the most decisive step.

So when exactly should I

apply DuoDERM?

But it's not always a good thing.

DuoDERM is not a cure-all for every wound.

If you apply it blindly to a wound where infection is suspected,

you can actually trap bacteria inside,

which may make the condition worse.

If the skin around the wound becomes red and swollen

and there's warmth or throbbing pain,

seeing a doctor comes before DuoDERM.

That said, for simple wounds after squeezing

or superficial abrasions,

it's still the easiest and most effective

tool for preventing scars.

3 things patients really ask me a lot,

and I'll answer honestly

Q1. When I put DuoDERM on, it swells up and turns white. Do I

need to remove it, or leave it on?

This is a bit tricky, but the whitening and swelling

is a normal reaction as DuoDERM absorbs the exudate

and turns into a gel.

It's not a problem;

it means it's doing its job well.

But if the swollen area reaches the edge of the patch

or exudate starts leaking out from the edges,

then you should replace it.

Usually, one sheet lasts about 2 to 4 days.

The amount of exudate differs from person to person,

so it's hard to give an exact number of days.

Q2. A sheet of DuoDERM costs several thousand won,

so do I need to keep it on that long to avoid scarring?

To be honest,

the first week is the most important.

The 24 to 48 hours right after a wound forms

is when re-epithelialization is most active.

If you maintain a moist environment well during this period,

you don't need to obsessively keep applying it after that.

Usually, a small boil-extraction site

needs only about 2 to 3 patches.

In terms of cost, that's under 10,000 won.

Compared to the cost of filling in

a depressed scar with laser treatment later,

this is much more economical.

Q3. It itches after I put on DuoDERM,

is that an allergy?

This is something many people misunderstand,

but don't automatically connect itching with an allergy.

During wound healing,

a little itching while re-epithelialization is happening

is a normal reaction.

But if, when you remove the patch, you see a red rash

in the exact shape of the patch,

or if blisters have formed,

there's a chance of contact dermatitis.

In that case, remove it right away and switch to a different

type of dressing or ointment.

I hope today's article was helpful.

In the next article, I'll explain the 24 hours after squeezing acne,

and the scar-prevention routine I tell patients in the clinic."

I'll go over it.

Why does one person scar from squeezing in the same spot

while another stays clear?

I'll show you with concrete cases.

This has been Wi Young-jin.

Read together

• Pitted scars, gone with one CureJet treatment? Why that claim is dangerous

• DuoDERM replacement interval: just know this

• "Will one CureJet session fill in all pitted scars?" The reality, as told by a doctor