Causes of itching after Contractubex gel

Scars, cicatrices, stitches on the skin do not look aesthetically pleasing and greatly spoil a person’s appearance. Even small excisions, pits, tubercles of a violet-red or white hue are always noticeable, especially on the face, neck, and hands. To get rid of them, use pharmaceutical ointments and creams with regenerating properties. For example, Contractubex promotes rapid healing and disappearance of skin defects. What kind of drug is this, and how to use it correctly?

What effect does it have?

Healing ointment for scars Contractubex has the following properties:

• Regenerating. Stimulates the rapid restoration of the epidermis, due to which spots on the skin disappear without a trace.
• Protective. The application field forms a protective film that prevents the negative impact of environmental factors on the skin.
• Anti-inflammatory. Stops the inflammatory process in damaged tissues and soothes the skin.
• Preventive. Suppresses the synthesis of fibrin - the basis of scar tissue.

Interesting! The drug is available in the form of a gel, which can be called a cream or ointment. This is one and the same remedy, with the same composition and identical healing effect.

The ointment composition evens out the relief of the epidermis, increases its firmness and elasticity. Active ingredients penetrate deep into the skin, providing a healing effect from the inside and outside. However, they are not absorbed into the bloodstream and do not cause serious side effects.

Mederma - features

Mederma belongs to a new generation of modern drugs, the action of which is aimed at accelerating tissue regeneration. It also has anti-inflammatory and fibrinolytic effects. All components in the composition complement each other well, creating a unique formula for smoothing and eliminating collagen scars.

The composition contains the following substances:

1. cephalin – has a bactericidal effect, prevents inflammatory and purulent complications;
2. allantoin – prevents the appearance of unpleasant symptoms that accompany the scarring process, eliminates itching, soothes the skin;
3. auxiliary components - flavor, water, sorbic acid, xanthan and methylparaben.

Due to this composition, the drug has a complex positive effect on the skin in the presence of scars. Substances help eliminate defects by softening and smoothing them. The product also prevents allergization and has an antiproliferative effect. The keratolytic effect, in turn, which allantoin has, promotes better penetration of all substances into the layers of the skin.

Composition of the ointment

The ointment (gel or cream) contains:

• Onion extract. It releases special mediators that suppress inflammation and has antiseptic and antiallergic properties. Stimulates collagen production in the deep layers of scar fibers, making them less noticeable. Stops the formation of excess tissue in the area of ​​damaged integument.
• Heparin sodium. Restores epidermal cells, softens the keratinized surface of scar tissue, and has moisturizing properties.
• Allantoin. Soothes the skin, relieves irritation, eliminates itching and redness. Softens the epidermis, stops the proliferation of bacteria, activates the regeneration process in cells.

Auxiliary components include methylparaben (preservative), PEG 200, sorbic acid (natural antiseptic preservative), purified water, flavorings, xanthan gum (thickener with moisturizing properties). The gel/ointment is light brown in color and has a characteristic odor.

Beneficial properties of Contractubex for body skin

Contractubex has a positive effect on the skin of the body:

• perfectly softens and moisturizes the skin;
• has an anti-inflammatory effect due to the presence of onion extract in its composition;
• reduces allergy symptoms;
• stops the growth of keloids (scars) by suppressing mitosis (cell division) and reducing the formation of certain substances outside cells;
• has a bactericidal effect on the skin;
• heparin, which is part of Contractubex, has antiallergic, antiproliferative (reduces the rate of division of connective tissue cells that lead to scar formation) and anti-inflammatory effects on the skin;
• helps improve hydration (moistening) of tissues;
• allantoin, which is part of the product, heals wounds and improves the absorption of water into skin cells;
• reduces itching.

Indications for use

Combined cream for scars Contractubex is used for:

• the presence of hypertrophic, keloid, atrophic skin defects;
• joint inflammation;
• Dupuytren's disease, which arose against the background of chronic alcoholic hepatitis;
• stretch marks that appeared during pregnancy and after childbirth, as well as after sudden weight loss;
• treatment and prevention of marks formed after surgery;
• burns, acne;
• traumatic tendogenic contractures;
• treatment of marks left after laser tattoo removal.

Hypertrophic and keloid scars

Scars are the result of replacement of damaged own tissues with rough connective tissue as a result of surgical interventions and various traumatic factors (mechanical, temperature, chemical, ionizing radiation, deep destructive inflammation, etc.) [1, 2, 3]. Scars, being a pronounced cosmetic defect, often lead to psycho-emotional discomfort, as well as the development of psychosocial maladjustment and a decrease in quality of life.

Scar formation goes through several stages:

1. Stage 1 - inflammation and epithelization on days 7–10 after injury. The edges of the wound are connected by fragile granulation tissue; there is no scar as such yet. This period is very important for the formation of a thin and elastic scar - it is necessary to prevent suppuration and divergence of the edges of the wound.
2. Stage 2 - formation of a young scar. This is 10–30 days after the injury. Collagen and elastin fibers begin to form in the granulation tissue. Increased blood supply to the injury remains - the scar is deep pink in color.
3. Stage 3 - formation of a “mature” scar lasting from 1 to 3 months after injury, blood vessels completely disappear, collagen fibers line up along the lines of greatest tension. The scar becomes light and dense.
4. Stage 4 - final transformation of the scar. Duration 4–12 months after injury.

Scar formation occurs mainly due to the extracellular matrix, in particular with the help of collagen. The extracellular matrix is ​​a supromolecular complex that includes chemical compounds of various types (proteins, polysaccharides, proteoglycans, and others). It can be compared to a gel in which fibrous proteins (collagens and elastin) and viscous proteins (fibronectin, laminin) “float”, ensuring the interaction of molecules with each other and with cell surfaces [2, 9, 14, 17]. Of all proteins, collagens constitute the main component of the extracellular matrix and are the most abundant proteins in the body, accounting for about 1/3 of all its proteins. These are water-insoluble extracellular glycoproteins synthesized by fibroblasts, chondroblasts and osteoblasts. Due to the shape of the protein molecule, collagens are classified as fibrillar proteins [16]. The growth of excess extracellular matrix in the scar occurs as a result of the activity of “wound” fibroblasts. In intact (healthy) skin, fibroblasts are responsible for remodeling the components of the dermis; they destroy old collagen and lay down new one. During wounds, injuries, burns and surgical interventions, myofibroblasts appear in the wounds, which strive to “close the gap” in the tissues, intensively depositing components of the extracellular matrix: collagen, glycosaminoglycans, elastin and other proteins. It is due to the proliferation of fibroblasts and their production of excess extracellular matrix that scar growth occurs [2,19].

The following types of scars can be distinguished: normotrophic, hypertrophic and atrophic. During a normal physiological process, a normotrophic scar is formed. These are flat, light-colored scars with normal or reduced sensitivity and elasticity close to normal tissue. Such scars are optimal. In a typical wound, 6–8 weeks after injury, a balance between anabolic and catabolic processes is established. At this stage, the strength of the wound is approximately 30–40% of the strength of healthy skin. As the scar develops, its tensile strength increases as a result of the progressive bonds of collagen fibers.

When the connective tissue reacts excessively to injury against the background of unfavorable healing conditions (inflammation, scar stretching, etc.), hypertrophic scars are formed. Under conditions of hypoxia and inflammation, fibroblasts are activated by biologically active substances. Undifferentiated, pathological, functionally active cells with a high level of collagen synthesis appear. The formation of collagen prevails over its breakdown due to a decrease in the production of collagenase, a specific enzyme that destroys collagen, as a result of which powerful tissue fibrosis develops in the form of hypertrophic or keloid scars. Hypertrophic scars are often combined into a group with keloid scars due to the fact that both types are characterized by excessive formation of fibrous tissue and arise as a result of inadequate inflammation, the addition of a secondary infection, a decrease in local immunological reactions, etc. However, there are also significant differences, such as: on the basis of which differential diagnosis is carried out between these two types of scars, which will be mentioned below [3].

Atrophic scars result from a decreased response of connective tissue to injury. Not enough collagen is formed. Atrophic scars are located below the level of the surrounding skin (sink). With a small width, they practically do not differ from normotrophic ones. Often, atrophic scars appear in places of former exfoliation (acne) - the so-called “post-acne”.

Keloid (keloidum: Greek kele bulging, swelling + eidos appearance; synonym: Alibera keloid) is a dense growth of connective tissue of the skin, reminiscent of a tumor [2]. Keloid scars develop as a result of a perverted tissue reaction to injury; this is a special, most severe group of scars that differ from others in appearance and pathogenesis. As a rule, keloids form against the background of reduced levels of general and tissue immunity. When examining keloid tissue, extremely active fibroblasts are found, the degree of their activity is 4 times higher than that of cells during the normal healing process [9]. Collagen (mostly immature) is located in the form of wide loose bundles and nodes, elastin is absent. A keloid scar has an elastic consistency, an uneven, slightly wrinkled surface. Keloid is usually classified into true and false. A true (spontaneous) keloid scar occurs spontaneously without any prerequisites, most often on the skin of the chest, along the outer surface of the upper third of the shoulder, and in rare cases throughout the body. A false keloid can develop in any place where there has been previous trauma to the skin (mechanical, burn, etc.). For example, a casuistic case was observed by Chawla B., Agarwal A., Kashyap S. (2007), who diagnosed a keloid formation on the cornea of ​​the eye after surgery. Currently, this classification is relative. Most researchers believe that spontaneous keloid is preceded by microtrauma to the skin and etiologically it is no different from a false one (in pathogenesis and morphology, these scars are absolutely identical) [2]. A keloid at the site of abrasions or scratches is a raised area. The color and intensity of the color depends on the degree of vascularization (bright pink, pale, cyanotic). A keloid scar is characterized by pulsating growth, like the ebb and flow of the tide. Scar tissue in keloids extends beyond the original wound, usually does not regress spontaneously, and tends to recur after excision.

Theoretically, keloid can appear at any age, but most often develops during and after puberty. Young individuals are more likely to be injured, and young skin creates more tension, while older skin is less elastic and more rigid. Collagen synthesis levels are also higher at younger ages. Currently, the average age of patients is 25.8 (22.3 in women and 22.6 in men) [5].

Typically, diagnosing a keloid is not difficult. Gulamhuseinwala N., Mackey S., Meagher P. (2008), who conducted a retrospective study of 568 patients with keloids, found that the clinical diagnosis coincided with the histological diagnosis in 94% of cases. However, when scars begin to appear, the question of differential diagnosis between hypertrophic scar and keloid arises. As mentioned above, there are significant differences between these types of scars. The growth of a hypertrophic scar begins immediately after healing and is characterized by the formation of “plus tissue”, an area equal to the wound surface, while the boundaries of the keloid always extend beyond the damaged area. With a hypertrophic scar, subjective sensations are absent or insignificant. Keloid formations cause various subjective sensations (itching, pain, feeling of skin tightness, parasthesia, etc.). The change in color of a hypertrophic scar from pink to whitish occurs at the same time as in normotrophic scars, and over time they noticeably flatten. The keloid remains deep in color and does not regress spontaneously. Typically, one patient has several keloid formations. Keloid scars are most common in people aged 10–30 years, while hypertrophic scars can occur at any age. The morphological picture also has significant differences. It is known that collagen synthesis in keloids is approximately 8 times higher than in hypertrophic scars, which explains the lower quantitative content of collagen fibers in hypertrophic scars, and therefore the mass of the scar. In hypertrophic scars there are fewer fibroplastic cells than in keloids, and there are no giant, immature forms of the “growth zone” [1, 7, 8, 9, 12, 21].

Researchers have noted an unequal frequency of localization of keloid formation in individuals of different races. For example, in white-skinned people, keloids often form on the face (cheek and ear), upper extremities and sternal area; and in Asians the sternal region is almost not affected; in blacks, along with the auricle and neck, the lower extremities are more often affected [5]. This suggested the leading role of heredity in keloid formation. However, to date, no specific gene or set of genes has been identified as being responsible for keloid development [5, 8]. In addition, no significant differences were found between keloid DNA fibroblasts and normal skin DNA fibroblasts. This suggests that what is important in the development of keloid formation is not the increase in the number of fibroblasts producing normal amounts of collagen, but rather that each fibroblast produces more collagen than is necessary for wound repair [13].

Treatment of keloid and hypertrophic scars

The first rule in the treatment of keloids and hypertrophic scars is their prevention. First, unnecessary cosmetic surgery should be avoided in patients prone to keloid formation and severe scarring. A possible exception would be a disfiguring keloid on the pinna. If surgery cannot be avoided, closure of all surgical wounds should occur with minimal tension along the skin folds whenever possible. It is advisable that the incisions do not pass through the surface of the joints and in the middle part of the chest.

Treatment methods for keloid and hypertrophic scars can be divided into several groups:

• medications (corticosteroids, immunomodulators, drugs affecting collagen formation);
• physical and physiotherapeutic (use of occlusive dressings and compression therapy, excision, cryosurgery, laser therapy, electrophoresis, etc.);
• radiation therapy;
• cosmetic procedures aimed at external correction of the defect.

Medicines

Corticosteroids. Intraruminal steroids remain the mainstay of treatment. Corticosteroids reduce scar formation by reducing the synthesis of collagen, glycosaminoglycans, inflammatory mediators, and fibroblast proliferation during wound healing. The most commonly used corticosteroid is triamcinolone acetate at a concentration of 10–40 mg/mL, administered into the injured area by needle injection at 4–6 week intervals. The effectiveness of such an introduction as a monomodel and as an addition to the scar excision procedure is very high. Topical corticosteroids are also widely used, which are applied daily directly to the formation. Complications of corticosteroid treatment include atrophy, telangiectasias, and pigmentation disorders.

Immunomodulators. A new method in the treatment of keloid and hypertrophic scars is interferon therapy. Interferon injected into the suture line after excision of a keloid scar can prophylactically prevent relapses. It is recommended to administer 0.5–1.0 million IU every other day for 2–3 weeks, then 0.1–0.5 million IU 1–2 times a week for three months.

Drugs that reduce hyperproliferation of connective tissue cells. The classic treatment for scars is hyaluronidase. Hyaluronidase breaks down the main component of the interstitial substance of connective tissue - hyaluronic acid, which is a cementing substance of connective tissue, and thus increases tissue and vascular permeability, facilitates the movement of fluids in the interstitial spaces; reduces tissue swelling, softens and flattens scars, and prevents their formation. Preparations containing hyaluronidase (Lidase and Ronidase) are obtained from the testes of cattle. Lidase solution (1 ml) is administered in these cases near the site of the lesion under the skin or under scar tissue. Injections are made daily or every other day; the course of treatment consists of 6–10–15 or more injections. If necessary, repeat courses are carried out at intervals of 1.5–2 months.

A new enzyme preparation for the treatment of diseases accompanied by the growth of connective tissue is Longidaza. "Longidase" is a chemical compound of hyoluronidase with polyoxidonium. The combination of the enzymatic activity of hyaluronidase with the immunomodulatory, antioxidant and moderate anti-inflammatory properties of polyoxidonium provides a wide range of pharmacological properties. It is most effective to use the drug "Longidaza" by ultraphonophoresis or phonophoresis. For ultraphonophoresis, Longidase 3000 IU is diluted in 2–5 ml of gel for ultrasound therapy. The impact is carried out with a small ultrasonic emitter (1 cm2), with an ultrasound frequency of 1 MHz, intensity 0.2–0.4 W/cm2, in continuous mode, exposure time 5–7 minutes, course of 10–12 procedures daily or every other day . Using the phonophoresis method (1500 Hz), 3000 IU of Longidase is administered daily (total exposure time 5 minutes, course - 10 procedures). It is also possible to administer the drug inside the scar:

1. small keloid and hypertrophic scars: Longidaza 3000 IU once every 7 days for a total course of 10 injections into the scar;
2. keloid and hypertrophic large area of ​​​​the lesion: Longidase 3000 IU 1 time in 7 days inside the scar in a course of 8-10 injections, at the same time intramuscular injection of Longidase 3000 IU No. 10.

A well-known drug that inhibits the proliferation of connective tissue cells and at the same time has an anti-inflammatory effect is Contractubex. For many years, Contractubex has been used in surgery and cosmetology in the treatment of postoperative and post-burn scars, including rough scars that impede movement and keloids, as well as stretch marks (striae) after childbirth or after sudden weight loss.

The enzyme preparation of 9 collagenolytic proteases “Fermenkol” is a fundamentally new proteolytic drug. The anti-scar effect of Fermenkol is based on the reduction of excess extracellular matrix in scar tissue. The effect when using anti-scarring agents is observed approximately 3 weeks after the start of use of the product and the optimal result is usually achieved after 2-3 courses of electrophoresis or phonophoresis, 10-15 sessions or applications for 30-60 days.

Physical and physiotherapeutic methods

Silicone sheets and silicone occlusive dressings have been used with varying degrees of success in the treatment of hypertrophic scars and keloids. When using silicone dressings, the effect is more a result of a combination of pressure and surface hydration than the effect of the silicone itself. Studies show that the effectiveness of such dressings when used 24 hours a day for 12 months was observed in only ≈1/3 of patients [20]. The compression/pressure method achieved with silicone sheets causes thinning of the skin. In one study, applying two plates to the earlobes after keloid removal prevented its recurrence for 8 months to 4 years. A significant discomfort of the method is the need to wear bandages/plates throughout the day, as well as the impossibility of attaching them in some anatomical areas (folds, neck, etc.). Other devices (special compression garments and zinc oxide patches) are also used 12 to 24 hours a day for 8 to 12 months, which is a clear disadvantage of the method. According to various authors, their effectiveness does not exceed 40% [4, 5].

Cryosurgery. Cryosurgical agents, such as liquid nitrogen, attack the microvasculature and cause cell death through the formation of intracellular crystals. Typically, 1–3 freeze-thaw cycles of 10–30 seconds are sufficient to achieve the desired effect. Particular attention should be paid to the short duration of liquid nitrogen applications to avoid the appearance of reversible hypopigmentation. Please note that cryotherapy can be painful and cause depigmentation. A more promising method is the combined effect of cryotherapy and corticosteroids [15]. A simple and effective method of facilitating intraruminal steroid injection is to apply very light cryotherapy prior to injection, a step that will cause tissue swelling and subsequent cellular and collagen destruction. Liquid nitrogen is applied for 5-15 seconds, without allowing the skin to freeze. This technique allows for better distribution of the drug in the keloid tissue and minimizes its penetration into surrounding tissues.

Laser therapy. Argon laser (488 nm) is similar to carbon dioxide laser and can promote collagen contraction through local heating. A pulsed dye laser (585 nm) causes a process of photothermolysis, leading to microvascular thrombosis. In the early 1980s, authors noted that with the use of pulsed dye laser, scars became less erythematous, softer, and less hypertrophic. Laser treatment of keloids and hypertrophic scars using a carbon dioxide laser (10,600 nm) can ablate (can cut and cauterize) the lesion, creating a dry surgical environment with minimal tissue trauma. When carbon dioxide laser is used as a single model, the recurrence rate of keloid is quite high, so it is recommended to combine laser treatment with postoperative steroid administration, which significantly reduces the recurrence rate.

Radiation therapy. The use of radiation therapy to treat keloids remains controversial. One retrospective study found that the use of superficial radiation therapy after scar resection caused recurrence in 53% of patients [18]. Preoperative treatment of scars with a solution of hyaluronidase, followed by surgical removal and then external irradiation, is considered more promising to reduce the likelihood of relapse [6].

X-ray therapy (Bucchi rays) is based on the action of ionizing radiation on connective tissue, causing swelling and destruction of collagen fibers and fibroblasts. X-ray therapy is prescribed up to 6 irradiation sessions with an interval of 6–8 weeks at a single dose of up to 15,000 R. Only the superficial layers of the skin (in particular, the scar) are exposed to ionizing radiation, and the X-ray load on the underlying tissue is insignificant. Contraindications to Bucca therapy are kidney disease, circulatory decompensation, the presence of dermatitis and residual wounds. The idea of ​​using x-ray therapy is very rational, because in the case of destruction of a certain number of fibroblasts, a balance is achieved between the synthesis and degradation of complex collagen, up to a change in its very structure. This idea, in particular, has been implemented using modern laser technology. The total radiation dose to prevent recurrence of a keloid is 15 to 20 Gy. They also recommend one-time irradiation of the wound on the day of suture removal in the same doses - 15–20 Gy. Sometimes this procedure is repeated up to 6 times at intervals of 1.5–2 months.

Excision. It is advisable to avoid surgery, especially if a keloid is present. Excision relapses in 45–100% of cases and should only rarely be used as a standalone model of therapy. After excision, long-term anti-relapse therapy is necessary. Whenever possible, wound pressure bandages and linens are used in the early postoperative period. Reducing relapses is achieved by combining excision with other methods, such as radiation or radiotherapy, interferon or corticosteroids [10].

After surgical interventions or skin injuries, it is necessary to take preventive measures to reduce the risk of keloid formation or hypertrophic sutures. The period of active therapy should begin at the 2nd stage of scar formation, i.e. 10–30 days after injury. According to the authors, there is a proportional dependence on the effectiveness of therapeutic treatment on the age of the scars: scars older than 6 months are less responsive to therapy than younger ones. Most likely, the decrease in the effectiveness of therapeutic measures is associated with a decrease in the number of vessels and compaction of scar tissue, which worsens its trophism [3]. Preventive methods may include: occlusive dressings, compression therapy, external applications or intradermal administration of glucocorticosteroids, Contractubex, Longidase, immunotherapy.

With a formed scar with a duration of up to 12 months, it is possible to carry out therapy with all methods, and with a long-term formation (more than 12 months), only aggressive methods are effective: injection of corticosteroids into the affected area, excision, radiation therapy, Bucca therapy, laser therapy.

Cosmetic procedures aimed at external correction of the defect. The most popular cosmetic procedures (peelings, mesotherapy, dermabrasion) do not serve any therapeutic purpose when affecting scars. The use of these methods contributes to the aesthetic correction of small scars. It is important to know that hypertrophic scars can be resurfaced only after they have reached a calm state. To obtain satisfactory results in the treatment of scars with a duration of more than six months, cosmetic procedures must be combined with 1–2 injections of corticosteroids (Diprospan) [2]. Sandblasting dermabrasion (10–15 sessions with an interval of 10–14 days) with a standard course of treatment provides satisfactory results, but when conducting two courses of 10–15 procedures, the effectiveness of treatment increases [2]. Surgical dermabrasion of hypertrophic scars requires re-operation after six months. Complete epithelization of hypertrophic scars after deep surgical dermabrasion occurs much later than epithelization of normotrophic and hypotrophic scars and lasts for 3–4 weeks, even when using wound healing ointments [2]. O. S. Ozerskaya (2002) performed a transplantation of autologous keratinocytes to prevent recurrence of scars after dermabrasion. Unhindered removal of the bandages is possible on days 7–8; complete epithalization of the scars occurred within up to 14 days. Thus, a significant acceleration of epithalization during dermabrasion of scars with keratinocyte transplantation is obvious. To avoid even greater hypertrophy and hyper- or depigmentation, hypertrophic scars cannot be corrected using aggressive methods, and medium peels can be done only after a course of superficial peels. As for keloid scars, it is better not to expose them to irritating methods, since there is a high probability of provoking their further growth.

Peeling with fruit acids. During peeling, dead skin cells are exfoliated and the regeneration processes of its deep layer are stimulated. Fruit acids gently penetrate the skin without damaging it and stimulate the production of collagen and elastin. Thanks to this, the elasticity of the skin increases, the relief is evened out and hyperpigmentation is reduced, which externally corrects the cosmetic defect of small scars.

Chemical peels. For small, mildly expressed hypertrophic scars, chemical peels are best performed in two stages. At the same time, in daily home care on the 21st day, in order to smooth out scar hypertrophy, a silicone dermatological cream is included, which creates an occlusive film, protecting the skin from moisture loss, relieves inflammation and erythema, and stimulates repair. In parallel with peelings, you can conduct mesotherapy sessions with regenerants and local microcirculation enhancers. Treatment of mildly expressed hypertrophied scars after a course of chemical peels can be continued with topical medications. For severe hypertrophic scars, peelings are carried out six to eight months after excision of the pathological scar or a course of physiotherapy (galvano-, phonophoresis) with hyaluronidase and heparin. The course of chemical peelings is also carried out in two stages: first, several sessions of multi-fruit peels (glycolic, salicylic, lactic, citric acids) once a week, then a complex retinol yellow peeling. Peeling is performed according to an individual scheme in accordance with the parameters of the scar and skin reaction.

In conclusion, it should be noted that the therapy of keloid and hypertrophic scars, with all the variety of treatment methods, requires a strictly individual approach, taking into account the main parameters of the scar: the size and duration of its existence.

For questions regarding literature, please contact the editor.

Yu. A. Gallyamova*, Doctor of Medical Sciences Z. Z. Kardashova** * RMAPO, ** Russian State Scientific Center, Moscow

Key words: hypertrophic scars, keloid scars, keloid disease, keloid, keloid formation, keloid treatment, scar treatment, scar prevention.

Side effects

Undesirable side effects with the use of Contractubex ointment/gel occur extremely rarely. The most common of them are signs of allergies: burning, redness, dermatitis. Some patients report itchy sensations on the skin after application. If the itching is not severe, discontinuation of the drug is not required, since such a symptom may be associated with tissue restructuring of the epidermis in the affected area.

In rare cases, there is a change in the appearance of scars. They may swell a little, increase in size, and change color. This is considered a normal reaction during therapy with this drug.

Contraindications

Whether Contractubex helps with scars is of interest to many people. The product has proven its effectiveness in practical use. However, not everyone can apply it to the skin. If a person has hypersensitivity to at least one of the active ingredients in the composition, he should use another drug.

It is also not recommended to use the gel/ointment if:

• alopecia in men;
• atopic dermatitis;
• trichomycosis.

If the drug is used for the first time, it is worth conducting an allergy test. To do this, apply a little ointment to the bend of the elbow and observe the body’s reaction for 24 hours. If redness, itching, and irritation are not observed, the ointment can be safely used for medicinal purposes.

Doctors' opinion

The opinions of doctors regarding the possibility of using Contractubex against wrinkles are ambiguous.

Violetta Semyonovna Belasina, 29 years old, Krasnodar

I do not recommend using Contractubex for wrinkles on your own without consulting a specialist. The drug contains 3 potent ingredients that may cause unexpected reactions.

Svetlana Gennadievna Nichiporuk, 47 years old, Murmansk

Contractubex for wrinkles under the eyes should be used with caution. Do not allow the product to come into contact with your eyes. The cosmetics industry produces many products specifically designed to eliminate wrinkles. It is advisable to purchase products designed specifically for aging facial skin.

Mode of application

Ointment (gel) is intended for external use only. Depending on the degree of damage and old age of the marks, it is used in different ways. For example, patients using Contractubex leave positive reviews of scars after surgery. They note that doctors prescribe the gel immediately after removing stitches as a preventive measure for deep marks from healed wounds.

Fresh scars

Therapy begins immediately after the wound has healed. The medicine is applied to the damaged area, rubbing from the center to the edges until completely dry with slow, careful movements so as not to injure the recently healed wound mark. Treatment is carried out three times a day for 30 days.

The ointment is successfully used in the treatment of chickenpox and acne scars. Before the procedure, the skin is cleansed with a cleanser, an antiseptic solution is applied, and then the medicine is rubbed in. The duration of the course depends on the depth of the damage and the speed of healing.

Interesting! The drug is quite economical, as it has low consumption. One treatment requires no more than 2-3 g of product. To get rid of fresh scars, you only need one package of gel or ointment.

Old marks on the skin

Removing old scars is a long process, lasting 3-6 months. The drug is applied at night before going to bed and secured with a bandage made of polyethylene, gauze and adhesive medical tape. If problem areas are in the elbows, knees or feet, treatment is carried out using baths. To do this, add 2 cm of Contractubex ointment to 1 liter of warm (warmed to 36-38 degrees) water. The damaged area is immersed in the resulting solution for 15-20 minutes.

The patient will be able to see whether Contractubex helps with scars 4-5 weeks after regular application. By the end of the first month of corrective treatment, the defect on the skin will turn pale, bright redness will disappear, and the scar itself will become much more elastic. The final result appears after at least 6 months, and sometimes the process of restoration of the epidermis is delayed for a year.

Where to buy and how to store?

This drug can be bought without a prescription in any city at a pharmacy or ordered in an online store. There are gels on sale in tubes of 50, 20 and 10 g. The drug must be stored in a place away from children, at room temperature away from sunlight. The product can be used for 4 years from the date of its production.

On average, the cost of a gel package is 500-900 rubles lei, which will depend on the volume of the tube. A 10 g tube will be enough for the first time. If we consider analogues of the drug with similar compositions, then these include: Veniatin Forte, Lidaza, Strataderm gel.

Analogues of Contractubex

The average cost of ointment 20 g is 650 rubles, and 50 g is 900 rubles.

If a patient wants to find a cheaper analogue of Contractubex, he can opt for the following pharmaceutical products:

• Vaseline . Costs 35 rubles for a 25 g tube. Moisturizes and softens rough scar tissue, forming a protective waterproof film on the surface. The use of this drug will be much more effective with parallel massage of healed wounds.
• Heparin ointment . Costs 100 rubles. A combined product for external use that has anticoagulant, antiexudative, and anti-inflammatory effects. Improves microcirculation, promoting the resorption of hematomas and reducing swelling of damaged skin tissue.
• Camelox gel . Costs 250 rubles. Promotes restoration of the epidermis, softens the surface of rough scars, improves the elasticity of the integument, stimulates collagen synthesis, and inhibits the formation of scar cells.
• Hepatrombin . Costs 250-300 rubles. Relieves inflammation, removes swelling, accelerates wound healing, relieves pain, and prevents skin infection.
• Gel for scars Venitan Forte . Costs 300 rubles. Removes marks even from old thick marks left after surgery. Contains heparin, dexpanthenol, allantoin.
• Gel Dolobene . Costs 300 rubles. It contains dimethyl sulfoxide, which is why it has more contraindications than Contractubex. Heals wounds, relieves inflammation, gets rid of stretch marks on the stomach and chest. Can eliminate scars of varying severity and origin.

If we consider similar drugs for scars and scars, you can pay attention to the following drugs:

• Imoferase cream for the treatment of acne spots and scars. Costs 700 rubles. It is also used for burns of any degree, raised marks after operations, the effects of acne, skin diseases resulting from tattoo removal or piercing removal. Increases the elasticity of the epidermis, removes postpartum stretch marks, and prevents the formation of deformations and compactions during the healing of scars and wounds.
• Gel Solcoseryl 10%. Costs 450 rubles. Prescribed for minor skin damage (abrasions, scratches, cuts), 1st and 2nd degree burns, frostbite. Improves the transport of useful elements to epidermal cells, activates tissue regeneration, and inhibits the formation of scars. Softens the skin, helps retain moisture, destroys pathogenic flora and smoothes out unsightly marks from healed injuries.
• Gel Dermatix . Costs 1300 rubles. Prevents the formation of scar tissue and scars after acne and other skin damage. Consists of organic components. Maintains normal water balance of the epidermis, smoothes and reduces protruding parts of connective fibers.

Imoferase Solcoseryl Dermatix

Composition and release form

The drug is dispensed in the form of an ointment for external use. It has a water base with a light brown tint. Packaged in aluminum tubes and secondary paper packaging of 20 or 50 g.

The active components are:

1. Onion extract.
2. Allantoin.
3. Heparin.

Additional substances: pure water, sorbic acid, polyethylene glycol, perfume, methyl 4-hydroxybenzoate.

special instructions

The medicine has its own application features:

• it is necessary to strictly follow the instructions and apply the ointment regularly;
• Before applying the treatment composition, clean the treated area from dirt and wipe it dry;
• apply gel/cream only to healed wounds and abrasions;
• distribute the drug from the center of the skin defect, moving towards the edges;
• rub until completely absorbed using light massage movements;
• During the entire therapeutic course, avoid direct exposure to sunlight on scars, and also avoid hypothermia and injury to problem areas;
• do not apply decorative cosmetics to the treated areas;
• in the cold season, the procedure for applying the product should be carried out no later than 60 minutes before going outside;
• the amount of ointment/gel for one treatment is calculated in the ratio of 1 mm of preparation per 5 cm2 of skin.

Treatment of scars from acne, wounds, chickenpox, etc. with Contractubex ointment/gel will be much more effective if the effect of the medicine is enhanced by physical procedures and preliminary steaming of the skin. This will speed up recovery several times.

Important! The medicine is stored at a temperature not exceeding 25 degrees. Otherwise, it will lose its original healing properties.

Use in children

In children under 1 year of age, the gel is not used. From 1 year of age, the product can be applied to treat chickenpox scars 1-2 times a day. If a child has rashes on his body, Contractubex gel cannot be used. This is stated in the official instructions for the drug.

Use during pregnancy and lactation

The manufacturer indicates in the instructions that the ointment/gel is not a contraindication for use in pregnant and lactating women. The active ingredients are not absorbed into the systemic circulation, which means they do not penetrate the placental barrier to the fetus or through breast milk to the newborn. Therefore, the drug does not cause any harm to mother and baby.

During the process of bearing a child, white, unsightly stretch marks appear on the body. It's quite difficult to get rid of them. For the ointment to work, it must be applied 2-3 times a day for 1 month. Over time, stretch marks lighten and tighten.

Combination with alcohol

You can drink alcohol while using this drug. Contractubex ointment contains no substances that adversely affect the functioning of the liver, kidneys and heart. However, there is no data on the effect of ethanol breakdown products on the therapeutic effect of the external agent.

Drug interactions

Contractubex ointment or gel for acne scars and scars of various origins can be combined with other medications only after consultation with a specialist.

Rules for using Contractubex for wrinkles

The product was originally developed to eliminate scar tissue. The instructions for use of the drug do not contain information about the effectiveness of using the drug against wrinkles.

Attention! Before applying the product, experts recommend carefully reading the instructions for use of Contractubex.

When using the gel, you need to focus on the following steps:

1. Cleansing. The skin of the face should be thoroughly cleaned of dead cells using a scrub. Before applying the medication, the face should be rinsed with water.
2. Steaming. The skin is steamed to open its pores to increase the effectiveness of the anti-wrinkle drug. Cosmetologists recommend using decoctions of medicinal herbs. You can also apply a hot towel to your face for steaming.
3. Application of the product. The gel is applied with light rubbing movements to problem areas.

To eliminate wrinkles, the gel is used daily for 2 months. The course can be repeated after a break.

Attention! Please note that Contractubex is not intended to remove wrinkles. This explains the lack of effect in the presence of individual skin characteristics.

Advantages and disadvantages

The advantages of a medicinal product for external use include:

• effectiveness in the fight against various cosmetic defects: scars, cicatrices, post-acne;
• the ability to eliminate both fresh traces of subcutaneous and purulent acne, healed wounds of chickenpox and herpes, and to heal old, rough, scarred tissue;
• absence of serious contraindications and side effects;
• Possibility of use during pregnancy and lactation;
• ease of application: the product does not have a corrosive odor, is quickly absorbed, leaving no greasy stains.

The disadvantages include:

• high cost of the drug compared to analogues;
• itching at the site of application, which can be confused with an allergic reaction;
• long-term treatment (at least a month for fresh scars, and at least six months for old scars).

Reviews about Contractubex

When asked whether Contractubex helps with scars and stretch marks, 65% of users answered in the affirmative. It has been noticed that when stretch marks are treated for 30-40 days, they turn pale and significantly decrease in size. Fresh scars become barely noticeable after just a few weeks of regular application, but when removing old scars you will need to be patient - sometimes it takes at least one year for the skin in the damaged area to become elastic and elastic again, and for traces of past injuries to turn into barely perceptible marks . This can be seen in the photos with treatment results sent by patients.

Distinctive characteristics

1. Contractubex forms differ in their structure, and therefore in the method of application: the gel is applied by rubbing, and the patch is applied.
2. The composition is different: in the gel it is richer than in the patch, and this affects a wider spectrum of action. But it also causes more side effects.
3. The gel is used 2 times a day, and the patch is used at night.
4. The gel is used in the treatment of children from 2 years of age, and the patch - from 3 years of age.

The gel costs from 493 rubles. up to 955 rub . The price of the patch is from 1449 rubles .