Medical Skepticism and Scar Management
Part 1: The Changing Face of Medical Skepticism
Part 2: Guidelines of Medical Skepticism to Scar Management
The face of Medical skepticism has changed throughout history. At different times it has been the physician, the pharmacist, the medical researcher, the FDA, the insurance companies or the patients themselves. Medical skepticism is important because there is always a balance between the power of belief in the healing process with the power of skepticism in its suspension of belief to arrive a true and correct science of actually physiology. Both may be of at least equal importance but belief may be tied into all successful healing because also includes anything from the success of miracle from supernatural sources to the belief in the power of science and technology. Often placebos work just as well as real medicines. So is the need to reinforce the understanding of Medical skepticism which can be abused and have a negative influence.
A medical skeptical look at Scar management scams for individual patients and non-professional care givers
1. Deceptive Mass advertising Mederma
– Skeptics rating - not recommended. An advertisement or Doctor may recommend Mederma. This product with the main active ingredient as onion extract has failed to prove itself in clinical setting (meaning individual patient success) as well as in scientific studies.
2. Fake scientific associations
- The Scar Association www.scartreatmentassociation.com or www.scar-treatments-center.org recommending the Scarprin cream. Others go by www.scars.net/Review-Scar-Cream and a product called scarinx and scarremovalcenter.org skeptics rating- all not recommended- are complete scam sites to make it seem as though an independent objective scientific organization has actually done comparative studies and independent evaluation of scar management products. They recommend their own product Scarpin, scarinex cheap toxic ineffective products.
3. The claim that all silicones are the same
- Scar creams and ointments that contain silicone. Skeptics rating –not recommended. Most all scientific studies done on the effectiveness of silicone in scar management were done with silicone sheeting, not silicone oils creams of gels. Silicone is not one big homogeneous group . ReJuveness pure 100% medical USP grade 6 silicone sheeting is implantable grade silicone. This means it is completely safe to put on these problem scars which are often compromised and more susceptible to let ingredients into the body. You don’t want to put the silicone oils, creams , and ointments on these scars because they are composed of toxic silicone molecules that can stay in the body a lifetime. That is why silicone-gel breast implants are illegal according to the FDA and hundreds of studies. ReJuveness silicone sheeting is the same silicone as the shell of breast implants. It is not toxic. The toxic component of the silicone scar gels, creams and oils is thought to give whatever little success these products may have. It gets all the macrophages going like crazy in the attempt to rid the body of the toxic large silicone oil molecule. If you decide to go this route you might as well save yourself some money and go to the hardware store and get some silicone lubricant for $2. It is basically the same stuff as what these snake oil salesmen sell for $48.
Ancient Greek Medicine
The best known ancient Greek physician was Hippocrates( 460-377 BC) . Hippocrates is the model of how all doctors should behave towards their patients. Modern day physicians take what is called the Hippocratic oath which acts as a moral guide in their practice. Hippocrates was to point out that it was the patient’s belief in the power of the physician more than anything else which lead to successful healing. Once that belief was gone so was the power of the physician. The Greeks didn’t believe in sophisticated practices such as surgery. It was the Egyptian surgeons who had earlier advanced surgical practices, but this wasn’t adopted by the Greeks who were more in tuned with the psychosomatic aspects After the Hippocratic model, that relied on prognosis rather than diagnosis, Greek medicine started to become more sophisticated.
Three Schools of Medicine in Greece in the Third Century BC
1. Logical or Theoretical school – uses apriority reasoning (priori to & independent of knowledge) about the hidden causes of diseases “deep” causes. Dogmatic
2. Empirical school- denies we can have any knowledge of the deep causes of diseases
3. Methodical school- studies diseases only in terms of the succession of phenomena, refusing to dogmatize about the impossibility or possibility of any knowledge concerning non-evident causes. The third school listed, the methodical school is the philosophy of medicine based on the skeptical medical philosophy.
What is Medical Skepticism?
Medical skepticism was developed by the Greek skeptical philosopher Sextus Empiricus (3rd century BC). Skeptical medical philosophy is based on the “Practical Criterion” which is consistent with the loving life. Unfortunately modern medical practice and research does not apply the “Practical Criterion” consistent with the loving life much anymore. On occasion you may run into a medical practitioner who practices this type of medicine. You can feel the empathy as the physician places their hands and talks to you in a loving way. This practice has seemed to have disappeared in modern medicine. The impersonal non-loving manner in modern medicine has come as a result of the money interest as well as the more scientific approach to medicine. The science we thought would bring progress to medicine has also taken away from what ancient Greek Hippocrates and the skeptic Sextus Empiricus thought to be the most important components – belief and love. Although having its ups and downs Medical skepticism had maintained itself throughout the ages until very recently. Quite frankly it was discovered that with the advent of chemical preparations the doctor could and in some circumstances would keep his patient artificially ill for a lifetime. There was an intermediary needed between patient and doctor to assure medical skepticism was maintained. Frederick the Great (1200 ad) instituted the pharmacist to become this intermediary between physician and patient which assured a balance between patient need and physicians practice. The pharmacist became the operator of medical skepticism that help avoid fanaticism by sharply distinguishing between the arbitrary fiction of remedies that simply grab doctors and patients by their imagination and the ones that grab patients and doctors by their common sense. But medicine has lost much of its balance of truth offered by Medical skepticism as of late.
Modern Medicine was born with scientific skepticism. As witnessed above modern scientific skepticism is different from Ancient Skepticism. The real modern mark of the scientific practice of medicine came at the turn of the 20 century. Folk remedies, old wives tales, snake oil salesman needed the skeptical balance that actual science could give. Even John D. Rockefeller whose schools and foundations have contributed so much to modern medicine and technology had these dubious beginnings:
His incredible rags-to-riches success story owes much to what he learned from his father’s attitudes towards business and respect for the public good. Descended from hardworking German immigrants, his father William Avery Rockefeller was a travelling, snake oil salesman. “Big Bill” excelled as a quack doctor, or pitch man, conning the sick and desperate into buying expensive remedies that were either useless or downright dangerous. “He would be gone for months and come back with a great roll of money…. He would go to small towns and put up handbills advertising himself as ‘The Celebrated Dr. Levingston.’ He advertised to cure anything, but made a specialty of cancer and kidney troubles” (MacDonald, “Double Life,” New York World, February 2, 1908). At the turn of the century we see the institution of the FDA as a skeptical instrument in order to protect the patient and medical community at large from the unscrupulous practice of quackery and bad medicine. Although the FDA has down much good in this line it has also come under much criticism also as an agent of big pharma and money interest. It is said there exist a revolving door between the regulators at the FDA who are suppose to protect the American public and the big Pharma drug manufactures whose interest in profit at times foregoes that protection to the public. The triad of Big Pharma, Insurance companies, and the FDA with their main focus on money seemed to gained dominance over the original triad of Physician, patient and pharmacist. This takeover of Medicine by money interest consisting of Big Pharma, Insurance, and FDA is the topic of discussion for another essay.
To understand Medical Skepticism one needs to forget what immediately comes to mind when the word skepticism is used in its contemporary context. The ancient skeptics positioned themselves against the dogmatic and academic philosophies and stood as an open minded “inquirer”. The Skeptic is simply not a doubter, but accepts only things which are evident. This seems like obvious approach, but modern medicine has its foundation in things which are non-evident, such as probabilities and hidden theoretical causes. Modern medicine also uses dogmatic apriori reasoning about the hidden causes of diseases ,”deep “ etiology that are not immediately apparent to patient or doctor. These theories and proofs can often be what the skeptics call “trickster reason”
Medical Skepticism attempts to avoid practices that raise doubts such as hidden causes and probabilities and attempts to deal with only that which is evident and beyond doubt. The goal of this whole process is “Atraxia” or continual state of unperturbedness, happiness, peace of mind in day to day activities.
Patient should become a medical skeptic
Medicine and medical care have changed in several ways. In the modern setting the patient is apt to find less empathy and love from those who practice medicine if not from anything but the mere pressure to treat more patients in less time. More responsibility is also placed upon the patient to research options for his or her own care. The increase of valuable information on the internet is the perfect vehicle for the patients themselves or the individual care givers in families to play the part of the medical skeptic. Things to watch for as a medical skeptic is “trickster reason”. This means that procedures, solutions or medications offered may not be in the best interest of you or your family member the patient. That means “practical criterion”, the loving way can no longer be trusted in the hands of the physician, but must fall in the hands of the individual or the person who takes on the responsibility of care giver in their respective families and circles. Absent the love offered by the Physician It would be conducive that the individual care givers in families learn the methods of the ancient Medical skeptics.
Medical Skepticism can be applied to the modern patient in several key ways
Right now we are interested in how to reestablish the old “Practical criterion” consistent with the loving life of ancient Greek skeptical medicine developed by Sextus Empeiricus. How does medical skepticism it apply ReJuveness research and the clinical practice of scar treatment.
When I first started ReJuveness in 1995, scar management was a fairly new category for medical research. Clinically the practitioners were really at a loss at a solution for patients who formed Keloids and Hypertrophic scarring. Keloid removal by surgery results in even more severe reoccurrence of the keloid 95% of the time. The Physician had no practical solution to offer for these problem lesions, characterized by overgrowth tumor like discolored and painful scars that lasted many years sometimes. The Physician would often avoid the issue altogether and avoid this particular patient problem. I drew on my study of ancient philosophy in order to frame new approaches to the new emerging field of scar management.
Part 2: Guidelines of Medical Skepticism to Scar Management Guidelines of the Skeptical Philosophy to Scar Management
1. Guidance of Nature-the sensation and thought that their scar is foreign
2. Feeling- compels patient to try to find a way to get rid of the scar B. Healthcare Professional
3. Tradition of laws and customs- adhering to the FDA rules and customs and protocols of the medical community.
4. Instruction of the arts- Doctors and plastics surgeons recognizing effective protocols and products
Scar Management is a confusing medical market category for several reasons. As far as the FDA is concerned “ silicone sheeting is scar management device”. The FDA does not recognize silicone ointments ,gels or oils as effective as scar management and prohibit many of this high percentage liquid forms because of their toxicity (just like the gels in breast implants are considered toxic). The FDA indicated use corresponds with 95% of the research in scar management, which has been done on the safety and efficacy of silicone sheeting on hyper-prolific scarring disorders known as keloidal and hypertrophic scars. Practically speaking, the effectiveness of silicone sheeting goes beyond its FDA indicated use on keloids and hyper-prolific scarring and can be used to prevent problem scarring as well as giving an improved cosmetic affect if not other wised used. The main action of all scar management for all scar treatment and management can be derived from the Keloid wound healing model.
Rejuveness are the choice of both patient and medical professionals who are guided by Medical Skepticism
Keloids or hyper-prolific scarring disorders or actually unhealed scars that are characterized by a compromised Stratum corneum or top layer of skin. They are swollen or tumor like, rubor or red, can be painful or dolor and are unique to the human species. No other creature in the animal kingdom forms these types of problem scarring. Rejuveness had its start in treating severe scarring problems and was dispensed mostly by Plastic surgeons and in hospital burn centers. But Rejuveness works remarkably well on minor marks that are raised and indented, hyperpigmented and preventing hypo-pigmentation (white scarring) when used early enough.
Although some residue of the scarring may always remain when used with ReJuveness Hyper-Heal Scar cream patients are reporting back our ultimate goal of near scarless wound healing. Results may vary from patient to patient and scar to scar, the results are permanent. ReJuveness is a reusable sheet of medical grade silicone that one simply places over the scarred area daily. It can be used with ReJuveness Hyper-heal cream for improved and quicker results. The longer one wears it per day , the more effective it is. Results can be seen from as little as one day of use but length of treatment is usually six weeks to six months for more severe scarring. Although the mode of action is not fully understood, clinical trials show that silicone sheeting is 88% to 95% effective in significantly reducing hypertrophic and keloidal scarring. Rejuveness can be applied with special Hypo-allergic medical tape provided. ReJuveness is especially cost effective for large scars such as breast reduction and breast augmentation as well as tummy tucks . The Large silicone sheets are simply washed between uses and represent a 300-1000% savings over gel -sheeting brands.
How medical skepticism would apply to scars
The practical application of a medical philosophy to scarring would go as follows. Medical skepticism involves itself with the observation of symptoms, the description of syndromes and the relationship between symptoms and syndromes. A scar is a syndrome as well as a commemorative sign of all that occurred in getting that scar. A commemorative sign is in contrast to an indicative sign which is not accessible to decisive observation, but is hidden as an abstraction (such as a probability or hidden cause). To the patient a scar is a commemorative sign o often tragic experiences that proceeded it. So the scar is a commemorative sign of the tragic accident or a serious surgery or of going to the hospital or cystic acne. In the process the patient could have almost been killed or been terrible self-conscious teenager. This psychological aspect of problem scarring gives it a distinction also because results to scar management are not only emotionally magnified but can lend itself to skepticism that a hidden disease or malady doesn’t .
Because of the emotionally charged context a physician may view a scar much differently from a patient. A physician may see a problem scar scientific objectivity- as an over abundance of unwanted collagen. The physician is also going to be less interested because there is really no way he can personally generate money from scar management because money generating protocols such as surgery or laser or what ever don’t work. Within the Skeptical context the phenomena of scarring as well as it remedy is mostly within the hands of the individual patient.