Pamela Maloney, PhD, DHM, Dipl. OM, LAc, is no stranger to scars. Perhaps it comes with the territory: Dr. Maloney lives in Southern California, where attention to appearances (the "beach bod") is a high priority for many. Perhaps it comes from personal experience: at 72, Dr. Maloney has collected more than a few scars of her own over the years, most notably one on her ear where a surfboard hit her out of the blue as she dove under a wave, knocking her unconscious.
In any case, Dr. Maloney has lectured about rehabilitative cosmetic acupuncture for scar healing in the doctoral program at Emperor's College of Traditional Oriental Medicine, where she is a senior faculty member, and at Oregon College of Oriental Medicine. I had the privilege of interviewing her to compile this Q&A with tips on acupuncture for scar healing from a master of the "scar arts."
What are some examples of scar anatomy?
In contrast to indented scars, keloid scars grow outward and are raised. Some scars try to anchor themselves, often excessively, by grabbing on to nearby structures such as bones and especially other scars. Dr. Maloney even had a patient whose pain at the site of a scar from a surgery on her lower back flared after she had a hysterectomy that resulted in two scars on her abdomen: a horizontal keloid scar, and an indented scar superior to it up the midline.
What is the purpose of local needling, on an anatomical level, to help a scar heal?
For indented scars, the goal is to build a pathway from one side of the scar to the other so the blood vessels can recircuit themselves. Dr. Maloney achieves this by inserting needles opposite each other on both sides of the scar, angled toward the scar and slightly downward such that each pair of needles forms a V-shape above the skin and criss-crosses underneath it (see photo). The needles should reach across to the other side of the scar. This technique can also limit or reduce a scar's attachment to a nearby structure.
For keloid scars, the goal is to create space for blood to enter so it can carry away the excess scar tissue. This involves two techniques. First, Dr. Maloney needles lengthwise through the center of the scar. If the needle does not reach the other end of the scar, she makes sure that it reaches at least halfway and then uses another needle of the same length to mirror it. As the scar flattens, she needles it from the sides, at different angles. It is not necessary for the needles to reach across to the other side of the scar, as it would be for an indented scar.
Which needle lengths and diameters work best for treating different types of scars?
Dr. Maloney has found that shorter-length needles (15mm or 30mm) with a diameter of 0.16mm work best for treating scars on the face and the rest of the head. She has used needles with much larger lengths (up to 150mm) and diameters (0.25mm to 0.35mm) to needle longitudinally through the center of long keloid scars, followed by smaller needles (15mm or 30mm in length, 0.20mm in diameter) to needle these scars from the sides.
Which acupuncture points not local to the scar might also be beneficial?
Dr. Maloney tends to needle the scar first for a longer retention time at the area of primary concern. She may then needle points such as GV 20, PC 6 and HT 7 to promote relaxation, as well as points such as SP 10 to invigorate blood. If the scar is close to a point on one side of the body, Dr. Maloney may needle the corresponding contralateral point. Additionally, she may needle points closer to the beginning and end of the channel on which the scar is located.
How long is it appropriate to wait for a scar to form on its own before treating it with acupuncture?
Dr. Maloney allows at least six weeks for the body's natural repair mechanisms to lay the foundation of a scar before using needles to guide the rest of the healing process.
How many treatments does it taketo optimally improve the look and feel of a scar, and at what frequency?
For indented scars, generally one treatment per week makes a difference while also providing enough of a break for the scar to calm down before the next treatment. While it is possible to see a reduction in color between each treatment for these scars, depending on factors such as their dimensions and degree of inflammation the repair process can take about five months, with another three months or so needed for finishing touches. By contrast, Dr. Maloney had a patient with liposuction-induced keloid scars that softened significantly and almost completely disappeared after only three weekly treatments.
How painful is it to have a scar needled?
Most patients report that they feel little or no pain, although in some cases this may be because the relief caused by the needling distracts patients from the pain it can cause. For example, when blood backs up on both sides of an indented scar, needling this swollen tissue can release the pressure built up by the stagnated blood, which brings patients tremendous relief. As a result, they may not register the needling as painful.
However, desensitization to pain can also be a red flag. Scars can result from injuries that are not only traumatic, but also traumatizing; and desensitization to pain can be part of a larger shutdown in awareness indicative of a history of traumatization when activated as a threat-defense reaction in a relatively safe context such as an acupuncture treatment. For this reason, it is especially important to maintain communication with patients and encourage them to share their feelings, or lack thereof, during the needling of a scar.
What are the benefits of acupuncture for scar healing?
Scars can cause pain and distress, both emotional and physical. People with a scar located on a highly visible part of the body such as the face often fear that it might be off-putting to potential romantic interests or employers, for example; and even a scar in a location that generally remains hidden can make someone feel unattractive. By treating mind and body, acupuncture for scar healing is not just cosmetic; it can significantly improve a person's self-esteem, mood, well-being and outlook on life.
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The Oregon College of Oriental Medicine (OCOM) has announced it is closing after 41 years. Pending accreditor approval, OCOM will cease offering classes after September (fourth-year OCOM students graduate Aug. 26). All current / incoming OCOM students have the option of continuing their education at the National University of Natural Medicine or Five Branches University, or transferring to another school altogether.
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