From the Guidelines
Singular does not have a significant role in reducing scar formation, as the provided evidence does not support its use for this purpose. The evidence provided focuses on the management of eosinophilic oesophagitis (EoE) and discusses various medications, including montelukast, which is also known as Singular. However, it does not recommend the use of montelukast for reducing scar formation. In fact, the evidence suggests that montelukast is not effective in reducing eosinophil count or improving symptoms in EoE patients 1.
Key Points to Consider
- The primary use of Singular (montelukast) is for the treatment of asthma and allergies, not for reducing scar formation.
- The evidence provided does not support the use of montelukast for scar reduction, and its effectiveness in this area is not established 1.
- Other medications, such as anti-IL-5 agents (e.g., mepolizumab, benralizumab), have shown promise in reducing eosinophil count and improving symptoms in EoE patients, but their role in scar formation is not clearly defined 1.
- The management of EoE and scar formation requires a comprehensive approach, including the treatment of underlying inflammatory conditions and the optimization of wound healing processes.
Important Considerations for Treatment
- Patients with EoE should be managed by a gastroenterologist and specialist allergy clinic to optimize treatment and address concomitant atopic disease.
- The use of medications such as montelukast should be guided by evidence-based recommendations and individual patient needs, rather than off-label uses that are not supported by strong evidence 1.
From the Research
Mechanisms of Scar Reduction
- Silicone gel sheeting has been shown to reduce the incidence of hypertrophic scarring in people prone to scarring, with a risk ratio of 0.46 2.
- The use of silicone gel sheeting has also been found to produce a statistically significant reduction in scar thickness and color amelioration 2.
- Daily treatments with silicone gel sheeting can begin as soon as an itchy red streak develops in a maturing wound, and the dressing is effective in reducing the bulk of these lesions 3.
Comparison with Other Treatments
- Silicone gel sheeting has been compared to intralaesional steroid therapy, with both methods being efficient in treating hypertrophic scars, although intralaesional steroid therapy had a more rapid effect and lasted longer 4.
- Silicone gel sheeting is considered the first-line prophylactic and treatment option for hypertrophic scars and keloids, with its efficacy and safety demonstrated in many clinical studies 5.
Morphological Analysis
- A light and electron microscopic analysis of linear hypertrophic scars treated with intralesional steroid or silicone-gel sheeting revealed marked differences in tissue reaction following the two different treatments 6.
- The analysis showed that both treatments resulted in a decrease in the activity of fibroblasts and the numbers of collagen fibers forming bundles, as well as an increase in the amount of elastic fibers 6.