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Hello,

My 4 year old daughter had a bad fall in March that left her with facial scarring. We were treated by the wonderful Max Fax team at Kings but several months on I would value the advice of a specialist to know that we are doing the best to minimise her scarring. Would anyone have experience of seeing a professional in South London/Greater London that specialises in children that they could recommend ?

Also potentially as a result of the accident or just being 4, my daughter is being very difficult, complete oppositional defiance. We are just struggling as every morning has become a battle that is resulting in everyone in tears. I am thinking I might need professional insight to help me know how best to proceed as this has not been an issue with my other child and I am struggling, it is probably more me who needs to learn to help her. Rereading Calmer Easier Parenting is just not going to cut it right now.


If anyone has any recommendations on either issue it would be much appreciated.


Claire

I don't have any info on a specialist, but a friend who's son had a fall at a similar age was told to use sunscreen on the damaged skin every day, even if it isn't sunny as its way more delicate and any sun damage would make the scarring worse. You can barely see his scars now so it seemed good advice for him!


Good luck with it all - the behaviour thing might just be being 4 though - my 4.5 year old seemed to have a personality transplant around 4 ish that lasted a couple of months. She's much better now....

Sorry to hear you have had a difficult time.


I can recommend Dr ali Rendu at dulwich therapy rooms as well as Dr Priya vigneswaran http://www.pvchildfamilytherapy.co.uk/ for help with the emotional difficulties and support for parenting your daughter


Best wishes


Dr Christine Langhoff CPsychol Clinical Psychologist

Dulwich Psychologist

Thanks as ever for recommendations. We were told to use Sun screen. We are using a scar gel kelo cote uv which has made a vast improvement.

Initially the forehead was stitched and cheek laceration glued. The forehead was not a clean cut so more complicated to stitch so not a smooth scar, bit of bumpy tissue I guess, antibiotic cream and oral antibiotics as there was a lot if mud in The cuts. Max fax were super and we were signed off after a couple of weeks. We just want to do as much as possible to minimise scarring. She never once complained but suddenly has us worn down with her behaviour. Thanks, Claire

Silicone-based therapies and sunscreens are definitely useful. You should be using a silicone product both day and night.


Am I correct in understanding that the maxfax team were concerned with primary healing from a surgical point of view, but you haven't had any further consultation with a dermatologist or plastic surgeon specifically for longterm scar therapy?


In which case, it may be worth asking for a referral through your NHS GP. Silicone products are excellent for scar therapy, but you could also look at IPL treatment, or even laser treatment.


Fractional laser resurfacing (like Pixel laser) has a rapid healing time due to the way the laser is pixelated over the skin. But it's not suitable for all skin types, and it may be better for older scars than new scars. This is something you need to discus with an experienced plastic surgeon or dermatologist.


IPL is not a laser. It's intense pulsed light. It's suitable for most skin types and has been shown to improve all scar types, though it is a less aggressive treatment than laser therapy.


I've had both privately, though it's worth investigating whether your daughter qualifies for some further treatment through the NHS. While IPL is relatively affordable, Pixel laser therapy is pricey.


If you decide to go private, you may want to consider a consultation here: http://www.harleystreetpaediatricgroup.com/.

They're a paediatric group with GMC registered specialists, e.g. in plastic surgery.

thank you Saffron, that is exactly the information I didn't have that I needed. MAxfax were just involved initially. Her GP just told us to keep doing what we are doing re. scar gel but 5 months on I'd like to know where we go / if we go forward from here. This information is a brilliant starting point.

Much appreciated.

I would try also some cranial osteopathy as the fall may have caused other problems and tensions in the body and this could affect her behaviour too. I have used an ostheopath called Jhon Mellinder in Neals Yards London Bridge but I am sure there are some other good local ones.
Sorry it's been such a hard time for all of you - hopefully the tips from Saffron and others will help with the scarring. On the emotional side, it may seem trite to suggest a book, but Calmer, Easier, Happier Parenting has some incredible tips for helping reconnect with your kids. Our nearly 5 year old has been super challenging (agree with the comment about the personality transplant!) and the book has been a useful guide with tips that you can really put into practice. It's about focusing on the positive and the good rather than the negative which has been as helpful for my mental state as for making progress with our LO. Not a panacea, but I think it has really helped. Good luck x

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