A man in his 30s cut his wrists at the age of 15. Since he was in elementary school, he had been subjected to severe violence by his father, such as being hit with a bat. He was also bullied at school, which caused him to feel like he had no place to belong.
“It all started when I fell into a deep valley of despair, with no hope, hope, or salvation in anything,” the man NHK (Jan. 21). “I remember feeling liberated from something when I cut myself.”
His living environment changed when he entered high school, and he stopped cutting his wrists. He has cut off contact with his parents and is now living a peaceful life.
However, every time he sees the scars on his wrists, he feels like he is taken back to the time when he was abused.
“When I hold onto a strap on the train, I can see my arm right in front of me,” he says. “It reminds me of the past and makes me sad. The most painful thing for me was that every time I see the scars, I remember the pain I felt at the time when I had no way out.”
However, a new treatment for wrist-cutting scars has been devised to remove them and respond to the desire of those who injured themselves to “say goodbye to the person I was at that time.”
“He couldn’t put his painful feelings into words”
A survey has shown that there are many children who have experienced self-harm.
In 2021, the National Center for Child Health and Development conducted a survey among 2,500 students between fifth grade high school. The results showed that about 15 percent of the respondents said they had hurt themselves in the past week.
According to NHK, self-harm can take many forms, including not only cutting one’s wrists, but also pulling out hair and hitting oneself.
Dr. Arisa Yamaguchi conducted the survey at the National Center for Child Health and Development. She points out that people hurt their own bodies to deal with the uncontrollable emotions they have been holding in due to their harsh living environment.
“One child told me that when he couldn’t put his painful feelings into words, he cut himself and bled, which allowed him to finally see that he was in pain,” Dr. Yamaguchi says. “I think the act of self-harm itself functions in part as a coping mechanism for the child to survive.”
“What patients want is to make the scars unnoticeable”
For those who want to escape the emotions that come back to me every time they see scars on their body, there is a doctor in the metropolis who has been thinking about treatment methods to meet this wish.
He is Dr. Hideyuki Muramatsu, a plastic surgeon who runs a clinic in Koto Ward that specializes in treating scars.
Initially, Dr. Muramatsu had in mind patients seeking treatment for burns and injuries. However, shortly after opening his clinic, he began to receive a sudden increase in consultations about treating scars from wrist-cutting.
“Some people have had the experience of being rejected at job interviews because of the scars from wrist-cutting, or having their engagement called off because the parents of the person they were planning to marry did not understand,” says Dr. Muramatsu. “I strongly felt that this treatment was necessary to free them not only from their own memories, but also from the discrimination and prejudice that society has against wrist-cutting. Wrist-cutting scars are distinctive. So, they are obvious no matter how much they fade. What patients want is to make the scars unnoticeable.”
As a result, Dr. Muramatsu came up with a method to peel off a thin layer of skin from the scar area, change the direction of the scar and then put it back.
By doing this, the scars will look more like injuries or burns, rather than the scars characteristic of wrist-cutting.
This treatment became known to people who wanted to get rid of the scars from wrist-cutting. Now, about 300 people come to consult with him every year, not only in Japan but also from overseas, including from China.
“Cultured epidermis”
However, although the shape of the scar changes with this method, the scar itself remains. So, Dr. Muramatsu thought of applying another means utilizing regenerative medicine technology.
A so-called “cultured epidermis” is made by culturing cells taken from the patient’s skin and forming them into sheets. This is how severe burns are treated. As much clean skin as needed can be produced from the small amount of skin taken.
Dr. Muramatsu, in collaboration with a regenerative medicine product manufacturer in Aichi Prefecture, received a government subsidy last year to carry out an experimental treatment in which the sheets were transplanted onto the scars of nine patients.
As a result, the treatment was started in November last year after confirming its safety and improvement in scars. The recipients also showed positive behavioral changes, such as being able to wear short-sleeve shirts.
The transplant is performed as follows:
▽ A thin layer of skin is scraped off from the area with the scar.
▽ The scraped skin is cut into a mesh and returned to the patient.
▽ A sheet made from cultured epidermis is then attached on top of the skin.
Using one’s own skin as a base makes it easier for the cultured epidermis to attach. As well, the scars are less visible.
“When I was treating a patient with severe burns at a general hospital, I was surprised that the scars improved so much after treatment with cultured epidermis that the patient could live without having to go to the hospital for a long time,” Dr. Muramatsu says. “I believe that treatment using cultured epidermis can help patients who suffer from scars from wrist-cutting to be free from pain in the rest of their lives.”
Had to roll up her sleeves
A woman in her 50s who visited Dr. Muramatsu’s clinic in January of this year chose this method to treat her arm.
This woman said that she had been wearing long sleeves for nearly 40 years to hide the scars from wrist-cutting in her student days.
When she was in her 20s, she enrolled in a vocational school to qualify as a dental hygienist, but she had to roll up her sleeves in the practical training because she used her hands.
She felt such strong stress about “what if people see my scars” that she could no longer attend school and was forced to drop out.
“I don’t want to give up,” she says. “At the end of my life, I want to be able to use my arms properly and work responsibly. I want to feel that I can contribute to society.”
What scar treatment means
After the surgery, the woman said she felt like she had put an end to her painful days and was starting a new life.
“I want to be of help to someone else in return for all the help I’ve received, so I’m going to get a nursing qualification,” she says. “I’m very happy that once the scars are gone, I’ll finally be able to take the training and get qualified. I’m looking forward to trying things I’ve always wanted to do but couldn’t before. I’m really grateful to have been given this opportunity.”
However, treatment for scars from wrist-cutting is not covered by health insurance. Treatment using cultured epidermis costs more than 1.6 million yen.
Dr. Muramatsu has repeated conversations with patients to find out why they want to remove the scars and that it’s been more than two years since they last cut their wrists. He then asks them to carefully choose whether or not to have surgery.
“It is not covered by health insurance, so it is expensive, but the patients who receive it really brighten up. So I feel that it is an important treatment that can change their lives,” says Dr. Muranatsu. “I hope that this kind of treatment that leads to solving problems will spread to those who need it.”
“Get rid of visible scars”
The man mentioned at the beginning also said goodbye to his scars with the same treatment.
“In my case, the wounds I bear in my heart are greater than those that can be seen on the surface, so I chose treatment to heal those wounds even a little,” he says. “Before treatment, the scars were really vivid memories of the past, but now they feel like the scars of a minor injury. I was able to think about how to take care of myself, and with that burden lifted from my heart. I feel that it is important to get rid of visible scars.”
Dr. Yamaguchi says that the most important thing is not to force the person into a situation where they have no choice but to do so, but experts point out that if you see someone self-harming, it’s important to first show sympathy.
“Self-harming is also a sign of a cornered child’s cry for help. So, it may be surprising to see them doing it, but trying to stop them can be counterproductive,” says Dr. Yamaguchi. “First, it’s a good idea to understand why they are doing it. It may also be a good idea to tell them that you care about them and that you think they are important.”
