A scar is the body’s natural way for healing, in the process replacing damaged or lost skin. Fibrous tissue makes up such scars. Varying reasons, such as injuries, tissue inflammations, infections, or surgery may cause the formation of scars. Scarring results from the natural biological process of repairing wounds in the skin and tissues, and it is unavoidable that most wounds result in certain degrees of scarring. Scarring may occur on any part or location of the human skin tissue and its composition may vary – from flat, to lumpy, itchy, painful, pigmented, or sunken; and its resultant look is dependent on different factors, like the age of the person, his/her nutritional status, the skin type and location of the scar in the body, the injury type, and the direction of the wound inflicted.
Formation of Scars
When the second layer of the skin – the dermis, or the thicker layer of skin – is damaged, scarring occurs. Collagen fibers, which are naturally induced body proteins, are formed on the damaged skin tissue to mend them, thus forming a scar. This scar tissue will be of a different quality and texture from the original surrounding skin tissue. Scars appear on a completely healed wound, burn, or cut.
Scars form differently from each other. A lot of scars are pale and flat. Too much collagen in the body, however, makes for raised scars, or what is known as hypertrophic or keloid scars. These scars are common in young and dark-skinned persons.
Some scars appear stretched, such as those that form on the belly during a pregnancy. The stretched scars may also form on wounds on skin under tension, such as on joint areas, during the healing process.
Scars can also have a pitted or sunken appearance, and these come about when the wounding causes some fat or muscle tissues to be removed. This is true in some surgical scars and also those caused by acne.
Types of Scars
Keloid scars- These are scars that result from an overly aggressive healing process, and scarring usually cover smore than the original injury. Some keloid scars affect mobility over time. Such scars can be treated by way of steroid injections or removal via surgery. Small keloids may be treated by freezing therapy using liquid nitrogen; a process known as cryotherapy. Keloid formation can be prevented or minimized by pressure treatment with silicone gel pads when injuries are sustained. Keloid scars are prevalent in African-Americans.
Hypertrophic scars- These are similar to keloid scars in that the scarring is reddish and raised, but these do not go beyond the original injury area. Steroid injections may be resorted to to minimize the inflammation of such scars.
Contracture scars- These are burn scars, which cause the tightening of the skin and the impairment movement at the area of the scar. Sometimes, these types of scars even breach the muscles and the nerves.
Acne scars- Severe acne problems often result in this type of scarring. Appearances may vary – from deep pits to angled or wavelike scarring. Different possible treatments are available, depending on the type of acne scars sustained.
Treatment of Scars
In general, scars cannot be completely removed. However, different treatment methods can mitigate or lessen the impact of scar appearances, such as:
- Topical treatments - like cocoa butter cream, vitamin E, and other commercially available skin care products.
- Surgery - Albeit not for purposes of removing scars entirely, surgery may be performed to alter or conceal the scarring a great deal. Surgery, however, is not recommended for keloid or hypertrophic scars because of the danger of recurrence after surgery, which at times is even worse than the original scarring.
- Injection of steroids - This may help flatten scars in the long term, and it could help make the appearance of hypertrophic and keloid scars look subtle.
- Radiotherapy - Used only in extreme cases due to potential long-term side effects; radiotherapy, done superficially and in low doses, can prevent the recurrence of hypertrophic and keloid scars. Again, this may be done only in extreme and critical cases.
- Dermabrasion - This treatment involves the removal of topical skin with specialized equipment, and is useful for raised scars, such as hypertrophic or keloid scars. There is also a substantially less invasive procedure called microdermabrasion for very superficial scars.
- Resurfacing by laser - This is similar to dermabrasion, but it uses different types of lasers as its implements. They work on the collagen substance in the dermis without interfering with the epidermis or the upper layer of the skin, and takes a lot less time for recovery and healing.
- Filler injections - Used for sunken scars, these injections raise the level of the scar to the surrounding skin. However, due to the temporary nature of this treatment, the procedure may need to be done regularly and repeatedly.
Prevention of Scars
Healing of wounds on the body may occur without a mark. In other instances, scarring may occur without warning. The key to the prevention of scars is taking good and ample care of wounds. There are available silicone-based products which aid in the reduction of scars and considerably flatten the skin. Here are some useful instructions:
- Address the infection- Redness of the wound, irritation, itchiness, and warmth are indicators of infection, which increases the chances of scarring. Immediately consult with your physician so that immediate treatment may be done to mitigate infection.
- Avoid picking or scratching the wound- Especially during the healing process, do not peel off scabs, as these are nature’s healers and should be left alone to peel by itself in due course.
- Clean the wound area with mild soap and water, then apply antibiotic ointment, which is available at local drugstores- This ointment helps in the smoother and faster healing of wounds and in preventing infection. Doctors must be consulted first as to the use of such topical antibiotics in cases of larger wounds or surgical incisions.
- Always moisturize-Moisturization is the key to better healing of the skin and to mitigate, if not outrightly prevent, scarring. Moisturizers with silicone content are recommended, and these should be applied twice daily. This also helps alleviate irritation and itchiness.
- Use scar-reducing silicone pads- Hospitals have used silicone pads for years for the treatment and reduction of scars. Over-the-counter sales of such pads are already available at local drugstores for use at home. Depending on the severity of the scar, silicone pads may be cut to size and worn daily for weeks to a couple of months.