Scar Facts
Published: Wed, October 27, 2010 by Dr. Clive Anderson
A scar is an important part of the natural healing process that occurs when the deeper layer of the skin- the dermis is injured. The scar that we see is made up of a protein called collagen. After the wound is completely healed new collagen is formed and blood vessels return to the tissues causing the original scar to fade gradually. Most scars will fade or improve in appearance over a period of time.
A scar is an important part of the natural healing process that occurs when the deeper layer of the skin- the dermis is injured. The scar that we see is made up of a protein called collagen. After the wound is completely healed new collagen i¬s formed and blood vessels return to the tissues causing the original scar to fade gradually. Most scars will fade or improve in appearance over a period of time.
There are many causes of scarring – accidents, surgery, skin disease, burns, acne, and infection to name a few. Not all scars are the same however.
Flat pale scars – these are the most common scars. Initially they are dark or red and raised above the skin. Gradually they become paler and flatter over a period of up to two years. Hair does not grow in the area, as damaged hair follicles are not replaced.
Hypertrophic scars – are thick and may be itchy or painful. They may continue to thicken over a period of up to 6 months but do not extend beyond the edges of the original wound. These scars usually improve over 1-2 years but cause distress due to their appearance and the itching and/or burning. They may also restrict movement over a joint.
Keloid scars – result from an overproduction of collagen in the scar tissue. These scars can continue to grow indefinitely and extend beyond the edges of the original wound. They are often itchy and painful. These scars usually do not improve with time. Keloid scars can result from even minor injuries such as scratches or insect bites or acne bumps. They can occur anywhere on the body but are more common on the ears, chest, shoulders and back. A very common site of keloid scarring in our population is the ear lobes as a result of piercing of the ears. Persons who develop one keloid or hypertrophic scar are likely to develop others and should alert their doctor or surgeon if they are undergoing surgery or need injections.
Sunken scars – These scars are lower than the skin surface. A common cause of these scars is acne or chicken pox. Often these small acne scars are mistaken as “ open pores”. Not all acne scars are sunken some may even be keloid.
Stretch marks – These dermal scars develop when the skin is stretched rapidly, for example during pregnancy, weight gain or the adolescent growth spurt. Initially stretch marks are pale but they may become darker over a number of years.
It is important to realize that scars cannot be removed completely.
Sometimes it is possible to improve the appearance of a scar with some of the therapies listed below.
- Surgery – any surgery will leave a new scar but this scar may be improved in size, shape or position. There is a high rate of recurrence of keloid or hypertrophic scar after surgery. and the surgery is often followed by radiation therapy or steroid injections to prevent this.
- Laser surgery-may help to flatten the scar.
- Steroid injections – a course of steroid injections into the scar will help to flatten and soften the scar and relives itching and burning.
- Radiotherapy – low dose superficial radiotherapy helps to reduce the recurrence of keloid and hypertrophic scars after surgery.
- Dermabrasion is helpful in reducing raised scars and making them less visible.
- Collagen injections are used to raise a sunken scar. The effect is only temporary and the injections need to be repeated at intervals.
- Silicone gel sheets-work by moisturizing and covering the scar area thus flattening, softening and fading red and raised scars. They also decrease itching.
Cosmetic camouflage is a very effective way of disguising a scar.
