What causes scars?Scar tissue is composed of collagen that forms as the body begins to heal from a trauma. It serves an important function, similar to that of stitches to close a large wound. The scar reconnects damaged or broken tissues, allowing them to heal. It becomes problematic when excess scar tissue is formed, or remains after it has served its purpose. Like stitches, scar tissue is no longer needed when the healing process is complete.
Most scars occur on the skin, and they may extend deep into the tissue if the injury was deep. Genetics, skin type, and the location of the wound also have an effect on the amount of scarring. The most common cause of scars is injury, though they can also be caused by surgery, burns, or even skin conditions such as acne or chicken pox.
Types of scarsJust as each person’s skin is unique, each scar is a little different. However, there are four main classifications:
- Keloid scars are formed as part of the healing process. They may occur following events such as surgery, injury, body piercing, skin eruptions, or insect bites. Occasionally they seem to appear spontaneously, with no known triggering factor. Keloids are raised above the surface level of the skin, and they feel firm to the touch. They often extend beyond the initial injury.
This type of scar may be red, dark brown, or pink in color. They appear most commonly on the ear lobes, chest, or back, but they can develop in other areas. Keloid scars do not pose a risk to your overall health but at times they can be painful and itchy. For many people they can be a serious cosmetic concern as well.
- Hypertrophic scars occur when the healing process is overactive. They are typically red in color and raised. Unlike keloid scars, they do not extend beyond the area of the initial wound. Most hypertrophic scars respond to treatment very well, and some may even fade away naturally.
- Contracture scars most commonly occur where the skin has been burned. They are made of hard tissue, and tend to cause surrounding tissue to contract. These scars can sometimes inhibit movement, depending on the location and size of the scar. They may affect the nerves, tendons, or muscles as well as the skin. Incorporating exercise as part of burn therapy can help prevent the formation of contracture scars.
- Acne scars often occur in individuals with severe, untreated acne, particularly if they pop or pick at their pimples. The scars remain long after the acne breakout clears up, although they may diminish or disappear over time. There are several types of acne scarring: Atrophic scars are recessed, hypertrophic scars are raised, and pitted scars are narrow holes punched into the skin similar to those from an ice pick.
Scar treatment at Dr. W DermatologyThere are several methods of treating scars. The best choice depends on the type, size, location, and severity of the scar. It is important to understand that some scars are permanent, at least to an extent. Treatment can alter the size, color, and extent of a scar, making it less noticeable and easier to disguise with cosmetics. We will begin by evaluating your condition, and then recommend the most effective treatment options. If necessary, we will refer you to a skilled plastic surgeon, when an extensive scar revision procedure is required.
The sooner you visit us, the better. Scars can be treated at any stage, but the best results can be achieved by beginning treatment while the injured area is still healing.
Scar treatments include:
- Surgery – Several different surgical options are available, depending on the scar, including Z-plasty (surgical removal). Triangular incisions are made to surrounding skin, and carefully closed for a more natural appearance.
- Laser resurfacing – This procedure may reduce the size and improve the coloring of some scars. The procedure is comfortable, and relatively fast to perform.
- Steroids – The tough collagen fibers in scar tissue break down when injected with steroid-containing formulas, which softens the scar. A series of injections is scheduled, usually every four to six weeks. The duration of treatment is different for each person, but it is usually somewhat long-term. Due to the nature of scar tissue, very little, if any of the solution enters the bloodstream, it does not pose a risk.
- Skin grafting – In this procedure, the doctor moves healthy skin from one area of the body (the donor site) to another area (the recipient site). This technique may be used to improve severe scarring; however, it is important to note that there is a risk the grafted skin will differ from the surrounding area in color or texture.