Everything You Need To Know About Scarred Skin

Scars can be embarrassing and unsightly, yet most of us sustain them during the course of our lives. Here's how to prevent and treat them.

Whenever skin is damaged, whether it is through accident, disease, surgery or other trauma, scar tissue will form as part of the natural healing process.

But have you ever wondered how and why this process happens? Scar tissue consists of special connective tissue cells called fibroblasts that replicate when the skin is damaged to make it tougher, thicker and stronger than usual in the area of the injury. 

This is why scars stand out from the rest of the skin.

It is highly unlikely that you will live out your life without sustaining any scars, but when a scar is unsightly, it can be a problem.

In fact, apart from being embarrassing, ugly scars can even lead to psychological problems such as negative self-image. The way scars form depends on your age and the location of the wound on your body.

Young skin bounces back quickly and easily, while older skin is more likely to scar. T

he most noticeable scars occur on parts of the body that are notorious for scarring badly, such as the shoulder and the middle of the chest, or on areas in which there is a great deal of movement, such as near joints.

Types of scars:
The skin is the largest organ in the body and consists of three layers: a surface layer called the epidermis, followed by the dermis and the subcutis.

Superficial cuts and scratches are unlikely to leave scars, but any injury that penetrates below the epidermis will probably leave a scar. Scars are divided into a number of categories:

Contractures are formed during the healing process of large injuries that cause the tissue to contract as it mends, leading to puckered, unsightly scar tissue. Burns often lead to this kind of scarring. 

Atrophic scars lie below the surface of the surrounding skin, leaving a noticeable depression, or pocked effect on the skin’s surface. They are commonly the result of severe acne.

Hypertrophic scars are caused by overproduction of connective tissue during the skin’s healing process, and are common in children and fair-skinned people.

These scars are usually raised above the level of the surrounding, undamaged skin, and tend to be red, thickened and itchy. They can form when the tissue is placed under strain during healing, especially in areas that are subjected to constant movement.

Keloids are similar in appearance to hypertrophic scars. These thick, puckered, discoloured, bulging masses of scar tissue are caused by an overproduction of fibrous protein in the area while the skin heals.

Unlike hypertrophic scars, keloids tend to creep beyond the original area of the wound, giving them a claw-like appearance on the surface of the skin. They may be sensitive to touch, and are likely to burn or itch. Predisposition to develop keloids is genetic and they are more likely to affect people of Asian or African descent.

Treatment:
No scar can be erased completely, but your dermatologist can advise you on ways to make them less noticeable.

OperationsThe affected area can be cut out and the wound sewn up, but there is a risk that the operation will leave a scar.

LasersHigh-intensity laser beams can be used to treat scar tissue.

SteroidsThese are used to slow down the production of tough connective tissue and can be used to smooth out and soften scar tissue.

Cryosurgery 
The scarred area is frozen.

Compression therapy Often used after burns or major injury. The affected area is covered with elastic bandages, or tailor-made compression garments that are worn for several months.

AbrasionA technique that is used on sharp-edged scars to erode and smooth their edges. This procedure is usually performed under general anaesthetic.

Skin grafts 
An option in the case of severe burns. Patches of healthy skin are removed from one area of the body and transplanted to the burned area.

Reduction patches: are used to lessen the thickness and discolouration of scar tissue. Elastoplast Scar Reduction Patches – available over the counter from pharmacies – are effective on hypertrophic and keloid scars and have been proven to reduce the visibility of raised and discoloured scars by up to 95 per cent in a natural and permanent way.

Prevention is better than cure
If you cut yourself deeply enough that a scar is likely to form, consult a dermatologist, especially if the wound is on your face or another part of your body that will make a scar hard to hide.

Do not expose skin that has recently been cut or damaged to sunlight, because this may impede the natural healing process.

Contrary to popular belief, allowing cuts to dry uncovered is not always the best option because air-drying kills off even more tissue.

There will be less damage to skin if you keep the wound covered until all redness has disappeared. Remember to replace the dressing whenever the wound gets wet because a moist dressing may encourage the growth of bacteria.

Do not use creams or oils on wounds until all redness has disappeared.

Vitamin C speeds up wound healing, so take a supplement.

Do not be tempted to pick at loose scabs. They should be allowed to fall off on their own to minimise lasting damage to the skin.

Don’t apply make-up to scar tissue until it has healed completely. Then, if you wish to hide your scar, ask your doctor to advise you on which foundation or concealer to use.

Do not scratch or squeeze pimples, because you could be left with a scar.

Avoid undergoing unnecessary surgical procedures, such as chemical facial peels or dermabrasion, because of the risk of scarring.

If you need surgery, ask your doctor about steps you can take to avoid or minimise keloid formation.

If you are uncomfortable with the appearance of a scar after treatment or healing is complete, consult a dermatologist and ask about ways in which the scar can be concealed.