Scars

What causes scars?

So, what exactly is the deal with fibrotic (scar) tissue? If you’ve ever thought of speed healing as a superpower then you should know that if you adjust your definition of “speed” you technically innately have super healing (yeah, we know it’s a bit of a stretch).

When we injure ourselves our bodies first close any damaged blood vessels with clotting cells (platelets), and start sending infection fighting and healing cells to the area. The swollen, puffy appearance of healing wounds, and the normal fluids that ooze from them are all correlated to our body's own healing mechanisms.

Here’s the even more interesting part, as the body knits itself back together cell by cell, the skin cells and proteins (like collagen fibers) do not follow the same randomization pattern they normally do. Instead, they arrange themselves in a unilateral linear pattern creating the different appearance of scar tissue.

Scar tissue does not contain sweat glands or hair follicles, and is less able to protect itself from UV light. There are various types of scars, and certain individuals and skin types are more prone to noticeable scarring than others.

What are the main concerns related to scars?

Scar formation mainly depends on the size and depth of the wound that caused it. According to the American Academy of Dermatology, there are six classifications of scars:

• Flat Scars: The classic pink/reddish, slightly raised lesion. These scars usually flatten and lighten over time.
• Raised Scars: aka hypertrophic scars. These are raised from the skin initially, but over months or years will usually flatten.
• Depressed Scars: aka atrophic scars. These scars sit lower than skin level and usually occur on the face (especially after severe acne).
• Keloid Scars: These scars are raised and significantly larger than the initial wound that caused them. They usually appear well after the injury and do not resolve without intervention.
• Contracture Scars: These form most often after severe burns. They cause the skin to thicken and tighten becoming resistant to stretching, which can impact the range of motion of the area.
• Stretch Marks: Most often associated with pregnancy, stretch marks (a.k.a. striae) can form with any rapid changes in size. Puberty, weight loss, and bodybuilding can cause these marks.

Who may wish to seek treatment for scars?

When it comes to scars, location and type will be a big factor in directing treatment. For individuals with high melanin levels, like those of African and Asian ancestry, all types of scarring will typically be more perceptible. Scarring on noticeable areas of the body may prompt someone to seek treatment to alleviate aesthetic concerns.

Scars that are more severe and have the potential to impact quality of life, like keloid and contracture, will require treatment to restore function or preserve health.

How can someone get help for Scars?

For minor cosmetic scars, over the counter or minimally invasive treatment options will most likely be sufficient. For more severe scarring, a medical evaluation and professional intervention will be needed.

• For Raised (a.k.a. Hypertrophic) Scars: Laser Resurfacing is a laser treatment to remove excess, unwanted skin and encourage new growth in the area. Depending on the type of laser there may be few or numerous side effects.
• For Flat Scars: Microneedling aims to increase collagen and elastin production through a small device that rolls across the skin, creating pin-sized holes in the fibrous scar tissue. Dermabrasion uses ablative pressure and friction to remove layers of the skin allowing new skin to form. Microdermabrasion can be performed via a Diamond Tip Microdermabrasion or Crystal Microdermabrasion in which a handpiece is used to exfoliate scar tissue. Chemical Peels can be used to exfoliate excess skin tissue and encourage the formation of new skin.
• For Contracture Scars: Embrace Scar Therapy uses controlled pressure therapy and tension relief dressings to encourage appropriate collagen production.
• For Stretch Marks: Carboxy Therapy stimulates circulation by infusions of carbon dioxide to promote healing.
• For Depressed (a.k.a. Atrophic) Scars: Dermal Fillers & Injectables like Juvederm®, Restylane®, and Belotero® work to lift and plump the skin where depressions have formed.

For a more in-depth look at the treatment options listed above, check out our guide to Scar Solutions.