Whether from an injury, surgery, or a skin problem such as acne, scars are something almost everyone has to deal with at some point or other. Scars may be flat, indented, raised, inconspicuous or obvious.
Scar Therapy is very important within the first 3-6 months of scar-maturation. Understanding how scars form, scar therapy & what type of scar you're dealing with can enhance the appearance of your scar.
How does a scar form?
Scars form when the dermis (deep, thick layer of skin) is cut / damaged. The body forms new collagen fibers (a naturally occurring protein in the body) to mend the cut / damage, resulting in a scar. The new scar tissue will have a different texture and quality than the surrounding tissue.
Regardless of how they heal all scars go through a well defined period of change and maturation which can last over a year. After initial healing, scars begin a process of thickening and contraction as the body replaces and reorganizes the structure of the initial soft tissue fibers (collagen).
This process starts around 3 weeks after injury and peaks around 3-6 months.
Eventually, the scar tissue softens and fades in color as the excess blood vessels in the scar disappear. Mature scars do not usually have equal pigmentation of the normal surrounding skin, and can appear either white or more darkly pigmented (especially in darker skin).
Types of Scars
There are three main types of scars, generally described as flat, indented, or raised.
- Flat scars are the most common, and usually occur from everyday injuries or minor burns. Depending on your skin color, flat scars may be pink to red (and eventually fade to very light pink or white) or tan to deep brown or black (eventually becoming lighter).
- Indented (atrophic) scars often result from cystic acne or a bout with the chickenpox virus. Other names for indented scars are pockmarks, ice pick scars, and depressed scars. These scars result from destruction of the skin's underlying support structure, which is why they don't heal as well as flat or raised scars.
- Raised (hypertrophic) scars result from overproduction of collagen in response to injured skin. This type of scarring can result from a slight tear in the skin or from a deep wound, and everything in between. Sometimes referred to as keloid scars, these are more common in dark skins. Raised scars flatten over time, but can take years to resolve.
The direction of the scar
The direction of the scar also plays a large role in how it appears. Scars that are aligned with natural relaxed skin lines (Langers Lines) will remain much thinner and less noticeable than scars that travel across those skin lines.
Different areas of the body
Different areas of the body will scar differently due to both the tension found at the area and the movement across it. Notoriously, areas such as the mid chest, upper shoulders and back tend to display more widening and thickening of scars than other areas.
Genetics can play a role in how nicely a scar heals, especially if person has a history of scarring disorders such as keloids or hypertrophic scarring.
Aftercare to Minimize Scar Formation
- During initial healing, it is important to keep the wound moisturized by applying an antibiotic ointment 2-3 times a day over a supportive tape strip.
- In order to protect the area from repeated trauma, activity restrictions (no sports or gym classes) and quieter activity are usually recommended for 3 weeks.
- New scars are especially sensitive to sun damage, avoiding sun exposure and use sunscreen, especially during the first year of healing - This is important to minimize permanent dark discoloration.
- Apply a silicone treatment gel or cream with tape with healing, antioxidant and anti-inflammatory ingredients; such as kelocote or scarscience. Ten weeks of twice-daily application can make the scar less noticeable, especially if it's a fresh scar.
- Any unusual appearance or excessive thickening of the scar during the healing period should prompt a checkup to allow early diagnosis and treatment of hypertrophic scarring / keloid formation.