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Scars - Diagnosis, Treatment and Prevention

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Scars are part of the body's natural healing process to replace cut or damaged skin. Read this article below to learn more about it.

Medically reviewed by

Dr. Arunima Dhabal

Published At May 19, 2022
Reviewed AtMarch 2, 2023

What Are Scars?

A scar forms part of the body's healing process to replace cut or damaged skin. The composition of a scar varies, but it is usually composed of fibrous tissue. Scars appear for different reasons, including infections, surgery, and tissue inflammation. They may develop anywhere on the body, with different shapes and sizes. Some scars may be painful or itchy, while others are barely visible.

What Are the Different Types of Scars?

The different types of scars are:

  • Keloids: They are thick, rounded, irregular clusters of scar tissue that spread beyond the wounded area. The overgrown scar tissue may affect movement. They often present as red or dark-colored compared to the surrounding normal skin.

  • Contracture: A contracture scar often develops after a burn and causes the skin to tighten or contract. These scars can make moving difficult, especially when the scarring gets into the muscles and nerves or occurs over a joint.

  • Depressed or Atrophic: These scars mainly result from chickenpox or acne and appear as rounded pits or small indentations in the skin. They are also called ice pick scars and develop mainly on the face.

  • Flat: These scars are slightly raised but gradually flatten as they heal. Flat scars are often pink or red.

  • Raised or Hypertrophic: These raised scars can get smaller over time, but they never completely flatten. They do not grow or spread beyond the wounded area.

  • Stretch Marks: They appear when the skin expands or shrinks quickly. Stretch marks often develop during puberty, pregnancy, or after massive weight gain or reduction. They are visible on the abdomen, buttocks, hips, breasts, stomach, thighs, and upper arms.

Why Do Scars Form?

A scar forms when the dermis, the deep thick layer of the skin, is damaged or injured. The body creates new collagen when the skin is injured to mend the damage, resulting in the formation of a scar. The newly formed scar tissue consists of different texture and quality compared to the surrounding tissue, and it protects the skin from infection. Scars develop once the wound is completely healed.

How Are Scars Diagnosed?

Scars are easily diagnosed by looking at the area of skin that has healed from an injury. They often look darker, lighter, or pinker than the surrounding skin. The healthcare provider diagnoses based on physical examination to evaluate a scar. The size, texture, and color of the scar help determine its type.

What Is the Treatment for Scars?

Scar treatment depends on several factors like type, size, location, and duration of scars. Treatments can not completely remove scars but can improve their appearance.

Several methods for improving the appearance of scars include:

  • Topical treatments: Applying topical creams and ointments such as cocoa buttercream, Vitamin E, silicone gel or lotion, onion extract products may help heal scars.

  • Surgery: Surgery may alter the shape of a scar or make it less noticeable. It is not recommended in hypertrophic or keloid scarring (raised scars) because of the increased risk of recurrence and severe scarring that results from the treatment.

  • Steroid Injections: Steroid injections may help flatten the scars. Injections soften the appearance of scars, particularly keloid or hypertrophic scars. 5-fluorouracil (5-FU) or Bleomycin are usually injected into scars to flatten scars and ease itchiness and pain due to scars.

  • Radiotherapy: A low-dose, superficial radiotherapy helps prevent recurrence of severe keloid and hypertrophic scars. Radiotherapy is used only for severe scarring because of the long-term side effects.

  • Dermabrasion: This is a common scar treatment that removes the top layer of the skin with special equipment. Dermabrasion is helpful to soften and smoothen the skin and improve the appearance of scars.

  • Laser Treatments: Laser and light treatments can make scars less noticeable. Laser treatments are done with a particular wavelength of light to cause a particular action in the skin. The V beam and Fraxel laser are such lasers available to improve the appearance of scars and ease pain and itchiness.

  • Filler Injections: These injections help raise sunken scars to the level of surrounding skin. The procedures may need to repeat regularly as the effects of these injections are temporary. The newer forms of injectable fillers may be a better option.

  • Microneedling: This involves making many small puncture holes into the superficial skin to stimulate collagen production to improve the appearance of scars.

  • Cryosurgery: This treatment freezes the scar and thus reduces its size and relieves pain and itchiness.

What Are the Preventive Measures for Scars?

Following reasonable measures may reduce the risk of scarring:

  • In case of a wound that may leave a scar, visit a health care provider for a thorough examination. The doctor may apply stitches or bandages to hold the skin together while it heals to minimize scarring. The doctor may prescribe medications like oral or topical antibiotics to prevent infection based on the wound's type and location.

  • Wash the scar area using mild soap and clean out any dirt or dried blood. Followed by that, apply a clean bandage over the wound to keep germs out.

  • Applying petroleum jelly provides moisture to the wound and prevents it from drying and developing a scab. Scabs can make scarring worse.

  • Cover or protect the scar from the harmful sun rays with sunscreen, as sun exposure can make a scar darker. Sun exposure to scars also increases the risk of developing skin cancer.

  • Vitamin D and C deficiency in the body can make scarring worse. It is essential to take a high-quality protein diet to help the skin heal.

What Is the Outlook for Scars?

While most scars fade over time and do not pose long-term health problems, some scars may cause problems later. For example, the scar may gradually become painful or itchy as nerve endings grow back. In addition, there is a risk of developing skin cancer, especially in burn scars, if unprotected from sun exposure.

Conclusion:

Scars can be painful, itchy, and discomforting. They can also lead to poor esthetics in some cases. Several effective treatments can flatten scars or make them less noticeable. Not all scars require treatment, and many fade away over time. Reach out to a healthcare provider if a scar causes discomfort or difficulty in movement. Treatments can improve movement and relieve pain. It is essential to protect scars from the sun to reduce the risk of skin cancer. However, if a scar is bothering causing pain, treatments can help.

Frequently Asked Questions

1.

How to Get Rid of Scars?

Treatments cannot completely remove scars but can lighten them over time. Topical treatments, surgery, steroid injections, radiotherapy, dermabrasion, laser treatments, filler injections, microneedling, and cryosurgery are the methods that can improve the appearance of scars.

2.

What Are the Different Types of Scars?

The different types of scars are:
Keloids: They are thick, rounded, irregular clusters of scar tissue that spread beyond the wounded area.
Contracture: A contracture scar often develops after a burn and causes the skin to tighten or contract.
Depressed or Atrophic: These scars mainly result from chickenpox or acne and appear as rounded pits or small indentations in the skin.
Flat: These scars are slightly raised but gradually flatten as they heal. Flat scars are often pink or red.
Raised or Hypertrophic: These raised scars can get smaller over time, but they never completely flatten. They do not grow or spread beyond the wounded area.

3.

What Are Scars?

Scars are part of the body's natural healing process to replace cut or damaged skin. They may develop anywhere on the body, with different shapes and sizes. Some scars may be painful or itchy, while others are barely visible.

4.

Are Scars Permanent?

Although scars are permanent, most scars fade over time with scar treatments. Complete scar removal is impossible, but several treatments are available that may improve a scar's appearance and help make it less noticeable.

5.

Is Vaseline Good for Scars?

Vaseline contains nutrients and multi-layer moisture that penetrates deep down and helps keep skin hydrated and healthy-looking. Applying vaseline on scars helps heal the scars and improve the appearance of scars.

6.

How Long Do Scars Take To Heal?

Scars usually take between two and three years to turn pale and the skin to mature. However, one can speed the process of healing with available scar treatments.

7.

Why Does a Scar Appear Red?

The developing scar may appear red or reddish-purple in the early stages of wound healing. This happens because the injured area sends signals to the body to direct more blood flow to the site to help heal.

8.

How Long Does It Take for Facial Scars to Fade Away?

Although scars are permanent, most scars fade over a period of up to two years with scar treatments. Normal scars become darker initially, and after some time, this starts to fade. However, dark scars can last for years in dark-skinned people.

9.

How to Get Rid of Facial Scars?

Numerous treatment options are available for facial scars, including dermabrasion, chemical peels, laser resurfacing, and plastic surgery. In addition to these methods, several home remedies can also help minimize facial scars.

10.

Is Vitamin E Good for Scars?

Vitamin E has beneficial properties for skin, especially in support of wound healing and reducing scar appearance. However, there is little clinical evidence that Vitamin E heals scars.

11.

How to Lighten Scars?

Several methods, such as topical treatments, surgery, steroid injections, radiotherapy, dermabrasion, laser treatments, filler injections, microneedling, and cryosurgery, can lighten the scars and improve the appearance of scars.

12.

Which Cream Can Lighten Scars?

Topical creams and ointments such as cocoa buttercream, Vitamin E, silicone gel or lotion, and onion extract products may help lighten scars.

13.

What Causes Scars to Turn Dark?

A scar typically becomes darker initially, and after some time, they start to fade. However, dark scars can remain for years or indefinitely in people with darker skin. In addition, new scars are more prone to hyperpigmentation from unprotected sun exposure.

14.

Can Laser Therapy Remove Old Scars?

Laser treatment can erase or fade old scars to the extent that they become almost invisible. However, laser resurfacing does not make the scars disappear entirely, but it helps minimize their appearance.

15.

Can Plastic Surgery Help Remove Scars?

Yes, plastic surgery can remove scars entirely, leaving a smooth, virtually seamless appearance. Scar revision is a type of plastic surgery performed to improve the appearance of a scar anywhere on the body. This surgery helps scars be more like the surrounding skin tone and texture.

16.

How Long Does Scar Removal Surgery Take?

The length of the surgical procedure typically depends on the size, location, and complexity of the scar. In most cases, a scar revision procedure is completed within one to two hours. However, the surgery may take longer for large scars in an area that may be challenging to address or requires extensive revision and tissue repositioning.

17.

How to Get Clear Skin?

A few general tips can help clear skin fast.
Avoid popping pimples.
Wash your face twice daily and again after sweating using a mild cleanser.
Avoid touching the face.
Apply a good moisturizer.
Always wear sunscreen and reapply if needed.
Exfoliate skin with an exfoliant.
Get plenty of sleep.
Apply water-based, non-comedogenic, and fragrance-free makeup products to avoid clogging the pores.
Dr. Arunima Dhabal
Dr. Arunima Dhabal

Dermatology

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