A scar is a mark which is left on our skin after an injury or wound has healed. We know that scars are natural parts of the healing process. Most scars will fade and they will become paler over the time, although scars never completely disappear. Scarring can affect people in both ways – psychologically and physically. If the scar is located on the face, then this can be very distressing. This situation can get worse if you noticed that someone is staring at it. If someone is avoiding people because of his or her appearance, then he or she can easy become socially isolated. This will lead to feelings of depression [1]. You should seek medical help if your scars are affecting your everyday activities or they are making you feel depressed. Scarring is a part of our body’s natural healing process after some tissue is damaged. When our skin is wounded, then the tissue breaks, which is causing a protein called collagen to be released. Collagen builds up where our tissue is damaged which is helping to heal and strengthen the wound. The new collagen continues to form for several months and the blood supply increases which is causing the scar to become lumpy, raised and red. [2] In time, some collagen will break down at the site of the wound and the blood supply will be reduced. The scar will gradually become paler, softer and smoother. You should know that scars are permanent but they can fade over a period of up to 2 years. It is unlikely that they will fade any more after the mentioned time.
Types of scars
A scar can be an abnormal overgrowth of tissue, a fine line or a pitted hole on the skin. Here are some types of scars:
- Hypertrophic scars: These types of scars are result of excess collagen that has being produced at the site of a wound. But in these types of scars collagen is not produced in big quantities compared to keloid scars. These scars do not extend beyond the boundary of the original wound, but they can continue to thicken for up to 6 months. These scars are red and raised to start with, before becoming paler and flatter over the course of several years. [3]
- Keloid scars: This type of scar is an overgrowth of tissue which is happening when too much collagen is produced on the site where the wound is. Keloid scar keeps growing and even after the wound has been healed. These types of scars are raised above your skin and they are purple or red when new one is formed, before gradually they become paler. They are often painful or itchy. They can restrict your movement if they are near a joint and they are tight. [3]
- Scar contractures: These types of scars are often caused by burns. They are happening when the skin shrinks which is leading to tightness and a restriction in the movement. [4]
- Normal fine line scars: A minor wound which looks like a cut will usually heal to leave a red and raised line and it will gradually get flatter and paler over the time. This process can take up to 2 years and the scar will not disappear completely. This means that you will be left with a visible line or mark. Fine line scars are very common and they are coming after surgery or following a wound. These types of scars are not usually painful but they can be itchy in a period of few months. People who have darker skin can have a brown or white mark after the scar tissue has fade which is leaving the previous mentioned marks. Also it is known that the pale scar can be more obvious on tanned skin because the scar tissue does not tan.
- Stretch marks: These types of scars are narrow lines or streaks which are appearing on the surface of our skin when the dermis (the deeper layer of the skin) tears. They are often caused by hormonal changes which are happening during puberty or pregnancy, or as a result of hormone replacement therapy or bodybuilding. [5]
- Pitted or sunken scars: There are some scars which are caused by skin conditions, such as chickenpox and acne, that can have pitted or sunken scars. Pitted scars also known as ice – pick scars or atrophic scars. They can also happen as a result of an injury that is causing a loss of underlying fat. [6]
References:
[1] Gibson JAG, Ackling E, Bisson JI, et al. The association of affective disorders and facial scarring: Systematic review and meta-analysis. Journal of Affective Disorders. 2018;239:1-10.
[2] Oxford University Press USA. Scientists find new ways to prevent skin scarring. Science Daily. 2020. Retrieved from www.sciencedaily.com/releases/2020/02/200204121455.htm
[3] Tripathi S, Soni K, Agrawal P, et al. Hypertrophic scars and keloids: a review and current treatment modalities. Biomedical Dermatology. 2020.
[4] Goel A, Shrivastava P. Post-burn scars and scar contractures. Indian Journal of Plastic Surgery. 2010;43(Suppl):S63–S71.
[5] Wollina U, Goldman A. Management of stretch marks (with a focus on striae rubrae). Journal of Cutaneous and Aesthetic Surgery. 2017;10(3):124–9.
[6] American Academy of Dermatology. Scar treatments can improve patients’ quality of life. Science Daily. 2016. Retrieved from www.sciencedaily.com/releases/2016/07/160728102212.htm
