Did you know that there are different types of scars and that scar tissue lacks sweat and hair glands?

Scars, everyone has a few of them but never really talks about them with other people. But how do they form, why are they red/white and do they ever disappear? What are they and more importantly, what can I do for myself? In this blog, I will explain everything about scars and how you can treat a scar best.

What is a scar precisely?
A scar is the connective tissue that replaces the normal tissue after a trauma or illness. The body forms new collagen fibres which are a natural protein in the body to heal the damage. The tissue that will form the scar is a different type of tissue than the surrounding tissue. The scar tissue lacks sweat and hair glands, is also up to 70% less moist than the undamaged skin and is less resistant to ultraviolet radiation.

What does a scar look like?

• It can have a pink, red or white colour
• It can have a sunken or pitted appearance
• It can be thick, flat, shiny or paler

What are the different types and causes of scars?
There are a lot of different types of scars but the most common are:

Normal (atrophic) scars
This type of scarring is often associated with acne, infection such as staphylococcus, certain insect and spider bites, surgery or accidents. They are flat against the upper layer of the skin or serrated. The atrophic scar feels a little bit thinner than the surrounding skin and is sometimes also recessed.

Hypertrophic scars
This type of scarring is often associated with acne, piercings, cuts and burns. They generally form after thermal or traumatic injury that involves the deeper layers of the skin, but most commonly mechanical tension on a wound will cause hypertrophic scars.  The hypertrophic scar feels thicker than the surrounding skin and looks a little bit shinier than an atrophic scar.

Keloid scars
This type of scarring is often associated with burns, acne, ear piercing, chickenpox, surgical cuts and vaccination sites. Keloid scars often spread beyond the boundary of the original injury and occur mainly in dark skin. They are also thicker and more colourful than the atrophic or hypertrophic scars and have a shiny look.

Characteristic	Normal (atrophic) scar	Hypertrophic scar	Keloid scar
Aspect	flat	exalted	exalted
Limited to wound edges	yes	yes	no
Response of treatment	does not apply	good	bad
Redness	temporarily	possible	alternating
Speed of origin	fast	fast	delayed
Spontaneous recovery	n/a	sometimes, gradually	no
Symptoms (itching, pain)	no	possible	yes
Preceded by trauma	yes	yes	not always

There are also stretch scars and contracture scars. Stretch scars (also known as striae) arise during pregnancy, weight gain or an acute trauma affecting the skin. Contracture scars arise after the skin has been burned and this type of scarring may go deeper, affecting the nerves and muscles.

Acne scars
Acne causes different scars. See below overview:

 

 

 

 

 

• Ice-pick scars are deep, narrow, pitted scars -> they form when cystic acne gets infected
• Rolling scars have broad depressions with a sloping edge -> these occur in skin that has had long-term infinflammatory acne.
• Boxcar scars have broad depressions with sharply defined edges -> they also occur in skin that has had long-term inflammatory acne.

Treatment
There are several treatments for scars:

• Fractionated CO2 laser
• Scar tissue massage
• Microdermabrasion
• Microneedling (acne scars)
• TCA CROSS peeling  70-100% (acne scars)

Mostly you can start with the scar treatments 21 days after the surgery/trauma. This is because all wounds go through several stages of healing and if all goes well the skin will be ready for scar treatments after 21 days.

There are also a lot of different scar creams that you could use but the best thing to do is go to a doctor or dermatologist to ask them if it is useful for your type of scar. Every scar needs a different treatment so before you buy some cream or silicone sheeting, just ask a specialist.

If you have a scar that is older than two years, do realize that a treatment often does not achieve the optimal result. After two years the scar has finally formed and the skin will never be the same as the surrounding healthy skin.

For questions or tips, e-mail me: isla@myskinfacts.com

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125033/pdf/88.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3639020/pdf/ccid-6-103.pdf

https://www.alhydran.nl/oud-litteken-oud-litteken-verwijderen/

http://www.webmd.com/beauty/cosmetic-procedures-scars#1

https://www.dermeffacefx7.com/info/6-types-of-scars-and-how-to-treat-them/

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