How to Take Care of Your

Scars

What Are Scars?

• A scar is a permanent patch of skin that grows over a wound. It forms when the body heals itself after a cut, scrape, burn or sore. Scars also appear after surgery that cuts through the skin, infections like chickenpox, or skin conditions like acne. Scars may be depressed (atrophic) or raised (hypertrophic and keloids).

• A total of 100 million patients develop scars in the developed world alone each year as a result of 55 million elective operations and 25 million operations after trauma.

What Causes Scars?• Scars form when the dermis (deep, thick layer of skin) is damaged. The body

forms new collagen fibers (a naturally occurring protein in the body) to mend the damage, resulting in a scar. The new scar tissue will have a different texture and quality than the surrounding tissue. Scars form after a wound is completely healed.

• There are different kinds of scars:• Atrophic: This kind of scarring occurs when underlying structures

supporting the skin (for example, fat or muscle) are lost. Some surgical scars have this appearance, as do some scars from acne. Some atrophic scar may appear when the skin stretches rapidly (for example, as in growth spurts or during pregnancy). In addition, this type of scar can occur when the skin is under tension (near a joint, for example) during the healing process.

• Hypertrophic or Keloids: The body produces too much collagen resulting in raised scars called hypertrophic scars or keloid scars. Keloid scars result from an overproduction of collagen that grows beyond the margins of the original wound. Both types of scars are more common in younger and dark-skinned people.

Signs and Symptoms of Scars

• Atrophic: Atrophic scars may be flat and pale. Some atrophic scars can have a sunken or pitted appearance. This kind of scarring occurs when underlying structures supporting the skin (for example, fat or muscle) are lost. Some surgical scars have this appearance, as do some scars from acne. Some atrophic scars also can appear as stretched skin. Such scars result when the skin stretches rapidly (for example, as in growth spurts or during pregnancy). In addition, this type of scar can occur when the skin is under tension (near a joint, for example) during the healing process.

• Hypertrophic Scars. Hypertrophic scars are thick, red, and raised, however, unlike keloids the scar remains within the boundaries of the original incision or wound.

Signs and Symptoms Cont’d

• Keloid. Keloids are thick, protrusive mounds of scar tissue and are often red or darker in color than the surrounding skin. See table 1 for differences between hypertrophic scars and keloids.

• Contractures. Burns or other major injuries may form a scar that pulls the edges of the skin together, a process called contraction. The resulting contracture may affect the adjacent muscles and tendons, restricting normal movement.

Signs and Symptoms Cont’d

Scar Treatment

• Topical treatment:• Atrophic Scars: There is no topical treatment that

can prevent or remove atrophic scars. Retinoic acid• Hypertrophic scars and Keloids: The best treatment

to prevent the formation and to reduce some signs and symptoms associates to this type of scars is 100% topical silicone. It comes in gel or spray. The most effective is the one that dries itself in seconds, allowing the use of other cosmetics like sunscreens, moisturizers and make-up, on top of it.

Scar Treatment Cont’d

• Procedures:• Atrophic scars: These lesions can be treated with a procedure

called microneedling and some types of laser to stimulate collagen. A procedure called subcision is used to remove the fibrous tissue of scars attached to deeper tissues. Sometimes derma fillers can be used to fill in depressed scars. The best results are obtained with the combination of procedures.

• Hypertrophic scars and Keloids: Intralesional corticosteroids and cryotherapy with liquid nitrogen are the most common for the treatment of this type of scars. Some other procedures including scar revision, radiotherapy, intralesional 5-fluoruracilo, lasers have been used with variable results.

Where to Get Help?• http://www.askderm.com• http://www.askderm.com/skin-care• http://www.askderm.com/skin-care?skin_con

cern=288• http://www.askderm.com/kelo-cote-advanced

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