Scars develop after accidents, surgery, specific diseases and chronic wounds. They are caused by injuries that reach down to the corium. Depending on the specific zones of the body there is also a different healing process to observe. While wounds on mucous membranes heal without scarring, specific medical conditions like e.g. acne and chickenpox leave holes or “pits” that are visible for quite some time.
Below the scarred areas the collagen fibers are spread irregularly and the natural elasticity of the skin is disturbed. The surface of the scar is clearly marked, sometimes even reddish at first and stands out against the surrounding skin as there are no hairs, sebum and sweat glands. The reddish color is caused by various blood vessels that shine through the upper layer of the skin (horny layer). As time passes, the number of blood vessels shrinks and the reddish color fades with the result that the scars may even become pale due to the lack of pigment producing cells (melanocytes). Hardened areas or softer zones may form as there are also modifications in the connective tissue.
Different kinds of scars
There are different kinds of scars according to the specific genesis. Acne causes atrophic scars. During the shrinking process in the wound the originally developed granulation tissue is replaced by fiber-containing connective tissue. But this process finally results in a deficit of collagen fibers.
An increased formation of connective tissue can be found in hypertrophic scars. In most of these cases the healing process had been delayed, either caused by continued mechanical irritation or by renewed inflammation as a consequence of infection. Hypertrophic scars have a bulging appearance.
We speak of keloids if the newly formed connective tissue is not confined to the original wound area but continues to grow into the surrounding skin. This process leads to nodular swellings even sometimes of enormous extent. The collagen forming fibroblasts are more active in keloids than in hypertrophic scars.
Skin hardenings combined with reduced skin elasticity are characteristic for sclerotic scars which tend to shrink.
By contrast, fibrous scars (physiological scars) are smooth and their elasticity is similar to the condition of the surrounding skin. They attract attention through the optical contrast.
While both wound and scar change their appearance quite fast in the beginning, the visible modifications slow down to the end of the healing process. Years later gradual adaptations to the surrounding skin can still be noticed. This is the reason why it makes sense to maintain a long term follow-up treatment. Adequate preventive treatment may even avoid the formation of the scar-like stretch marks. While a preventive treatment of wounds is impossible of course, it is advantageous though to start with the cosmetic skin care already at an early stage in order to achieve as much elasticity in the tissue as possible. A delayed healing process due to a deficient microcirculation in the wound area which occurs for instance in the diabetic leg has rather negative consequences.
As irritations have counterproductive effects it is recommended to use cosmetic creams and gels without perfumes and preservatives. On top of it, the scarred skin has to be protected with UV filters in form of sun screens as the scars lack melanin. Consequently there is an extremely high risk of sun burns.
Treatments to minimise the appearance of scars
At Pure Skin Clinic we offer a range of topical home and in clinic treatments carefuly chosen for your skin and scar type. MTS dermal home rollers, EXCEED Collagen Induction Therapy and MAX+ LED light therapy are great treatments for unwanted scaring and streach marks. Please book advanced skin consultation to find out abot the best treatments for your specific needs.