A scar is a mark on the skin after a cut, wound, or injury has healed. Scarring is a natural part of the healing process but scarring that is obvious on the skin of the face, hands or body is often unwanted. Treatment to remove or at least to minimise the appearance of scarring is an important aspect of medical dermatology.
Here at The Devonshire Clinic in London, our team of dermatologists can provide a range of scar removal treatments to help remove and minimise scarring.
What causes scarring?
Any damage to the skin has the potential to cause scars:
- Severe trauma such as a car accident or other major injury
- Scalding or burning
- Surgery to remove a tumour that is affecting the skin
- Infections like chicken pox and skin conditions like acne can leave deep and obvious scars that persist for the rest of your life without treatment. The scarring tends to be worse if the original spots were scratched or, in the case of acne, left untreated
- Animal bites and severe scratches
How does a scar form?
When the skin is injured, damage usually occurs to the epidermis, the outer layer of skin and to the dermis underneath. This skin layer contains nerve endings, blood capillaries and hair follicles and these can all be damaged and cause scarring.
Once bleeding has stopped, blood flow to the site of the wound continues to be high, bringing in the white blood cells that fight infection and the cells that repair the tissue. Some of these cells produce new collagen fibres to hold the skin together.
The new collagen fibres are not arranged as they were originally in undamaged skin, so the surface above the scar can be raised. It is often also red for several weeks until the increased blood flow starts to subside.
After several months, the scar becomes less obvious. The skin level can adjust and the colour of the skin starts to return to normal. Most scars fade but the healed skin is never quite the same and, in some people, scarring is more noticeable.
What kind of scar do I have?
- A flat, pale scar – this is the most common type of skin scar. The original scar that forms soon after healing is red or darker than the surrounding skin but it fades over time. This type of scar fades over time but rarely disappears completely.
- A pitted or ‘ice pick’ scar – if the new collagen produced during healing is not sufficient to repair the damage to the skin, the surface of the skin sinks, forming a depression or pit.
- A contracture scar – this is due to the skin shrinking during healing. The edges of the skin are drawn together causing tightening that feels uncomfortable and can restrict movement.
- A hypertrophic scar – this is a red raised scar that persists for a long time. This type of scar is usually caused by surgery.
- A keloid scar – this is due to overgrowth of the underlying tissue during healing, leaving a permanently raised area of skin. The scar can revert to normal skin colour but it is obviously raised. It may even become larger than the site of the original wound. Keloid scars aren’t necessarily the result of a major wound. Sometimes very minor cuts, grazes and acne spots can result in a keloid scar in people who are very susceptible to them.
The emotional impact of scars
Scarring can be particularly difficult to deal with, particularly on visible areas such as the face, It can make you feel very self-conscious, uncomfortable and embarrassed. Some individuals with scarring may avoid leaving home, meeting other people or social situations. This can lead to isolation and even depression.
Can scars be treated?
Fortunately, the appearance of many scars, even those that are severe, can be improved by treatment. Read more about the scar treatments available from our consultants at The Devonshire Clinic.