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Scars

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What is a scar?

Scars are the body's natural way of healing and replacing lost or damaged skin. Scars are usually composed of fibrous tissue and may form for various reasons, such as injuries, infections, surgery, or inflammation of tissue. Scars may appear anywhere on the body. The look of a scar depends on many factors, including the skin type and location on the body, direction of the wound, type of injury, the age of the person with the scar, and his/her nutritional status. Scar composition may vary - appearing flat, lumpy, sunken, colored, painful, or itchy.

How can a scar be minimized?

Scars usually fade over time. Some scars can be minimized by several dermatological procedures or make-up. Treatment cannot completely erase a scar but can improve the appearance of it.

The following are some of the more common procedures for minimizing scars:

  • Chemical peels are often used to minimize sun-damaged skin, irregular pigments, and superficial scars. By removing the top layer of the skin using a chemical application, the skin regenerates and often presents improved appearance.
  • Collagen injections place purified collagen underneath the skin to substitute the body's natural collagen to improve the scar’s appearance.
  • Dermabrasion may be used to minimize scars by removing the top layers of skin with an electrical machine that "abrades" the skin.
  • Cryosurgery can help reduce the size of a scar by freezing the top skin layers and causing it to blister.
  • Laser resurfacing burns away damaged skin by using high-energy light and can also be used to minimize fine scars and wrinkles.
  • Surgical scar revision involves removing the entire scar surgically and rejoining the skin to create a less obvious scar.
  • Autologous fat transfer takes tissue from another site on the patient’s body and places it underneath the surface of the skin to elevate depressed scars.
  • Steroid injections help decrease itching, redness, and burning sensations, and also may reduce the size of the scar.
  • Pressure therapy involves a pressure appliance worn over the area of the scar continuously for up to six months.
  • Z-plasty is a procedure that uses a Z-shaped incision to help decrease the number of contractures of the surrounding skin, or to relocate the scar so that the edges of the scar look more like the normal lines and creases of the skin.
  • Skin grafts are performed by taking a piece of healthy skin from another area of the body and attaching it to the needed area.
  • Punch grafts are small skin grafts that remove the scar and then replace it with unscarred skin, usually from the back of the earlobe.
  • Skin flaps are similar to skin grafts, but the section of skin used includes the underlying blood vessels, fat, and muscles.
  • Tissue expansion increases the amount of existing healthy tissue available for reconstructive purposes.

What are the different types of scars?

  • Keloid scars are irregular thick and rounded clusters of scar tissue that grow at the site of an injury but beyond the edges of the borders of the wound on the skin. They oftentimes appear red or darker in color, as compared to the surrounding healthy skin. Keloids may occur up to one year after the original trauma to the skin.

  • Hypertrophic scars are similar to keloid scars, however, their growth is confined within the boundaries of the original skin defect. They are often elevated and thick and may appear red. Usually starting to develop within weeks after the injury to the skin, Hypertrophic scars may improve naturally, although the healing process may take up to a year or more.

  • Contractures are an abnormal occurrence that happens when a large area of skin is damaged and lost, resulting in a scar. The scar formation pulls the edges of the skin together, creating a tight area. The decrease in the size of the skin can then affect the muscles, joints, and tendons, causing a decrease in movement.

Recovery from Scar Revision Surgery:

Scars cannot be removed completely. Many factors will be involved in the degree of healing of a particular scar, with some scars taking more than a year to show improvement in appearance following surgery. As with all surgeries, it is important to follow all instructions to help maximize healing and recovery. Depending on the type of surgery that was performed, a physician will advise on all activity restrictions.