Scars form when the outer layer of the skin is damaged. They are caused by the build up of collagen which is produced to help a wound heal. Initially, the wounded area will have an increased blood supply and the scar may appear inflamed and the skin raised. This settles down after a few months. Scarred skin is often fibrous and hairless. Some scars can be itchy or uncomfortable and they may restrict movement or be particularly unsightly.
Are there different types of scarring?
- Hypertrophic scars are red and raised above the surrounding skin but do not extend after the original wounding.
- Keloid scars can continue to grow after the initial scar is formed. They can be painful. They are more often found in African and Afro-Caribbean skin. They are caused when the extra collagen that is produced to help the initial wound heal is not broken down and excessive collagen is produced.
- Pitted, atrophic scars sink below the surrounding skin.
- Contracture scars can affect function and are caused by the skin shrinking and tightening.
Why would I need to provide treatment for scarring?
Extra attention to scars may be required if they affect function and are restrictive, causing pain or discomfort, or if they are particularly unsightly.
What treatment options are there to reduce the effects of scarring?
Pressure can flatten scars and possibly increase collagen breakdown. It is often used for burns and large scars.
If the scar is particularly problematic such as keloid and hypertrophic scars, intralesional injections can be used to help flatten the scar. This can help to improve the appearance of the scar.
Silicone gel sheets
These can reduce redness and the long-term effects of scarring.
Laser resurfacing and surgery
Laser resurfacing can be used for pitted scars. Surgery can be used for tight restrictive scarring but may make keloid scars worse. Surgery can be combined with corticosteroid injections for a better outcome.