Scarring occurs when an injury causes damage to the dermis (the layer of your skin beneath your epidermis, which contains collagen, elasticin, and blood vessels). Scarring can be caused by major traumas like car accidents but can also happen from minor traumas such as skin picking, acne, falls, or other traumas. Mary Stevenson MD and I will discuss the various types of scarring and how to treat them in the article below.
Different types of scars
Scars can look different for everyone. There are five main ways to describe scars. You can use more than one descriptor to describe a scar.
- Normal scars, which are well healed, look normal and appear exactly as they should. They are the same color as the surrounding skin and not raised or too shallow.
- Atrophic scars refer to scars that are larger than expected or stretched.
- Hypertrophic scars refer to scars that are thicker than normal.
- Hyperpigmented scars refer to scars that are darker in color than the surrounding skin.
- Erythematous scars appear redder than the surrounding skin.
How a Scar Looks will Depend on Three Factors
- What caused scarring. A surgical excision closed with stitches rather than left alone will heal faster. Although certain body areas heal naturally, such as the hands or the face, this is not a general rule.
- How to care for the scar. Infected wounds will not heal as quickly as wounds that have been properly treated. Additionally, stretching the underlying muscles (e.g., working under the scar) in the initial stages of healing may lead to stretched and thickened scars.
- Your genes. Each person tends to have scarring. Some people heal well with barely visible scars are met. Some people are more prone to thickened scars or keloids, while others are more prone to thinning, stretched scars.
Sun protection to protect the scar
Stevenson states, Scarring tissue can be hyperpigmented and is subject to constant change for at least one year. To prevent hyperpigmentation, healing scars should be covered in sun protection and clothing.
Make sure to cover the wound.
Many people believe it is a good idea for a healing wound to be exposed to the elements. This is incorrect. Stevenson and I recommend that patients use an ointment to heal wounds for the first few days. This will speed up healing. You can leave the wound open during the shower so soap and water can run over it.
To promote normal healing, use a Silicone Gel.
Silicone is one of the best topical treatments to heal scars. Silicone promotes healthy scar formation. Avene scar gel is an over-the-counter scar gel that is easily available. After the skin’s top layer has healed, apply twice daily.
Massage gently to prevent scarring from pulling on surrounding tissue. Massage the area for two to three minutes with gentle pressure, 2-3 times per day.
Minimize Relevant Movement During Healing
Scars heal most quickly if there is minimal stretching. This can be done with exercise. Three weeks after surgery, I recommend that you avoid activating the underlying muscles. Not all exercise should be avoided. After a shoulder resection, you can still walk and do lower-body exercises. Running would be a problem.
Topical Retinoids to Treat Thin Scars, Stretch Marks, and Other Skin Conditions
A deficiency causes atrophic scars in collagen and elastin beneath the scar. To stimulate collagen production, retinoids may be beneficial. Although the results may not be immediate, prescription retinoids can help eliminate scarring.
Intralesional Kenalog to Thickened Scars
A simple in-office injection can flatten thickened scars. Although it may take several treatments to improve thickness, any associated pain or itching should decrease with each treatment.
Laser and microneedling for thin scars
Procedures that reach the dermis level are best for treating scar tissue once it has formed. Stevenson points out many options for improving scar appearance, including picosecond lasers and CO 2 Lasers. She also suggests microneedling with or without radiofrequency. It is often best to use a combination approach, she says.
Red Scars with Pulsed Dye Laser
Pulsed dye lasers are designed to target blood vessels. These lasers are used to reduce redness from rosacea and can also be used to treat redness in scar tissue. They may also improve the scarring appearance.
Laser for Pigmented Scars
It can be difficult to treat pigmentation in scar tissue. However, laser treatments like laser genesis and clear and brilliant can make a difference.
Replace the Scar
Stevenson mentions that stretched scars can sometimes be removed and replaced by a better scar.
Consider Filler for Acne Scars
In addition to the procedural and retinoid treatments, Filler can also be used to fill in scarring from acne.
For up to one year, a scar will continue to heal. You will see continued improvement with proper care, including massages and sun protection. It is better to start treatments earlier than later if necessary. It is a good idea to consult a board-certified dermatologist to determine the best course of action for you.