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Perfect Imperfections

Updated: Mar 6, 2023

A blog on scars and their management (5 minute read)

There cannot be a single human without scars of some form or the other. And we are not talking about the emotional scars here.

Unless you are a celebrity willing to flaunt his/ her imperfections, I am sure you'd like to know more and address your scars if any.

Firstly, what are scars?

Any plastic surgeon would tell you, scar (or scar tissue) is an area of fibrous tissue that replaces normal skin after an injury. The most common injury can be in the form of accidents and other external trauma.

But scars can also occur due to acne (pimples), chickenpox, sun damage, burns, surgeries, certain animal/ insect bites, and even by a genetic connective tissue disorder, such as Ehlers–Danlos syndrome

This brings us to the next question;

Why do scars form?

Scars form when the dermis (deep, thick layer of skin) is damaged. The body forms new collagen fibres (a naturally occurring protein in the body) to mend the damage, resulting in a scar.

Simply put, superficial wounds usually heal without a scar. You may have noticed that minor scratches on your body due to any reason heal without a scar. This is generally in the epidermis.

Deeper wounds involving the dermis usually lead to a scar. In these types of injuries, your body's priority is to build up tissue to close the wound up regardless of how the tissue looks.

And voila, you are presented with a scar.

Why do some injuries scar while others don't? Why do some people scar while others don't?

Scars occur when there's a barrier of any kind to closing up the wound.

  • This can occur due to contamination in the wound. (Infected wounds are highly likely to leave scars)

  • Size of the wound. Larger wounds obviously take longer to heal and tend to leave scars compared to smaller wounds (<2 cm)

  • The severity of the injury, location of the wound, and mechanical factors such as stretching of the wound.

  • Your overall health and nutrition also play a key role in scar formation. Malnourished or chronically ill patients may have insufficient resources to heal the wound.

  • Genetics - Your genetics can determine your tendency towards hypertrophic scarring/ keloids.

  • Ethnicity - Generally darker skinned individuals tend to scar abnormally when compared to lighter skin individuals.

What are the types of scars?

  • Hypertrophic scars

Hypertrophic scars occur when the body overproduces collagen, which causes the scar to be raised above the surrounding skin. Hypertrophic scars take the form of a red raised lump on the skin for lighter pigmented skin and the form of dark brown for darker pigmented skin. They usually occur within 4 to 8 weeks following wound infection or wound closure with excess tension and/or other traumatic skin injuries

  • Keloids

Keloid scars are a more serious form of excessive scarring because they can grow indefinitely into large, lesions. It is a result of an overgrowth of granulation tissue. Those who have a family history of keloids are also susceptible since about 1/3 of people who get keloids have a first-degree blood relative (mother, father, sister, brother, or child) who also gets keloids.

  • Atrophic scars

An atrophic scar takes the form of a sunken recess in the skin, which has a pitted appearance. This type of scarring is often associated with acne, chickenpox, surgery, certain insect and spider bites, or accidents.

  • Stretch marks

Stretch marks (technically called striae) are also a form of scarring. These are caused when the skin is stretched rapidly (for instance during pregnancy, significant weight gain, or adolescent growth spurts).

How to treat scars?

Non-surgical treatment options for scars:

  • Topical therapy either with steroid creams/ scar release creams.

  • PRP/ Platelet-rich plasma

  • Microneedling

  • Chemical peels

  • Filler injections

  • Laser

  • Dressings and topical silicone

  • Massage

  • Steroids

  • Dermabrasion

Surgical treatment options for scars:

  • Surgical excision or scar revision

  • Fat fill

Combination therapy for scars:

Combination of the above-mentioned therapies for stubborn scars.

Scars make for great stories. Especially in the mainstream media. They also serve as means of identification. Our mythology and history reveal numerous stories and characters with scars on them. But that is exactly what we want them to be. History.

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