When damage or deep injury occurs in the skin, scar tissue may form during the healing process. While surface scrapes often regenerate without issue, deeper damage may result in various forms of scarring. Following injury, special cells in the lower layer of skin begin to create collagen to repair and reconnect the skin, like natural stitches. What the individual scar ends up looking like depends on a variety of factors, including the location and cause of the injury, age and overall health of the patient, and presence of inflammation in the skin.
Types of Scars
There are several different types of scars that can form, and they can all look and behave differently.
- Superficial Scars — this type of scar is long and thin. It may be slightly raised and red in the first few months, but then usually flattens and heals neatly.
- Hypertrophic Scar — this type scar has an over-active wound healing process and has generated additional collagen. As a result, the scar is thicker and therefore elevated above the skin. The area may feel tight and itchy. These scars may flatten over time, but often remain thickened. A hypertrophic scar is limited to the injured area, which distinguishes this type of scar from a keloid scar.
- Keloid Scar — in a keloid, scar tissue develops beyond the area that was originally injured. Keloid scars may look like large, firm nodules or lumps. Keloids can continue growing long after the initial injury has healed, and may be itchy or painful. Often, these scars require treatment if they are continuing to grow and be bothersome.
- Depressed Scar — the scar is lower than the surrounding skin in a depressed scar, and may resemble a divot in the skin. This usually happens when supporting tissue, like fat or muscle, is lost or damaged in the injury. Stretch marks and some acne scars are considered depressed scars.
As time passes, many scars will slowly improve and become more pale and less thick. Scars never completely go away, but there are several options to make them less noticeable, more comfortable, and blend them into the surrounding skin.
In-Office Treatments for Scars at Ganger Dermatology
- Corticosteroid Injections — this treatment is helpful for both hypertrophic and keloid scars; scars that are thick or raised. The injection of a steroid medication decreases inflammation that may cause itching of the scar and helps to thin out the abundant collagen of thickened scars. Corticosteroid injections can result in flattening out raised scars, stop growth of enlarging scars, and make itching or painful scars less bothersome.
- Chemical peel / Microlaser peel — this procedure can be very helpful for improving very superficial scars or dark marks left behind after acne or other injury. By stripping away a thin layer of surface skin, new healthy skin cells start to grow, leading to a more even skin tone and more radiance to the skin.
- Laser Resurfacing — this is the hard-hitting treatment for improving the way scars look. A laser creates very small, defined columns of controlled injury into the upper and lower levels of skin in the scar. This causes the production of new, orderly, healthy collagen and skin cells. Laser resurfacing is great for many types of scars - acne scars, stretch marks, depressed scars, hypertrophic scars and superficial scars.
Ways to Improve Scar Appearance with Over the Counter Treatments
Although less effective than in-office treatment, there are a few things you can do at home to improve the appearance of your scar over time.
- Sun Protection — scars exposed to sunlight may stay red longer and heal more darkly. Cover up your scar when you’re outside, and use sunscreen with an SPF of 30 or higher every day.
- Silicone Sheets or Gel — once the wound has completely healed, sheets or gel containing silicone can be applied to help improve the appearance of new scars. Apply twice a day for five weeks after the injury has fully healed.
- Gentle Massage — massaging new scars with a moisturizing lotion can prevent your skin from drying out, prevent scar tissue from building up, and may improve the final appearance of the scar.
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