Scars – Types of scars, why they form, and how to treat them
For many of us, visible scars are a painful reminder of the past. Whether it’s a reminder of an embarrassing pimple, an old injury, or a surgery we’d prefer people didn’t ask about – most of us have some type of scar somewhere on the face or body that we would like to forget.
So why do scars form in the first place? Why are some pitted and some raised? And of course – what can we DO to minimize these unwanted bumps, marks and dents for GOOD?
Scar tissue formation is part of the natural process of healing after any injury to the skin. When a cut or injury of the dermis occurs, the body works to quickly close the wound by producing an abundance of collagen at an accelerated rate. As a result, the skin quality is sacrificed in a sense, in order to minimize the chance of infection. The scar tissue that forms can differ depending on the extent of the wound, and certain factors such as age, heredity, even sex or ethnicity, will all affect how skin reacts.
There are 3 basic “types” of scars that may form on the skin: Hypertrophic, Atrophic, or Keloid scars.
A hypertrophic scar is a raised scar that forms above the normal skin level when collagen is over-produced. It can thicken over time and is often red, painful and itchy. Hypertrophic scars do not extend beyond the boundary of the original wound.
An atrophic scar is a sunken or “pitted” looking scar. This type of scar often occurs as a result of severe acne, chicken pox, or other skin diseases.
A keloid scar is a more severe type of hypertrophic scar. Keloids are often thick, painful, irregular in shape and can grow over time beyond the perimeter of the original wound.
There are several treatment options for scars, however it is virtually impossible to completely eradicate scar tissue. We can work to fade it’s colour or minimize it’s size and appearance, but essentially – it will always be there. Treatment is determined by the type of scar and it’s severity.
Laser treatments are a good place to start to reduce both the colour and irregular texture of certain types of scars. A few sessions using intense pulsed light (IPL) therapy can fade dark red and brown pigment in scars, and also works to generate the production of new collagen which can help to smooth out bumps or rough texture in the skin.
Raised, hypertrophic scars can benefit from steroid injections, which can help to shrink and flatten out the raised scar tissue. A series of these types of injection are performed over the course of a few months and are very effective.
In the case of more severe keloid or hypertropic scars, surgical correction may be required. In this instance, the doctor would surgically remove or “cut out” the irregular scar tissue and then re-suture the wound. Special attention would be paid afterward to reducing tension on the wound with special surgical tape and careful monitoring throughout the healing process. Dr. Born specializes in scar revision surgery and performs the procedure often.
One question we inevitably hear from potential surgery patients is “Will I have noticeable scars?” The goal with any surgical procedure is to get the best results with minimal scarring. Sometimes, a larger or elongated scar is the “trade off” for a more aesthetically pleasing shape, such as with breast lift surgery or tummy tucks. A skilled surgeon like Dr. Born is able to close the incision in such a way as to minimize the potential for heavy scarring – but again, many factors that are beyond anyone’s control may cause a person to develop irregular scars.
At the TMB practice, we provide extensive post procedure care in order to minimize the chances of irregular or unsightly scarring. One of the ways we do this is by providing all surgery patients with a series of LED light therapy treatments after their surgery. The “Gentle Waves” treatments work to heal your incisions and minimize the growth of scar tissue post procedure. Each treatment is a minute long, completely non invasive and totally painless. The non ablative LED light stimulates the body’s own regenerative processes on a cellular level, effectively combating damage caused to the skin.
For pitted atrophic scars, a combination of treatments may be used to effectively re-texturize the skin and fill in the depressed areas of the scar. Chemical peels and microdermabrasion can work to smooth out rough patches of skin over time and are particularly useful in the treatment of acne scarring. Both treatments work to increase cellular turnover and stimulate new collagen, leaving the skin smoother and clearer. For deeper pitted “icepick” scars as they are sometimes called, we may use an injectable filler such as Restylane to fill out the hollowed area. Filler injections can be done in office, with minimal downtime.
If you are concerned about an unsightly scar, it’s definitely worth it to explore these treatment options. Feel free to get in touch, or ask Dr. Born about solutions at your next appointment!