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We all want healthy, beautiful skin. But scars, a natural part of the healing process, leave a lasting mark and cause some people to struggle with the negative impact on the appearance of their skin and in some cases, limitations in function or other concerns. If you’re unhappy with the appearance, texture, or health of your skin after an injury, surgery, or other damage that leads to scarring, the U.S. Dermatology Partners team can offer treatment to improve the appearance of scarring.
Scars are made up of fibrous tissue that replaces skin after an injury. Scars can be caused by many different things from burns to other trauma, such as surgery. They can also be caused by acne or, in the case of keloids, caused by the excessive healing of wounds.
The skin is our body’s largest organ, and the role of the skin is to protect the body from external dangers or irritants. When the skin is damaged by a traumatic accident, injury, burns, acne, illness, or other cause, the result is the formation of new skin cells and tissues to repair the structure and restore skin to its natural purpose, protecting the body. When damage only affects the outer layer of skin, the epidermis, you may not see scar formation. When skin damage penetrates deeper, reaching the dermis tissue, scarring is likely to occur. The surface of the skin is very thin, and we’re constantly shedding these cells and replacing them with new ones, so when a cut or scrape only damages those exterior cells, the odds are good that there won’t be any permanent scarring. When damage reaches the interior dermis layer, new collagen fibers need to be created to knit the skin back together. The new skin is often a different color and texture than surrounding tissue, which is what we call scar tissue.
Dermatologists use different names to identify scars that share a specific set of characteristics. Scars are a natural part of the healing process and can result from inflammation such as acne, infection, injury, or surgery.
Some common types of scars include:
Hypertrophic scars are the most common type of scar. These scars are raised above the natural surface of the skin directly over the wound site. Tissue develops over the course of weeks after the initial injury and will remain within the borders of the wound. Hypertrophic scars may appear red and raised next to healthy skin and will sometimes fade naturally. Though this type of scar tissue is often red in color, coloring can actually be darker or lighter than the natural skin tone.
Contracture scars are formed after the skin is burned. Unlike other types of scar tissue that is just the body’s attempt to repair and replace damaged skin, contracture scar tissue is often much tighter and less movable than surrounding tissue. It can even impact muscle and nerve function, limiting your range of motion.
Keloid scars may appear as irregular clusters of tissue that form a thick, rounded lesion. A keloid scar extends beyond the original boundaries of the wound, can develop as long as 12 months after the initial injury, and may be darker than surrounding skin. These scars are caused by an overactive healing response that creates scar tissue that extends far beyond the original wound. Common among people of color, this type of scar development may be prevented in some cases with the proper use of compression garments, especially in higher-risk patients.
Atrophic scars are well-defined depressions in the skin and are the result of a disruption in the formation of collagen after a skin injury. This scar tissue causes pits or indentations in the surface of the skin and is commonly caused by acne, cystic acne, or chickenpox. Not everyone with acne develops scars, and there are preventive measures you can take to limit scarring from acne, including following your dermatologist’s skincare recommendations and avoiding picking or popping pimples. Cystic acne and other types of acne that form cysts and pustules deep within the skin’s layers are much more likely to cause scarring.
Stretch marks appear due to the rapid production of new skin cells. Common among pregnant women, those who gain weight quickly, and those who experience a rapid growth spurt. Stretch marks also develop if a skin injury occurs at a joint.
Scar treatments and revisions are used to address specific side effects of scarring. Specifically, scar treatments may be used to improve the cosmetic aspects of scarring, including:
Scar treatment or revision may also address changes in the way skin feels, including:
Finally, your dermatologist may recommend treatment or revision for scars that cause functional concerns or discomfort. Contractile healing after burns can result in skin tightening and impaired function. When this occurs, we may need to provide intervention to improve functionality and avoid long term issues. Some scar tissue can cause dysesthesia, which is a condition caused by nerve damage that leads to symptoms like pain, itching, and numbness. In some cases, we can address the nerve damage and improve associated symptoms.
Each person will respond differently to scar treatments, but scar tissue will seldom completely disappear. However, there are many options available that can address common side effects of scarring and improve appearance, including:
If your scar does not fade on its own, it may be treated with dermatologic care. Your treatment will depend on many factors including the type of scar, your skin type, your age, and the location of the scar.
Certain scars respond to topical solutions that work by encouraging collagen production. Laser treatments or exfoliating treatments such as chemical peels and microdermabrasion may also be effective in reducing the appearance of scars.
The most common scar treatments are:
Revision is the process of redoing something with the hopes of improving the end result. Scar revision is no different. This treatment for scarring involves surgically removing scar tissue and closing the wound differently to improve the final appearance of the skin after healing. Scar revision is typically only recommended after other, less invasive treatment options have been considered.
There are a few surgical scar revision options that can improve skin health and appearance, including:
The doctors at U.S. Dermatology Partners can help you find the best type of laser treatment for your specific type of scar.
While results vary from person to person, people of ethnic background, such as Asians and African-Americans, face a greater risk of altered pigment after any type of laser treatment.
Certain scars respond differently to different treatments. How long the effects of your treatment last depend on the type of scar and the response of the scar to treatment.
The number one way to prevent scarring is to talk to your dermatologist about the injury or other causes of scarring right away. In most cases, damage that reaches the dermal layer of the skin will leave a scar, but your dermatologist can help you minimize the appearance of the resulting scar tissue. While your specific skincare plan will differ depending on the cause of scarring, you may want to take the following steps to limit your risk for scarring:
*Results may vary by individual