The skin repairs itself after an injury or wound, but the affected area is often altered by a scar. Although scars fade with time and become less noticeable, they are permanent. But although scars cannot be erased, proper wound care can help minimize scarring, and treatments can help make the scars inconspicuous.
Scar Formation
Every break in the surface of the skin results in scar formation, says Eugene L. Alford, M.D., director of the Alford ENT and Facial Plastic Surgery in Houston, Texas. Not only cuts and punctures, but also some infections such as chickenpox and conditions such as acne cause scarring. The body produces excess amounts of collagen--a connective tissue--and new cells to heal wounds. A rich supply of blood vessels feeds the new tissue, making new scars appear red and raised compared with surrounding skin.
Appearance
New scars appear thick and red, and gradually fade over 12 to 18 months, says Alford. Further changes are unlikely after 18 months. Scars appear more prominent in areas with tight skin, such as the ankle or jawline, compared with fleshy areas, for example the thigh or abdomen, explains the American Academy of Dermatology (AAD). Noticeable scars are more likely to form over large wounds that are slow to heal. Young skin generates a more aggressive healing response, resulting in larger and thicker scars compared with older people. People with darker skin tones tend to have more noticeable scars than those with fair skin, says Alford. Scars occurring in line with wrinkles are less noticeable than those that run across natural folds.
Types
Scars fall into one of three types, according to Alford. Atrophic scars are depressed, causing indentations or valleys in the skin, whereas hypertrophic scars appear raised. Hypertrophic scars usually recede with time. Keloids consist of large, raised scar tissue that extends beyond the area of the original wound into normal tissue. Keloids are a form of benign tumor.
Treatment
Proper wound care helps prevent scarring, says Alford. Wounds should be properly cleaned and dressed to prevent further injury or wound reopening. Proper nutrition and topical or oral antibiotics promote healing and reduce scarring. Scarring can be minimized using laser treatments or surgical revision, notes the AAD. Treatments blend scars into the surrounding skin by altering the depth, color and size of the scars. Injections of the corticosteroid triamcinolone prevent collagen formation and stimulate the body to reabsorb excess collagen, reducing scarring. Aloe vera helps minimize redness of new scars, but Alford maintains vitamin E has no noticeable effect, although the vitamin does no harm. Aloe vera and vitamin E should not be applied to new scars less than three weeks old.
Cautions
Closely watch wound healing, advises Alford. See a healthcare provider if a scar changes in appearance--for example, becomes larger, or if the initial redness fails to fade. A scar that itches, hurts or restricts movement requires medical attention.
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