Scars on the skin

Scars on the skin
Scars on the skin are formations that have arisen due to tissue regeneration after injury or inflammation. The scar tissue consists mainly of collagen, therefore, in its structure and shade it differs slightly from the skin surrounding the scar. In addition, such a fabric differs from the one it replaces also by reduced functional features. First of all, it is worth knowing that scars are very sensitive to the effects of ultraviolet radiation, hair follicles and sweat glands do not recover after healing in them.

The content of the article:
Scar formation
Types of scars
Prevention of the appearance of a problematic scar
Methods of scar correction
Scars on the skin
A variety of methods are used to eliminate scars on the skin today:

laser grinding;
cryotherapy;
dermabrasion;
chemical peels;
surgical excision;
injections of steroid hormones.
The choice of the most appropriate method of scar removal mainly depends on how long ago it arose and how much it has grown on the skin. Keloid scars are considered to be the most difficult to treat, which are a serious aesthetic disadvantage, as well as for a long time accompanied by unpleasant sensations such as pain, itching, burning.

Scar formation
Scars are an inevitable consequence of injuries and surgeries. At the same time, they are a rather serious aesthetic disadvantage, especially when they are located in open areas of the body. The process of scar formation is quite complex and lengthy, it can last about a year. Scar formation consists of several links: tissue damage, the release of biologically active substances by cells that trigger an inflammatory reaction and attract cells to the injury zone for collagen production, collagen synthesis and the formation of a small scar.

It is worth noting that sometimes the wound healing process is disrupted for a variety of reasons: suppuration, features of the immune system, burn, hereditary predisposition. As a rule, a violation of the healing process of the scar appears at the stage of collagen synthesis, as a result of which a scar or keloid scar protruding slightly above the skin appears.

The first stage
I — inflammation and the process of epithelialization. This stage can last from a week to 10 days after skin injury. Within a week, post-traumatic inflammation of the skin begins to decrease. At the same time, the edges of the scar are connected with each other by a fragile fabric. This stage of scar healing is very important for the formation of a thin and elastic scar. Therefore, the doctor should not allow the divergence of the edges of the scar and its suppuration. To do this, surgeons usually apply special fixing sutures, and also prescribe anti-inflammatory drugs. It is advisable to limit physical activity during this week, since it can cause the edges of the scar to diverge.

The second stage
II — formation of a young small scar. This stage takes at least 10-30 days from the moment of injury. During this time, elastin and collagen are formed in the tissues. At the same time, the blood supply in the area of injury is preserved, since the scar has a bright pink hue. While the fibers are not yet fully ripe, the scar will remain quite easily stretchable. That is why it is incredibly important to prevent repeated injury during this period.

The third stage
III — formation of a mature massive scar. This happens 30-90 days after the injury occurred. At this time, there is a significant increase in elastin and collagen, and the fibers line up in directed bundles. At the same time, the number of vessels is rapidly decreasing, so the scar becomes pale and very dense. At this stage, repeated scar trauma can cause the formation of a keloid scar.

The fourth stage
IV is the final stage at which the final transformation of the scar takes place. This stage is completed for 4-12 months after injury. At this time, scar tissue matures very slowly, because vessels completely disappear from it, and collagen fibers line up along tension lines. You can see that the scar has become very dense and light. At this stage, the doctor has the opportunity to choose the most optimal method of removing the scar.

Types of scars
The classification of skin scars is very important, since the selection of therapeutic measures depends on the type of a particular scar. Therefore, the doctor needs to correctly determine the type of scar in order to get an idea of its properties and features, as well as choose the most effective method of treatment.

Normotrophic scars
This is the most common and almost imperceptible scar, which does not cause noticeable discomfort. The main advantage of these scars is that they are almost invisible, because they have exactly the same shade as the scar they replaced. Since these are quite small and shallow scars, it is very easy and fast to get rid of them without the need to use any radical methods of treatment. For example, you can do this with peeling.

Atrophic scars
These scars often occur due to the removal of moles or after the treatment of acne. The peculiarity of these scars is that they are slightly located below the skin level. Such scars are characterized by flabbiness of tissues, the formation of pits and other defects. Fortunately, this kind of scars can also be removed quite simply.

Hypertrophic scars
Such scars differ from others in their pink hue and the fact that they protrude slightly above the skin. Sometimes such scars disappear from the skin themselves without the need to treat them additionally. However, it is not worth waiting until they disappear, because it is very easy to treat such scars. Very small scars can be easily eliminated with the help of laser resurfacing or chemical peeling. Such techniques as the introduction of injections of kenalog and hormonal drugs into the scar zone also showed a positive effect. So that there is no trace of the scar, it can be surgically removed by excision of tissues.

Keloid scars
These are the most pronounced and noticeable scars that protrude above the skin. They are often quite painful, accompanied by itching and burning. This type of scar is incredibly difficult to treat. At the same time, in some cases, its relapses are even possible. Nevertheless, it is still possible to remove this scar with the help of modern methods of aesthetic medicine.

Features of keloid scars
Keloid scars are tumor-like tissue growths. The exact causes of this defect have not yet been studied. It is believed that risk factors are pregnancy, skin pigmentation, puberty, hormonal disorders, infection of the wound during its healing, genetic predisposition. Unfortunately, such a scar looks very ugly, therefore it causes severe discomfort to the patient, can cause deterioration of the psycho-emotional state.

In order for such a scar to form, it needs to go through four stages:

epithelization (about two weeks) — the injury is covered with a thin layer of epithelium, which over time begins to rapidly roughen and thicken, and its shade begins to fade;
swelling (about a month) — then the scar begins to increase dramatically in size, becomes very painful, rises slightly above the skin, after which the pain subsides, but the redness of the affected area increases significantly;
seal — over time, the scar begins to thicken and become covered with plaques, and looks like a keloid;
softening — at the final stage, the scar becomes mobile, pale and painless.
The keloid scar in most cases occupies a fairly extensive area, which can be a couple of times larger than the injury zone. Usually the scar has a pink or blue hue, a bumpy or smooth surface, a very dense consistency, clear boundaries with the surrounding skin. Unfortunately, over time, if such a scar is not treated, it can continue to grow — claw-like protrusions appear on it.

In most cases, keloid scars form on exposed areas of the body — the decollete area, auricles, shoulders and face. In addition to the fact that such scars look very ugly, they also cause unpleasant painful sensations — tingling, itching, burning. These sensations begin to bother the patient immediately after the beginning of scar formation and disappear after a long time.

Depending on how long it has been formed, it can be “young” or “old”. Scars that have appeared no more than five years ago are considered young. They usually have a smooth and even surface, are colored pink, and are characterized by an active growth of scar tissue. Scars that are more than 5 years old are called old: they differ in a pale shade and an uneven surface. The age of the keloid scar is important, because the correct selection of treatment largely depends on it.

Prevention of the appearance of a problematic scar
Treatment of keloid scars is very complex and long-term. It is for this reason that it is important to follow all methods of prevention in order to prevent the appearance of such scars. It is necessary to take the recommendations of doctors very seriously, because this will help to avoid serious complications for the whole body later. First of all, it is worth remembering that a serious injury to the face must necessarily be a reason to visit a plastic surgeon. He will provide timely medical care, thanks to which it will be possible to avoid the occurrence of a pathological process and the formation of a keloid scar.
You may also need to sign up for a consultation with a plastic surgeon if the patient has a small wound, the edges of which diverge very much. The specialist will apply special intradermal sutures and a tightening bandage around the edges of the scar. If you consult a doctor in time, you can avoid the development of a keloid scar.

In case of a wound, the patient should do everything possible at home to prevent its suppuration. Namely, it is necessary to treat it with antiseptics every day. This will help prevent the development of an inflammatory process that leads to the formation of a scar. At the earliest stage of scar formation, it is possible to suspend the pathological process or stop it altogether with the help of a silicone plate. The doctor may also prescribe a dissolving patch, which will significantly reduce the defect.

Methods of scar correction
A scar is an aesthetic flaw that can bother a person and cause him discomfort. Fortunately, you can get rid of most scars quite easily and quickly. However, it is necessary to know that some types of scars still heal much more actively and faster than others. Today, many different methods of removing scars are used in cosmetology. Of course, you can try to get rid of the scar with the help of special cosmetic preparations that stimulate tissue regeneration. However, creams and gels can only help in the early stages of scar formation. Otherwise, you should still use cosmetic procedures.

Physical therapy
The most used method of removing scars using physiotherapy is ultrasound phonophoresis. It is used to stimulate regenerative processes, as well as lymph and blood circulation. This technique allows you to inject medications into deeper layers of the skin using ultrasound. It is worth noting that ultrasonic waves penetrate quite deeply into tissues, actively affect them at the cellular level, warm them up, stimulate metabolic processes, saturate tissues with oxygen. Gradually, medications begin to accumulate, after which they are carried through the blood.

Laser grinding
This procedure implies an impact on the scar with a laser beam, which causes layer-by-layer evaporation of connective tissue. The technique allows the correction to be carried out fairly quickly and efficiently. It is worth noting that the procedure is accompanied by swelling and moderate soreness of the skin. However, over time, these symptoms disappear. Usually laser resurfacing is carried out together with other corrective procedures.

Photo correction
This procedure provides for the correction of the scar by masking it under the shade of the surrounding skin. This effect is achieved by destroying excessive pigmentation, which makes the scar very flat and allows it to acquire a physiological color. Usually this procedure is prescribed to eliminate normotrophic scars. To obtain the necessary result, the patient should undergo a course of 10 procedures.

Cryotherapy
This technique provides for the effect of ultra-low temperature on the scar. For this purpose, liquid nitrogen is used, which is supplied through an applicator. This technique is usually used to remove keloid scars. However, it is worth remembering that cryotherapy is not prescribed for people with dark skin, as this can provoke local depigmentation.

Injections
To eliminate keloid scars, which are often very difficult to get rid of, corticosteroid injections are prescribed. Often this procedure is accompanied by local pigmentation of the skin, which eventually disappears completely. To remove atrophic scars, injections of hyaluronic acid are usually administered.

Peeling with fruit acids
Small and shallow scars can be removed very quickly by peeling with fruit acids. During this procedure, the layer of dead cells is removed, as well as skin regeneration is stimulated. In addition, fruit acids activate the production of elastin and collagen, narrow pores, significantly improve skin relief, and also lighten areas with pigmentation.

Radiation therapy
This is a fairly effective method of removing scars. In addition, the procedure is ideal for eliminating relapses. This technique is used very rarely because of the harmful effects of radiation on the body.

Microdermabrasion
The technique of skin resurfacing, in which it is processed with microcrystals. Usually this procedure does not cause painful sensations, and also shows a very good result. To remove small scars, a softer grinding is used, which involves the use of an oxygen-oxide-aluminum mixture.

Chemical peeling
Separately, it is worth mentioning such a method of removing scars on the skin as chemical peeling. This is really a very effective and efficient tool that allows you to quickly and easily get rid of small and shallow scars. However, it is worth remembering that it is possible to prescribe peels only when the scar has already been completely formed. Otherwise, if such a scar is affected, serious complications may appear up to the formation of a keloid scar.

Chemical peeling is carried out in several stages. If it is necessary to remove a hypertrophic scar, then in this case the patient must undergo a preparatory course consisting of several procedures. This course is necessary in order to prepare the skin for a more serious and deep impact. After the skin has been well prepared, the doctor prescribes several peeling procedures (from 4 to 7). All these procedures are aimed at stimulating regenerative processes in the dermis.

To get a faster effect from chemical peeling, the doctor may additionally prescribe a cream containing silicone in its composition. Such a cosmetic product should be used to prevent inflammation and dryness of the skin. Peeling sessions are often combined with mesotherapy sessions. The introduction of vitamin complexes under the skin significantly accelerates the process of scar healing and regeneration of new tissue. It is worth noting that chemical peeling severely damages the skin, therefore, during the course of treatment, it is necessary to avoid direct sunlight on the damaged area in every possible way.

The course of chemical peeling
If the patient has very pronounced and noticeable scars, in this case, treatment will begin with excision of the scar. Also, the patient will need to undergo a whole course of physiotherapy procedures with the mandatory use of fibrinolytic drugs. After such treatment, chemical peeling is prescribed in two stages. First, to prepare the skin, the doctor prescribes a multifruit peeling based on citric, glycolic and lactic acid. Then, to obtain a more noticeable result, another retinolic acid-based peeling is applied.

Peelingretinolic acid is quite popular because of its highest efficiency. This is due to the fact that it affects the skin at the cellular level, as it enhances the production of collagen, proteins and elastin. In addition, it rejuvenates the skin, as it starts an active process of its regeneration. Separately, it should be said that the procedure is completely safe, since it does not cause serious complications for the patient’s health.

Often, to enhance the effect of peeling, doctors can additionally inject corticosteroid hormones. At an early stage of treatment, skin scars are considered the most effective method of scar correction. For the treatment of small atrophic scars, it will be enough to regularly apply ointment compresses that stimulate skin regeneration. More pronounced atrophic scars are treated by surface-median peeling, which is designed to smooth out their contour and relieve swelling.

Surgical excision of scars
To remove old and large scars, it may be necessary to use a more radical method of treatment — excision of scar tissue. This procedure is aimed at significantly reducing the area of the scar. The operation is based on the application of an intradermal cosmetic suture, which would fix and connect the edges of the scar well. Due to the imposition of such a scar, a neat and beautiful postoperative scar is formed in the patient.

However, it is worth remembering that it is absolutely impossible to perform surgery on a fresh keloid scar. This may cause its significant increase and even relapse in the future. Usually, the treatment of such serious scars begins with drug therapy. And only after a course of conservative treatment can surgical excision of the scar be started. Other types of scars also require careful attention — they can be removed only after complete healing.

It is almost impossible to predict exactly how a scar will look after surgery. This will largely depend on the body’s reaction to the operation, the healing process and the quality of the procedure. Scar formation is usually influenced by general and local factors. The general factors primarily include the features of skin regeneration and the age of the patient. More active wound healing is observed at a young age.

The wound healing process also largely depends on the state of the immune system. Namely, this process is caused by the activity of immune cells, as well as their effect on fibroblasts — cells responsible for the production of collagen. Hereditary predisposition also plays an important role.

As for local factors, they primarily include the location of the damage. In different areas of the body, the skin differs in the properties of blood supply, the structure of the fat layer. The condition of the blood supply to the suture also plays an important role. It is believed that a favorable outcome of this disease is possible only when blood circulation in the scar area is accelerated.

The scar healing process is also affected by the nature of the injury. For example, after lacerations and burn wounds, the patient may have a deformed scar. On the contrary, cut wounds usually heal much faster and easier. Of course, it is also worth remembering that timely surgical intervention can avoid the formation of keloid scars. Doctors also take into account the size of the affected area. However, it is worth noting that even in the case of extensive trauma, serious complications can be avoided if a qualified plastic surgeon intervenes.

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