What types of scar are there?
Skin scars are the most common types of scars, but scarring can also happen in the mouth, eye, urethra, bowel.....just about anywhere. This article will focus on improving scars on the skin.
Are all skin scars the same?
No, skin scars can be very different. Scarring happens in response to a wound, whether it is caused through having surgery or after an accident - all skin wounds will heal by scarring.
Often, scars begin flat. They will often be red in colour, due to the increased blood flow to the healing area. In time, this redness usually fades to leave a thin, pale, flat scar. If the scar is on an area of skin under tension, such as on the back, then the scar may stretch in time leaving a widened scar.
Some scars may become raised, red, itchy and lumpy as they form. If the scar does not become wider, then it is called a hypertrophic scar. Areas of skin such as the sternum (breastbone) are prone to forming hypertrophic scars as are people with pale skin.
If the scar becomes lumpy and continues to grow, widening outside its boundaries, then it is called a keloid scar. Keloid scars can happen on any part of the skin and are more common in darker skins or people that are genetically predisposed.
How can scars be treated?
A scar on the skin is permanent and cannot be made to disappear by any means. There are, however, numerous ways to improve on a scar, whether on the face, limbs or body.
Give the scar time to mature - as described above, it is common for a scar to look red in the first few months. In time this should fade and may well leave a very acceptable appearance, even on the face. Most scars can take a year or more to fully mature.
Scar creams - there are numerous scar cream treatments available on the market, some which seem quite promising and others which are perhaps less so. Many surgeons advise massaging scars with simple skin lotion to keep the skin supple and well hydrated, theoretically helping better scar formation. Click for more information on scar creams and gels.
Concealing the scar - a flat red scar can often be simply concealed with the use of make-up. More complex scars can have their appearance improved with specialist camouflage make-up, which can be taught by a specialist in this field. Your general practitioner or specialist should be able to refer you for such treatment.
Scar gel treatment - a relatively recent addition to scar treatments is silicone gel. This may be in the form of flexible gel sheets that stick over the scar, or liquid silicone that is smeared over the scar area. Treatment may need to continue for a number of months. Although the exact mechanism is poorly understood, improvements in the scar are often seen. Click for more information on scar creams and gels
Steroid injection - keloid and hypertrophic scars can become very firm as they grow. During this phase, a small amount of steroid can be injected into the scar in the outpatient department (children may need a short general anaesthetic). Often, the steroid will help the scar to soften, reduce itching, and even start to flatten the scar. Repeated injections may be needed a few weeks later.
- Scar surgery - Laser can occasionally be used to improve the appearance of scars, and dermabrasion (which shaves down the skin surface) may help some forms of acne scarring. If the above methods of scar treatment have not improved the scar to an acceptable appearance, then surgery can occasionally help. The scar can be removed and the skin re-stitched in a bid to produce a better result. Sometimes the scar may be 'broken up' into a zig-zag shape to help it blend better into the surrounding skin - this is known as a 'Z plasty procedure'. Surgery, however, will result in fresh scarring and there is always a risk that the new scar could form even worse than the original scar. In the case of keloid scars, the specialist may want to start using steroids or pressure devices to try and prevent recurrence of the keloid.
Other SurgeryWise articles
You may also be interested to read our articles on lasers or skin grafts
Have you read our article on scar creams?
The risks mentioned are not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.
The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer