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ScarsIntroduction Scars are a natural part of the healing process and they can happen both inside and outside the body. Visible scars sometimes form after the skin has been broken, but you can also have scars on your internal organs, for example where you have a torn a muscle or where a cut has been made during surgery. When a wound or injury has happened, and there is a break in some of the tissue in the body, the body heals it by producing more of a substance called collagen. This is a protein and it builds up at the place where the tissue is broken, eventually helping to close it. Collagen continues to be pumped into this part of the body for years after the original wound, which is why the scar will gradually become smoother and softer. Scars on the skin can take up to two years to fade, but after this time it is unlikely that they will fade any more. Certain areas of the body are more likely to have scars than others. The knees and shoulders often have more visible scars, because during the healing process they need to move and stretch a lot. Darker skin is also more likely to scar. Sometimes abnormal scars develop. A hypertrophic scar is a large scar that may form when a large area of skin is missing, or if a wound becomes infected. A keloid is an overgrowth of tissue, when too much collagen is produced at the site of the wound and the scar keeps growing even after the wound has healed. Symptoms Scars on the skin appear when a cut or other injury is healing. At first they may be red and sore looking, but they will usually fade. If the skin at the edges of the wound has come together fairly neatly, perhaps because of a narrow injury or because it was stitched, the scar will usually heal into a thin pale line. In wider scars, where more surface skin is missing and more scar tissue was needed to join the gaps between skin (such as a bad graze on the knee), the scar may be darker and take longer to heal. Scars are not usually painful. They can be dark and unsightly, and when the scar tissue fades it may be more noticeable when the rest of your skin tans and the scar stays pale, or if you have darker skin. Abnormal scars are often large (in proportion to the wound). Keloid scars push into the normal skin or hang off the skin in a saggy lump. Hypertrophic scars, which cover a large area, can restrict movement because scar tissue is not as flexible or sensitive as the original skin. Stretch marks are skin markings that can look similar to long thin scars, but they are actually formed in a different way. See the separate topic on stretch marks for more information. Causes Scarring is caused by the natural healing process when tissue in the body is broken. Breaks in the skin can be made in a number of ways: Accidental injuries, such as cuts from falling off a bicycle; Deliberate harm, from a weapon or from self-harm; Cuts made during surgery, such as a Caesarean section birth; Bites and scratches from animals or people; Burns and scalds from hot objects or liquids. Scarring is a symptom of some conditions, such as scleroderma, a condition affecting the connective tissue and involving hardening of the skin. Scarring can also be a side effect or complication of other conditions. For example, if you scratch your itchy spots during chickenpox, you may be left with scars in the places where the spots were. Internal scarring can be caused by accidental or deliberate injuries, or by surgery. Treatment Scars only need to be treated if you feel uncomfortable with the way they look, or if they are painful. Scars cannot be removed completely, but in many cases it is possible to make them less visible. Your GP may refer you to a specialist skin doctor (dermatologist) for treatment. Both men and women can use make up to cover up scars, especially those on the face. Pharmacies sell special camouflage make up, made particularly for covering up scars. Creams or supplements containing vitamin E may be helpful in speeding up the healing process and having less visible scars afterwards. Eggs and leafy green vegetables are both rich in vitamin E. Silicon gel sheets are sometimes used to try to reduce the visibility of scars, by flattening and softening them. They are available from some pharmacies. Silicon gel sheeting can be used to treat and prevent hypertrophic and keloid scars and is used on healing skin (not open wounds). Ask your dermatologist, GP or pharmacist for further advice on using this treatment. Dermatologists may prescribe drugs such as potassium aminobenzoate, to help break down scar tissue. These are often used to treat conditions such as scleroderma that can cause extensive scarring and hardening of the skin. Severe acne scars are sometimes removed using laser resurfacing, when the top layer of the skin is gently removed using lasers. Sometimes surgery is used to improve the appearance of scars. This is known as scar revision, and can include procedures such as a skin graft if the scar is not healing properly or if a lot of skin has been lost. After serious burn injuries, pressure garment therapy is often used to prevent and treat scarring. This involves wearing stretchy stockings over the burn area, which apply pressure on to wound, and help it to close neatly. For serious burns, they have to be worn up to 23 hours each day, and for up to 12 months. Other treatments for burn scars can include massage therapy and steroid drugs. Complications Scarring, particular when it involves the face, can have a psychological effect. People with scars can become depressed because they feel that they are being stared at, and this may mean they don't want to go outside or see a lot of people. Abnormal scars sometimes develop, often as a result of an infection in the wound, the loss of a large area of skin, or a serious burn. They can be itchy, painful and unsightly. Keloids are an overgrowth of tissue at the site of a scar. They grow beyond the site of the original wound and on to normal skin, and may form flaps that dangle or hang off the skin. Scars in certain parts of the body, such as the lower face, upper back and ears, seem more likely to develop abnormally. Hypertrophic scars are large scars that may form when a large area of skin is missing, or if a wound becomes infected. Unlike keloid scars, they tend to shrink and heal over time, and do not grow out beyond the edges of the original wound. Hypertrophic scars can restrict movement because scar tissue isn't as stretchy or sensitive as the skin it replaced. Prevention You cannot completely prevent scars from forming but there are some things your doctor can do to help your scar be less severe and heal better. Dirt and objects such as glass or gravel should be cleaned out of the wound. Dead tissue should be cleared out. This reduces the chances of infection. If stitches are required, the finest type of stitching material that can hold together the wound should be used. Silicon gel sheets and pressure garment therapy can also help to prevent bad scarring. See the treatment section for further information. Not scratching or picking at scabs and spots will also help prevent scarring. Essential oils can sometimes help scars to be less severe and heal better. Carrot Seed, Jasmine, Mandarin, Neroli and Patchouli are some of the best oils to try and if the scar is due to burns then try Lavender essential oil as quickly as you can after the burn occurs. For wounds and wrinkles try using Frankincense essential oil. |
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