Scarring

Any injury, burn or other type of trauma can result in a scar. Damage to the dermis, which is the deeper layer of the skin, is needed to produce scarring. Damage only to the epidermis, which is the superficial layer of the skin, may not always cause scarring.

After the skin is wounded, collagen is released by the body to repair the damage. Collagen helps in healing and strengthening the wound. For the duration of around three months or more, new collagen is formed continuously and there is an increase in blood supply to the area. The scar becomes lumpy, raised and red. Then some of the collagen breaks down at the affected area, the blood supply is reduced and the scar becomes softer, paler and gradually smoother. Scars are usually permanent; however, their appearance may fade over a period of 1-2 years. They are not likely to fade after this.

Several different kinds of scars exist including:

• Contracture scars: A contracture scar develops due to burning of the skin. The skin is tightened by these types of scars, which may adversely affect your ability to move around. Contracture scars may affect the deeper layers of tissue, including nerves and muscles.
• Pale, flat scar: These are the most common types of scars that are formed due to the natural healing process of the body. They may appear raised and red or dark initially after there is healing of the wound, but become flatter and paler over time as healing of the injury occurs. This can occur over a period of two years. Some evidence of the wound will always remain visible.
• Keloid scars: Keloid scars develop due to an increased healing process. These scars extend outside the boundary of the original injury on the skin. Keloids are scars that don’t have the knowledge of when to stop. A keloid scar is a heaped-up, tough scar that is raised abruptly above the surrounding skin surface. It typically has a purple or pink colour and a smooth top. Keloids are shaped irregularly and tend to progressively enlarge. Unlike other scars, they do not regress with time. Over time, keloids may impair movement.
• Hypertrophic scars: These scars are red, raised scars that resemble keloids but do not extend outside the boundary of the original injury.
• Acne scars: Acne scars develop as a result of healing of severe acne lesions. Many different types of acne scars exist ranging from scars that are like deep pits to scars that are wave-like or angular in appearance.