“Is it going to leave a scar?” is one of the most common questions after an injury, during a breakout, or before a surgery or procedure. In a society ever focused on beauty and perfection, a scar can make you feel self-conscious and sink your confidence. But fear not! There are ways to minimize their appearance.
What Are Scars?
When you get an injury to the skin, whether accidentally or as part of a surgery or procedure, the body repairs the skin with collagen, the same fibrous protein that makes up the tissue it replaces. The difference is that while regular skin is made up of collagen fibers linked in a random basket weave formation, in scar tissue the collagen cross-links and forms a pronounced alignment in a single direction, making it more visible compared to normal skin.
Factors Affecting scars
So why is it that some people seem to heal better while others scar easily? A number of factors seem to affect scar appearance, including:
- How large/deep the wound is
- Where the wound is located
- Type of injury
- Healing time
- Inherited traits
Differences in Scars
Not all scars appear the same, either. The most common types of scars include:
Keloid. These thick, red, raised scars result from an overly aggressive healing process and extend beyond the site of the injury. Over time, they can make movement more difficult. They are most common among people with darker skin tone.
Hypertrophic. These raised, red scars might look somewhat similar to keloid scars but don’t extend beyond the boundary of the injury.
Contracture. These scars can appear when skin is burned. They tighten skin, which can hamper movement. They may also go deeper, affecting muscles and nerves.
Acne. These marks that usually result from severe acne can vary in appearance, from deep pits to angular or wavelike scars.
While many scars can’t be fully erased, they can be dramatically improved in appearance and even become barely visible in the best circumstances. Whether you want to improve the appearance of an existing scar or minimize the appearance of a scar following a planned procedure, there are a number of treatments available, both time-tested and new:
A number of at-home treatments can be used to prevent or reduce scarring, most of which help by moisturizing skin. Some of the more effective ones include:
Antibiotic ointment. Keeping the wound moist and bacteria-free can promote more rapid healing.
Topical creams/gels. Products like Mederma®, made from onion extract, may help heal skin and minimize the appearance of scars.
Silicone sheets. Placing a silicone sheet (available at pharmacies) over newly healed skin (not open wounds) may diminish the thickness of scars, especially hypertrophic or keloid scars. These sheets need to be kept on for at least 12 hours a day over the course of a few months.
Aloe. With its natural healing and anti-inflammatory properties, aloe vera gel can help reduce swelling, soothe, and moisturize the wound, helping skin heal better. Look for a product with no parabens, fragrances, or petrochemicals to avoid irritating the skin. Or better yet, keep your own aloe vera plant at home and simply pick off a leaf, remove the outer skin and apply the fresh aloe directly (this also works great for treating sunburns!).
For more visible scars or those that need professional help, some effective treatment options often used alone or in tandem include:
Steroid Injections. Used for many types of scars, injections are placed directly into the scar tissue every few weeks to decrease itching, redness, discomfort as well as appearance.
Laser. Different types of lasers (CO2 fractional, Nd:YAG, IPL, etc.) can be used to smooth, flatten, or remove abnormal color in a scar. They tend to work best for hypertrophic scars.
Dermal Fillers. Fillers like collagen (Zyderm, Artefill, etc.), hyaluronic acid (Juvederm, Restylane, etc.), or even your own fat can be injected under the skin to help the appearance of depressed or pit-like scars, often caused by acne.
Needling. A device with fine needles makes tiny punctures in the top layer of the skin, stimulating collagen and elastin production to minimize scars and improve skin texture.
Dermabrasion. Small scars, surgical scars, and acne scars may benefit from the removal of the top layers of skin with an abrader, leaving smoother, fresher skin as it heals.
Chemical Peels. Good for superficial scars, a chemical can be applied to the skin to remove the top layer, allowing newer skin to emerge.
Cryotherapy. The top layers of scars can sometimes be “frozen” off; it blisters the skin and allows it to heal, leaving a less obvious mark.
Surgery. When other nonsurgical treatments are ineffective, especially for scars that are wide or long, heal in an unusual way, or are very visible, surgery can be performed to remove the entire scar and rejoin the skin. The result can be a less noticeable scar.
If you have a scar forming, it’s important to care for it properly to allow it to heal as well as possible. You should:
- Follow doctor’s orders. They know what they’re talking about.
- Leave it alone – touching it will irritate and possibly re-injure or infect the skin.
- Avoid physical activity that can aggravate the wound.
- Stay out of the sun – scars are more sensitive to UV radiation and prone to discoloration/hyperpigmentation.
- Stop smoking – it results in poor healing and can worsen the scar.
- Stay hydrated – dry wounds don’t heal well.
- Get proper nutrition – protein, zinc, vitamins A and C, antioxidants and anti-inflammatories are crucial for wound healing. And the better a wound is able to heal, the less significant will be any resultant scarring. Recovery Support Program and Clinical Support Program were formulated by an anesthesiologist to support healing.
- Have patience – some scars can take up to a year or more to fully heal.
With these tips, scars don’t have to be so scary. You can feel prepared no matter the situation, whether it’s an accidental injury or a planned procedure!
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.