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The skin is composed of five layers of cells. It is the surface layer, which is comprised of squamous, scaly dead cells , that is actively involved in the process of exfoliation whereby the dead skin cells are shed and protect the underlying healthy tissue from damage as a result of abrasion. Our skin is very sophisticated. It helps to keep us cool in hot weather and warm in cold weather and it also prevents us from dehydrating. Our skin is constantly shedding old cells and creating new ones, enabling it to repair itself if damaged. It is the repair process that can result in a scar.
Scars When we damage the thick layer of tissue beneath the skin, rebuilding is more complicated. Our bodies lay down collagen fibres (a protein which is naturally produced by the body) and this usually results in a noticeable scar. The way a scar develops depends as much on how your body heals as it does on the original injury or on the surgeon's skills. Many variables can affect the severity of scarring, including the size and depth of the wound, the blood supply to the area, the thickness and color of your skin, and the direction of the scar. There are different types of scars, such as keloid, hypertrophic, and contractures. After the wound has healed, the scar continues to alter as new collagen is formed and the blood vessels return to normal. This is the reason why most scars will fade and improve in appearance over the two years following an injury. However, there will always be some visible evidence of the injury and hair follicles and sweat glands do not grow back.
Keloid Scars Keloids can appear anywhere on the body, but they're most common over the breastbone, on the earlobes, and on the shoulders. They occur more often in dark-skinned people than in those who are fair. The tendency to develop keloids lessens with age.
Hypertrophic Scars
Contractures
The Scar Biz The Scar Biz functions on the assumption that regardless of degree, the scar will bother you. While no scar can be removed completely, plastic surgeons can often improve the appearance of a scar by making it less obvious. This is accomplished through the injection or application of certain steroid medications that provide the optimum healing environment for scar treatment. Another option is a surgical procedures known as scar revisions.
Keloids If steroid treatment is inadequate, the scar tissue can be cut out and the wound closed with one or more layers of stitches. This is generally an outpatient procedure, performed under local anesthesia. You should be back at work in a day or two, and the stitches will be removed in a few days. No matter what approach is taken, keloids have a stubborn tendency to recur, sometimes even larger than before. To discourage this, the surgeon may combine the scar removal with steroid injections, direct application of steroids during surgery, or radiation therapy. Or you may be asked to wear a pressure garment over the area for as long as a year. Even so, the keloid may return, requiring repeated procedures every few years. The keloid is certainly a stubborn breed of scar!
Hypertrophic Scars If a conservative approach doesn't appear to be effective, hypertrophic scars can often be improved surgically. The plastic surgeon will remove excess scar tissue, and may reposition the incision so that it heals in a less visible pattern. This surgery may be done under local or general anesthesia, depending on the scar's location and what you and your surgeon decide. You may receive steroid injections during surgery and at intervals for up to two years afterward to prevent the thick scar from reforming.
Contracture |