Scars: formation and types

If the skin z. B. injured by an accident or an operation, scars remain. Ideally, at the end of the scar formation process, only a faint outline can be seen, but unfortunately, this is not always the case. Unsightly scars often develop.

Scars – how do they form?

The skin is made up of three layers: the upper skin (epidermis), the leather skin (dermis) and the lower skin (subcutis). If not only the epidermis is severed due to an injury but also the underlying skin layer(s), a scar is formed. Our organism cannot regenerate the destroyed tissue in the same way. Typical properties of the new fabric:

• It’s less elastic.
• The function is limited (no hair, sweat glands, etc.).

Scars can be redder or lighter depending on the nature of the new tissue. If such scars are in clearly visible places, those affected often feel stigmatized and marginalized. In addition, scars can cause feelings of tension and restricted mobility.

Scars – what types are there?

• Scar proliferations (hypertrophic scars): They are caused by excessive formation of connective tissue. They can be itchy or painful, but they remain confined to the original area of ​​the injury. A wound subject to constant movement while healing increases the likelihood of such a scar forming. Scar growths develop within a few weeks after the injury.
• Scar bulges (keloids): These scars are also caused by overproduction of connective tissue. They are thick, convex often reddened, appear darker than the surrounding tissue, and extend beyond the original injury area. The grain structure can have an irregular shape.
• Scar indentations (atrophic scars): In scar indentations, in contrast to the two types of scars above, too little connective tissue is formed, resulting in a “sunken” scar. It lies more profound than the surrounding skin. Typical examples of this type of scar are acne scars.

Scars – what influences their appearance?

Various factors influence the development of a scar.

• Age: The skin of older people heals more slowly. The skin tends to overreact in children or younger people and produce more connective tissue than necessary. This creates more prominent, thicker scars.
• Hereditary factors/skin types:  The predisposition to noticeable scarring can also be hereditary. People of African or Asian descent are more prone to scarring or bulges than Europeans.
• Scar location:  Scars that are over or near areas of the body that are frequently used (e.g. shoulder, back and joints) are subject to greater tension and are, therefore, usually more pronounced or more visible than those on less used areas.
• Wound infection/complications in wound healing:  Wound infection or inflammation increases the likelihood of noticeable scarring.

Scars – what can you do about them?

Depending on the nature of the scar, you can choose from various treatment options. These methods include laser, surgery, injections, cryotherapy, abrasion (stripping), pressure bandages, silicone gel sheets/pads, ointments, and creams. The doctor can best decide which treatment is suitable for a scar.