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When scars don’t fade

Tuesday, January 01, 2019

If you have a scar that is bothering you, here are some measures you can take, says Dr Debraj Shome

Almost everyone you know is sure to have a scar on some part of the body. After all, getting a cut or a burn or falling down and hurting yourself is almost a part of one’s life, however careful one tries to be. And this is true even more for kids, as running and experimenting with things, including dangerous objects like matchsticks, is a normal part of growing up. Thankfully, most often, small scars fade.

But what about the scars that don’t? Sometimes scars may not completely fade and, especially if they are on the face, they can make the person conscious of their appearance and also impact their self-esteem and confidence. In such cases, some measures can be taken to ensure that the scar fades or is hardly seen.

Understanding scars
Scars are a part of our body’s natural healing process. For the healing of a wound it is natural to have scars, however, scars become a disorder when they don’t go away even when the skin under it is healed.

When we have any kind of injury (for instance, because of accidents, burns, stitches, acne), the body mechanism starts to work towards repairing the wound. It creates collagen, which helps in reconnecting the tissues that are broken by the injury. This is done in order to form a kind of protective covering called the scab over the wound. The main function of the scab is to protect the wound from external factors like germs and thus to aid in healing.

When the wound is healed, the scab falls off naturally. The scar may or may not be formed depending on the arrangement of collagen under the skin. When you get a wound, the body is in a natural hurry to heal and the collagen (which is responsible for the flexibility and suppleness of the skin) may not be laid out in the natural organised lattice that matches the skin. Hence, this results in scars. If there is too much collagen under the skin, then the scar will be a raised scar.

Over the years, the skin will work on straightening the collagen and it may reduce the appearance of the scar, but the scar never completely goes away.

Ways to reduce scars
Of course, in the case of an injury it is quite difficult to avoid a scar caused by damage to the skin. However, there are a couple of things that you can do to aid the healing and avoid making the scars worse:

  •     Don’t pick or scratch the scars It is quite natural to feel the urge to scratch the tissue but you should avoid picking the scab and scratching the area around the scab. This will reduce the risk of developing a scar.
  •     Keep the wound protected When your skin is healing, it is important that you keep the wound covered and cleaned. You should also avoid letting it go dry and use the prescribed ointment on the wound.
  •     Protect it Keep the wound area protected even after the scab has fallen off. Use sunscreens before you go out. This way the skin will not get darker. Keep the area of the wound well moisturised, as this will prevent the skin from becoming dry and stretching.

For scars that run deep in the skin there are various other treatment options available such as

  •     Chemical peels Chemical peels use a chemical solution to remove the outer layer of old skin. The new skin that replaces it is usually smoother and less irregular in appearance.
  •     Botox Botox relaxes the muscles on the face, preventing the scar from spreading.
  •     Steroid injections These injections have triamcolene and are often used to flatten and fade hypertropic scars. They can be used as soon as the scar is seen.
  •     Filler injects to level the skin Filler injections are used to add volume below the skin in the area of the scar to give it a smooth appearance.
  •     Laser skin resurfacing Repeated sessions of carbon dioxide (CO2) laser skin resurfacing produces collagen and leads to the scar becoming slowly imperceptible.
  •     Surgery Skin grafts and laser surgeries can also be done to deal with scars.
  •     Micro needling: Micro needling therapy is a procedure that involves small needles pricking the skin. This helps generate new collagen and skin tissue. It is often used in trophic acne scar treatment.
  •     Scar creams Regular use of special scar creams can help the wound heal better.

Whether you chose to get the scar treated or not is entirely up to you. But when you do choose to get them treated, make sure that you consult the best plastic surgeon in order to get the best possible results.

Dr Debraj Shome is a cosmetic surgeon and director, The Esthetic Clinics.

short takes

  •     For a wound to heal, it is natural to have scars.
  •     However, scars become a disorder when they don’t go away.
  •     It is advisable not to pick or scratch the scars.
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