Medical App & Medical Advice with Hello Doctor

Scars and scarring

Feeling self-conscious about an unattractive scar and wondering if there’s anything you can do about it?

Not all scars are unattractive; some can also cause pain, itch and restrict movement.

What is a scar?

A scar forms as a natural part of our body’s healing process to repair damaged skin and other tissues.

Your skin may look like a simple, single sheet covering your body, but it’s actually three layers:

  • epidermis
  • dermis
  • hypodermis.

Scars form when the dermis is damaged. The body produces new collagen fibres to repair the damage, but this collagen doesn’t heal in the same shape and form as your original skin.

Are there different types of scars?

  • Keloid scar: These are very raised scars, caused by the body making too much collagen. They are often red or dark.
  • Atrophic scar (also called a sunken or pitted scar): this scar forms when tissues underneath the skin are missing, like muscle and fat – so they form a hole. This includes scars from surgery and acne.
  • Hypertrophic scar: a scar that is slightly raised and red or purple, but tends to flatten and fade over time.
  • Stretched scar: a scar that occurs near a joint which may be exposed to tension, whilse healing occurs. During pregnancy, stretching of the skin can also result in scarring – those well-known stretch marks.

So, can anything be done to improve the appearance of a scar?

Some scars can be treated, so they are less obvious. However, they cannot be removed completely. You’ve probably seen all those adverts offering treatment of scars, but who can you trust? The best person to see, would be a Dermatologist or a Plastic Surgeon. They may make some of the following recommendations, depending on the type of scar:

  • Corticosteroid injections: these are used for keloid and hypertrophic scars, the aim is to reduce swelling and flatten the scar by giving multiple small injections into the scar.
  • Surgery: this is often combined with other forms of treatment. The purpose is usually to change the width, shape or position of the scar, or to release a tight scar located near to a joint to improve movement. There is always a risk that the scarring could worsen; so this type of surgery is usually performed by a Plastic Surgeon.
  • Pressure dressings: these are often used after skin grafts and for large burn wounds, to flatten and soften the scar.
  • Silicone gels/sheets: these can minimise keloid and hypertrophic scar formation. These are used on healing skin, not open wounds.
  • Dermal fillers: Fillers are a soft substance you inject underneath the skin. This is used to fill up pitted scars. It is quite expensive, and only has a temporary effect.
  • Other options can include: laser treatment, skin needling, and radiotherapy, use of cosmetic camouflage make-up, moisturisers and sunscreen.