Skin Disorder Series, Skin Scarring
Scar results when there are significant damage and repair of tissues. According to dictionary.com, a scar is a mark left by a healed wound, sore or burn. Acne or chicken pox lesions can also leave scars upon healing.
What is Scarring and why does it occur?
The process using which repair of wounds occurs is referred to as scarring. Any injury, burn or other types of trauma including surgery can result in a scar. Damage to the dermis, which is the deeper layer of the skin, is needed to produce scarring. Damage only to the epidermis, which is the superficial layer of the skin, may not always cause scarring.
After the skin is wounded, collagen is released by the body to repair the damage. Collagen helps in healing and strengthening the wound. For duration of around 3 months or more, new collagen is formed continuously and there is an increase in blood supply to the area. The scar becomes lumpy, raised and red. Then some of the collagen breaks down at the affected area, with a reduction in the blood supply and the scar becomes softer, paler and smoother gradually. Scars are usually permanent; however, their appearance may fade over a period of 1-2 years. They are not likely to fade after this.
A change in the structure of the deeper skin layers is produced by a scar, which is visible as an alteration in the structure of the normal features of the surface. Scar is characterized by not just a skin colour change. The appearance of a scar is dependent upon the size and depth of the cut or wound and where the injury is located. It also depends upon your age, gender, ethnicity and genes.
What are the different types of scars?
Several different kinds of scars exist including:
- Contracture scars: A contracture scar develops due to burning of the skin. The skin is tightened by these types of scars, which may adversely affect your ability to move around. Contracture scars may affect the deeper layers of tissue affecting even nerves and muscles.
- Pale, flat scar: These are the most common types of scars that are formed due to the natural healing process of the body. They may appear raised and red or dark initially after there is healing of the wound, but becomes flatter and paler over time as healing of the injury occurs. This can occur over a period of 2 years. Some evidence of the wound will always remain visible.
- Keloid scars: Keloid scars develop due to an increased healing process. These scars extend outside the boundary of the original injury on the skin. Keloids are scars that don’t have the knowledge when to stop. A keloid scar is a heaped-up, tough scar that is raised abruptly above the surrounding skin surface. It typically has a purple or pink colour and a smooth top. Keloids are shaped irregularly and tend to progressively enlarge. Unlike scars, they do not regress with time. Over time, keloid may impair movement.
- Hypertrophic scars: These scars are red, raised scars that resemble keloids but they do not extend outside the boundary of the original injury.
- Acne scars: Acne scars develop as a result of healing of severe acne lesions. Many different types of acne scars exist ranging from scars that are like deep pits to scars that are wave like or angular in appearance.
What are stretch marks?
Stretch marks are markings of the skin, which may look similar to thin long scars; however, they are formed in a completely different manner.
Who is more likely to get scars?
- Age affects the process of scarring. The process of healing is stronger in the skin of young persons. This results in thicker scars in comparison to scars that develop in the elderly.
- Keloid scars commonly occur in people who have dark skin including Asians and blacks.
- Children are more prone to develop injuries and cuts. They and persons with fair complexion are more prone to develop hypertrophic scars.
- The location of the injury also affects the size of the scar. For instance, if the injury is located on the shoulder or knee, the scar will eventually become wide as these areas are in continuous motion.
What are the lifestyle changes to prevent or reduce scarring?
The following are some lifestyle changes that you can follow to reduce scarring:
- Clean the dirt, dead tissues and objects from the wounds immediately to help heal the wound in a better way.
- Do not scratch or pick at spots or scabs.
- Cover wounds with an ointment preferably waterproof such as Vaseline.
- Use silicone sheets or gels to decrease redness and promote healing of the wound.
Avoid excessive exposure to sun’s rays
Staying out too long in the sun without applying sunscreen can cause long-term damage to the skin. Hence, avoid staying for too long in the sunlight. Moreover, exposing scar to sunlight for too long may result in their darkening and impairs the process of healing. Hence, before venturing outside, apply a sunscreen with a SPF of at least 30.
Smoking restricts the blood vessels and decreases the oxygen from the skin, thereby slowing the process of healing. To prevent the formation of ugly scars, your body should be allowed to heal to its greatest capability and naturally. Hence, it is imperative to stop smoking so as to minimize the interference in the process of healing of the skin. You should also be aware of the fact that smoking accelerates the process of ageing of the skin.
Drink at least 7-8 glasses of water every day. Water helps in detoxification of the body and in shedding dead cells from the skin. Getting adequate fluids to stay hydrated is a healthy, simple and natural method to detoxify your body and may even reduce the appearance of scars. You can also add lemon slices to the drinking water. Lemons are a rich source of citric acid, which helps in keeping your skin and body healthy. Moreover, the vitamin C present in lemons has anti-inflammatory and antioxidant properties and promotes collagen formation in the skin. It can thus help in reducing the appearance of scars. Lemon juice when applied sparingly on scars can help lighten them as it acts as a natural lightening agent.
This is a difficult task, but the greatest key to prevent and reduce scars is to wait. Scars may take few weeks or months to fade. If may seem difficult to wait; however, try and be patient.
Dietary changes and supplements to reduce scarring
Ensure that you are taking in enough essential nutrients via diet or supplements. Some nutrients are essential for maintaining your skin healthy. These nutrients allow proper healing of the skin, preventing the formation of scars. Some of these essential nutrients are described below:
- Zinc: Zinc is a trace element, which is present in almost all human cells. It acts as a vital co-factor in many cellular enzymes. The food sources of zinc are organ meats, red meat, whole grains, yeast and eggs. Zinc has antioxidant properties and is used in beauty products as it is found to be effective in maintaining the health of the skin. According to a study published in the international journal of tissue repair and regeneration, topical application of zinc has been found beneficial in wound healing. It also states that zinc deficiency can lead to delayed wound healing.
- Aloe Vera: Aloe Vera is also referred to as a miracle plant as it is a natural treatment for a variety of health ailments. It is most often used to treat skin ailments by applying it topically. The skin ailments include eczema and burns. It also helps in wound healing. According to various clinical studies, Aloe Vera promotes wound healing and has anti-inflammatory properties. In a study published in the Journal Molecular and Cellular Biochemistry, Aloe Vera increased the collagen tissue of the granulation tissue formed as a response to wound healing.
- Vitamin C: Vitamin C, also referred to as Ascorbic Acid is a water soluble vitamin. It is present in many plant based foods such as mango, kale, carrots, strawberries, raspberries and cabbage. It has many vital roles to play in human body one of which is production of collagen. Vitamin C contributes to the maintenance and integrity of connective tissues containing collagen. According to a study published in the journal wounds, administration of vitamin C prior to laparotomy expedites wound healing in rats.
- Vitamin A: Vitamin A is a fat soluble vitamin. It is found in nature as two types-retinol and carotenoids. Food sources of retinol are butter, cod-liver oils, egg yolks, oily fish and whole milk. Food sources of carotenoids are peppers, dark green leafy vegetables, broccoli, sweet potato, parsley, kale and carrots. Vitamin A has antioxidant properties that help in healthy growth of cells. According to an article published in the journal Alternative medicine review, wound healing can be impeded by nutritional deficiencies and several nutrients required for repair of wound may improve healing time and outcome of the wound. Among the various nutrients mentioned, vitamin A is required for epithelial and bone formation, cellular differentiation and immune function.
- Vitamin E: Vitamin E is a fat soluble vitamin. Food sources of vitamin E are sunflower oil, olive oil, sesame oil, corn oil, peanut oil, spinach, butter and salmon. It acts as a potent antioxidant. According to a study published in the Pakistan Journal of pharmaceutical sciences, CA, glycolic acid, vitamins A, E and C and their mixtures showed stimulatory effect on both extra-cellular matrix synthesis of collagen and fibronectin in in vitro studies, which is beneficial to therapeutic and skin care products formulation.
- Bromelain: Bromelain is a proteolytic enzyme that is present in the juice of Pineapples. It has been linked to reduction in inflammation throughout the whole body. According to an article published in the Aesthetic Surgery Journal, the efficacy of bromelain has been shown in several placebo-controlled trials in resorption of hematomas and in wound healing.
- Chlorella: Chlorella is a green form of algae that gets its colour from chlorophyll. It is organically sourced and grown in fresh water. In a study published in the International Medical Journal, Chlorella vulgaris has antimicrobial activity in addition to wound healing ability.
Scar is an area of fibrous tissue that is formed in place of normal skin after trauma or injury. Scarring is one of the natural parts of the process of healing. There are various types of scars. Scars are different from stretch marks. You can follow certain lifestyle changes to prevent or reduce the appearance of scars. You can also take various supplements such as vitamins A, E, C, zinc, bromelain and chlorella to promote wound healing and reduce the appearance of scarring.
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