The Types of Scars and Possible Treatments
External scars are caused by injury to the
skin. They occur when the body produces collagen to heal and close the
wound. This is a protein fiber that's naturally thicker and less
flexible than the rest of the skin. The scar tissue won't have hair
follicles or sweat glands, and it will usually start itching at some
point. In this article, we'll cover external scars only: the different
kinds and different treatments to each type, as well as why they all
itch. External scar tissues include:
- Stretch marks
- Keloids
- Atrophic scars
- Hypertrophic scars.
Why do scars itch?
New scars may itch due to slight damage to
the nerve endings near the injury. Nerves can become sensitized and
cause an itchy sensation as they heal. Therefore, if your scar itches,
it's healing.
An old scar is at least two years old. An old scar may itch if the skin
is too tight, as is often the case after a burn. Tight and dry skin is
easily irritated.
Possible Treatment Plans
Noninvasive treatments are fit for small scars, new and old alike. These
include the following topical treatments: creams, over-the-counter
silicone bandages, prescription compression bandages, or massaging new
scars while applying pressure. These treatments require diligent upkeep
for several months for you to see results.
Invasive treatments are fit for larger scars that cause severe
discomfort and don't respond to topical treatments. These may include
laser therapy, surgical excision, corticosteroid injections, cryosurgery
(a chemical freezing of the tissue), and as a last resort, radiation
therapy.
Prevention is Easier than Treatment
The best approach is to avoid injury instead of doing damage control.
This can be done even before the scar forms. The key steps are to keep
the skin clean, apply healing ointments, and use silicone bandages
diligently. This regimen will help you prevent abnormal scarring as well
as itching, and it will promote healthy skin healing. Do keep in mind
that some scarring is inevitable.
When to See a Doctor About a Scar
Since we were babies, our mothers told us not to itch a scab. The
medical reasoning behind that is that itching can introduce bacteria
into the healing wound, causing an infection. If the scar is swollen
more than usual, hot to the touch, painful, or the itching you
experience interferes with your daily life, see a doctor. Cosmetic
appearance is also a good reason to consult your doctor.
Stretch Marks
These can be caused by an increase of
cortisone, apart from the well-known causes like pregnancy, rapid
growth, or weight gain. Cortisone is a hormone naturally produced by the
body. Having too much of it causes the skin to lose elasticity. Raised
levels of cortisone (not to be confused with cortisol, the stress
hormone) are caused by adrenal gland disorders, as this is the gland
that produces this hormone.
Extensive use of corticosteroid creams, lotions, and pills can also
abnormally increase cortisone levels. These are used topically to treat
eczema, dermatitis, and other skin conditions. Taken internally, they
"treat rheumatoid arthritis, inflammatory bowel disease (IBD), asthma,
allergies, and many other conditions. These drugs also help suppress the
immune system in order to prevent organ rejection in transplant
recipients," according to Mayo Clinic.
A common myth about stretch marks is that they can be erased. However,
that is sadly not the case. They will fade over time, even with no
treatment at all. While there are treatments to improve their
appearance, these scars will never vanish completely. Exfoliating
treatments and collagen restoring creams, such as tretinoin may help,
but they must be combined with daily use of sunscreen.
Keloid Scars
Keloids occur when there's an abnormal
growth of scar tissue. They can be much larger than the original wound.
Keloids are harmless and mainly pose a cosmetic concern. They may take
weeks or months to grow, and they may be itchier than other forms of
scars. About 10% of the population is affected by them.
Removing a keloid scare can be tricky, as the skin will try to scar up
and heal again, growing more keloids that could be larger than the ones
before. Over time, a keloid will shrink, and moisturizing it will help
the discomfort. Silicone pads, pressure dressings, and even injections
can be effective for treating a newly formed keloid. Laser treatments
and cryosurgery will help an older keloid. While the risks of such a
procedure are low, the chances of it regrowing are high.
Hypertrophic Scars
A form of scarring that's usually confused
with keloids is a hypertrophic scar. It is an abnormal response to
injury in the form of overgrown scar tissue. Hypertrophic scars may be
genetic or caused by an infection. Hypertrophic scars are different from
keloids in that they don't grow beyond the wound size. They're not as
large or raised as a keloid scare, and are generally lighter in color.
Usually, hypertrophic scars are not treated in the first year after
injury. A scar takes a year or longer to fully form and settle, and the
body works relentlessly to rebuild damaged tissues. After a year, the
treatments are the same as for any other scar, as described throughout
the article.
Atrophic Scar
The exact opposite of hypertrophic scarring
is the atrophic scar. If hypertrophic scars are raised, then atrophic
scars are indented and heal below the normal layer of the skin. The most
common form of such scars is acne scarring, which leaves one's face
full of tiny indents. They're quite difficult to treat and require a
diligent and complex treatment plan that may involve any of the
following: chemical peels, filler injections, micro-needling therapy,
excision, and skin grafts.
Last but not least - if you're left curious as to whether regular boring
scars have a fancy name as well, we've got nice news: they're called
normotrophic scars!