Why do scars form?
When the skin is damaged the body responds in three phases; inflammation,
remodelling. The immune system responds immediately to fight off
infection. The body produces
inflammation to fight against infection. Inflammation causes an
increase in the local blood supply so
that large numbers of white blood cells can be brought to the damaged
area to fight infection. During
the rebuilding phase, the skin begins to repair the damage to help
heal the wound so that it may close.
Collagen fibres are produced during the repair process. Finally,
in the remodelling phase, more
collagen fibres are produced and organized to increase the strength
of the skin. Often, the immune
system overreacts with more white cells and collagen than necessary,
causing excessive scarring that
is red, raised and unattractive. A scar looks different from normal
skin because fibres are organized
differently than in normal skin. The resulting scar is genetically
determined. Scarring can be worse in
certain races (heavily pigmented skin), certain areas (chest, shoulders,
upper back, jaw line), at certain
ages (younger) and if placed across lines of skin tension.
What is a keloid scar?
A keloid is an overgrowth of scar tissue at the site of a skin wound.
The new tissue is elevated,
rounded, and firm, with irregular and claw-like margins. Keloids
occur most often in heavily pigmented
people and tend to get progressively worse.
What is a hypertrophic scar?
A hypertrophic scar is a wound that heals to greater than normal
size as a result of an aggressive lay
down of collagen, contained in larger than normal skin cells, producing
a raised, smooth,
hyperpigmented result. The site maintains a higher than normal level
of sensitivity and the tissue is
more fibrous in structure.