Scars can be classified into immature scars and mature scars. Mature scars can be “normal,” atrophic, or hypertrophic. Keloids occur in patients with a genetic predisposition and behave differently than hypertrophic scars, although there can be a continuum in terms of appearance.
These areas include the ears, the top of the shoulder and the area in front of the breastbone (sternum). There are lots of theories as to why this may be. Some people have suggested that it is due to the genes at these sites which have a more angry response to injury.
Hypertrophic scars that result from burn wounds are more difficult to treat. Superficial burn wounds usually heal without forming hypertrophic scars. Deep burn wounds are harder to treat. Many dermatologic and plastic surgeons treat these by removing the burned area and then using a skin graft.
Hypertrophic Scars and Keloids
If the skin creates excessive amounts of collagen while it heals, the result is a thick, widened, and sometime raised scar that remains within the boundary of the injury. This is called a hypertrophic scar.
Keloid scars are usually raised, hard, smooth and shiny. They can be skin colour, pink, red, purple, brown, or darker than the skin around them. You can get keloid scars on any part of the body, but they're most common on the chest, shoulders, chin, neck, lower legs and ears.
Cocoa butter cream and Vaseline are most often used to help reduce the appearance of scars. Applying the ointment daily will help heal scars but will not make them invisible. Another tip for caring for your scars includes surgery. Surgery will not eliminate the scar but can change its shape or make it less noticeable.
Scar Process
It will take six to 18 months for the scar to have its final appearance. Your scar should gradually soften and fade over these six to 18 months, but will look pink initially (photo B). Some scars never fade. If your scar stays pink after 12 to 18 months please call to discuss options.
For best results, you should perform scar massage for at least 10 minutes, twice a day, for six months. You should only stop sooner than that if the scar starts showing signs of infection or you experience intolerable discomfort.
Men with mild facial scars were typically ranked as more appealing by women who were looking for a brief relationship, though they were not considered better as marriage material, a study found. In the same experiments, women with facial scars were judged to be as attractive as those without, the researchers said.
The appearance of these scars is often worsened by the normal effects of aging. A number of options are available for the treatment of acne scarring, including chemical peeling, dermabrasion, ablative or nonablative laser resurfacing, dermal fillers, and surgical techniques such as subcision or punch excision.
Areas of the body that have increased susceptibility to keloid and hypertrophic scar formation include the earlobe, the sternum, the deltoid region of the upper arm, and the upper back.
Hypertrophic Scars – Raised scars that remain within the boundaries of the initial injury, incision or trauma, hypertrophic scars can be red and raised enough to be readily noticeable. In some cases, hypertrophic scars will fade over time on their own.
Most rolling scars will soften a bit eventually. But you'll probably need treatment to get your skin back to its original state. The good news is, since rolling scars are so shallow and soft, they're the easiest to treat.
Depressed scar
Sunken scars can become more noticeable as you age. This happens when the skin relaxes and sags, causing the depressions to become more noticeable. You're more likely to develop depressed scars after chickenpox or severe acne clears.
But here is what a mature surgical scar should look like from a cosmetic point of view: a parallel disposition to the folds and lines of tension of a relaxed skin. an unnoticeable fine line. an elevation similar to the surrounding skin.
Old scars break open in scorbutic patients because (1) the rate of collagen degradation is greater in an old scar than it is in normal skin, and (2) the rate of collagen synthesis is diminished throughout the body in ascorbate deficiency.
Some people experience scar tissue pain due to fibrosis, which occurs when the body grows excessive scar tissue. Fibrosis causes adhesions that may lead to ongoing pain, inflammation, and loss of function of the tissue or joint. Fibroblasts, which form during scar tissue growth, are responsible for fibrosis.
Generally, they contain relatively acellular centers and thick, abundant collagen bundles that form nodules in the deep dermal portion of the lesion. Keloids present a therapeutic challenge that must be addressed, as these lesions can cause significant pain, pruritus (itching), and physical disfigurement.
“Scarring is a natural part of our body's healing process. There are some people that are predisposed to forming thicker scars based on genetics, immune status, medications, and other factors.”
What Are Atrophic Scars? An atrophic scar develops when the skin cannot regenerate tissue correctly. Unlike keloids and hypertrophic scars, atrophic scars are indented in appearance due to healing that occurs below the expected layer of skin.