Nearly every human being on the planet has at least one scar on their body by the time they are five years old. It may be something as simple as a scraped knee, or something more serious, like a severe burn or injury site. As children become teenagers they are subject to immense doses of hormones switching on and off, some of them may get acne or pimples forming on their faces, backs and chests. Acne can be very mild and light, clearing away after an outbreak, leaving no scarring at all, but some sufferers can get heavy outbreaks that leave pitting and bad scarring.
Scars can be superficial, not even penetrating the deepest layers of the epidermis, or they can be severe, going through into the muscle and tissue beneath. Deep damage can have an effect on the skin, pulling at and even distorting other nearby features, especially on the face. Delicate skin lies over prominent cheekbones, noses and foreheads where the close proximity of mouth, nose and eyes means that any injury can have a knock-on effect over a wider area pulling features out of shape.
Very deep scars may need surgery to reduce their appearance or repair underlying damage, but are unlikely to be completely eradicated. If a scar is a deep purple or pink colour and has widened due to poor medical attention at the time of the injury, its appearance can be dramatically reduced. Any remaining blemish should be covered fairly easily with just a touch of make-up.
One innovative treatment is the use of fat from elsewhere in the body; a process known as fat grafting. The patient's own fat is harvested from the thigh or tummy – one of the very few occasions when it is good to be carrying a pound or so extra! The fat is purified and cleaned, then injected, drop by drop, in and around the site of a scar to plump out the area. As the fat is originally from the body, there is no danger of rejection occurring, and the body often works to reabsorb the fat, softening scar lines and reducing contraction distortion around the site.
Medical scars, if nursed properly and not picked at by the patient, should heal cleanly, leaving only a thin line which can be disguised with clothing, artful hair styling or a little make up. Sometimes, though, a keloid scar can form, which is when the repair process seems to go overboard and a thick shiny raised scar appears, often bigger than the original injury. Keloid scars can be removed, but once a patient has had one keloid scar there is nothing to stop another one forming. Treatment for keloid scars includes using dressings saturated with steroid solution, keeping dressings on for longer while healing, freezing the site when the keloid scar first appears and even using some medications which seem to reduce the overgrowth of collagen that causes the scar to become keloid.
Laser resurfacing works best on moderate to light scarring and essentially works by removing the top layers of dermis, clearing the way for fresh, unblemished layers to replace them. The lasers are focused on the scar only, not on the derma surrounding the scar in any way. The patient can feel some pain, like stinging or tingling, as the process is done, but it is a tolerable sensation. Very deep scarring will need a more intense laser, which increases the risk of any potential problems, but the doctor at the clinic will discuss the process fully before he or she begins.
Good results have been reported from a combination of laser removal and compression, the latter applied during recovery, to protect the new layer and allow it to 'settle' before being exposed to soaps, shampoos and even sunlight.
Microdermabrasion works, like the laser, to remove the scarred top layers. It is especially good at getting rid of acne scars. The most basic form of microdermabrasion happens every day when we wash our faces, or give them a good scrub! This process removes dead cells and paves the way for fresh new epidermis to grow, as well as encouraging circulation. Medically trained staff can perform a deeper cleanse with specialised equipment that scours away scar tissue and then clears it off the surface – something like sandblasting a building to clean it of graffiti and superficial damage! Only trained personnel should operate deep microdermabrasion equipment as it is too easy to make a mistake and end up with worse scarring than ever if it is used incorrectly.
There are also creams and lotions that can be very good against light scarring. An application of cream twice a day, can causing a gentle peel, lifting off the scarred layer and again, making room for the new, soft skin to grow through.
- Scars can be caused by accidental injury, surgery or disease
- There are a wide variety of treatments available to reduce the appearance of scars: from creams to operations
- Even severe scars can be reduced with modern methods