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Skin scars - Types, Causes, and Treatments

November 9, 2021

Scarring

A detailed and comprehensive discussion of scars starts with causes of scarring, prevention of scarring, types of scars, and treatments for scars.

Before talking about scars, a word about spots that may look like scars but are not scars in the sense that a permanent change has occurred. Even though they are not true scars and disappear in time, they are visible and can cause embarrassment.

Macules, "pseudo-scars" are flat, red or reddish spots that are the final stage of most inflamed acne lesions. After an inflamed acne lesion flattens, a macule may remain to "mark the spot" for up to 6 months. When the macule eventually disappears, no trace of it will remain like a scar.

Post-inflammatory pigmentation is discoloration of the skin at the site of a healed or healing inflamed acne lesion. It occurs more frequently in darker-skinned people, but occasionally is seen in people with white skin. Early treatment by a dermatologist may minimize the development of post-inflammatory pigmentation. Some post-inflammatory pigmentation may persist for up to 18 months, especially with excessive sun exposure. Chemical peeling may hasten the disappearance of post-inflammatory pigmentation.

 

Causes of  Scars

In the simplest terms, scars form at the site of an injury to tissue. They are the visible reminders of injury and tissue repair. In the case of acne, the injury is caused by the body's inflammatory response to sebum, bacteria and dead cells in the plugged sebaceous follicle. Two types of true scars exist, as discussed later: (1) depressed areas such as ice-pick scars, and (2) raised thickened tissue such as keloids.

When tissue suffers an injury, the body rushes its repair kit to the injury site. Among the elements of the repair kit are white blood cells and an array of inflammatory molecules that have the task of repairing tissue and fighting infection. However, when their job is done they may leave a somewhat messy repair site in the form of fibrous scar tissue, or eroded tissue.

White blood cells and inflammatory molecules may remain at the site of an active acne lesion for days or even weeks. In people who are susceptible to scarring, the result may be an acne scar. The occurrence and incidence of scarring is still not well understood, however. There is considerable variation in scarring between one person and another, indicating that some people are more prone to scarring than others. Scarring frequently results from severe inflammatory nodulocystic acne that occurs deep in the skin. But, scarring also may arise from more superficial inflamed lesions. Nodulocystic acne that is most likely to result in scars is seen in these photo:

 

The life history of scars also is not well understood. Some people bear their acne scars for a lifetime with little change in the scars, but in other people the skin undergoes some degree of remodeling and acne scars diminish in size.

People also have differing feelings about acne scars. Scars of more or less the same size that may be psychologically distressing to one person may be accepted by another person as "not too bad." The person who is distressed by scars is more likely to seek treatment to moderate or remove the scars.

Prevention of   Scars

As discussed in the previous section on Causes of Scars, the occurrence of scarring is different in different people. It is difficult to predict who will scar, how extensive or deep scars will be, and how long scars will persist. It is also difficult to predict how successfully scars can be prevented by effective acne treatment.

Nevertheless, the only sure method of preventing or limiting the extent of scars is to treat acne early in its course, and as long as necessary. The more that inflammation can be prevented or moderated, the more likely it is that scars can be prevented. (Click on Acne Treatments below for more information about treatment of mild, moderate and severe acne). Any person with acne who has a known tendency to scar should be under the care of a dermatologist. (Click on Find a Dermatologist to locate a dermatologist in your geographic area).

Two Types of  Scars

There are two general types of scars, defined by tissue response to inflammation:

(1) scars caused by increased tissue formation, and
(2) scars caused by loss of tissue.

 

 

 

 

 

 

 

 

Scars Caused by Increased Tissue Formation

The scars caused by increased tissue formation are called keloids or hypertrophic scars. The word hypertrophy means "enlargement" or "overgrowth." Both hypertrophic and keloid scars are associated with excessive amounts of the cell substance collagen. Overproduction of collagen is a response of skin cells to injury. The excess collagen becomes piled up in fibrous masses, resulting in a characteristic firm, smooth, usually irregularly-shaped scar.

The typical keloid or hypertrophic scar is 1 to 2 millimeters in diameter, but some may be 1 centimeter or larger. Keloid scars tend to "run in families" that is, abnormal growth of scar tissue is more likely to occur in susceptible people, who often are people with relatives who have similar types of scars.

Hypertrophic and keloid scars persist for years, but may diminish in size over time.

Scars Caused by Loss of Tissue

Scars associated with loss of tissue, similar to scars that result from chicken pox, are more common than keloids and hypertrophic scars.

Scars associated with loss of tissue are:

  1. Ice-pick scars usually occur on the cheek. They are usually small, with a somewhat jagged edge and steep sides, like wounds from an ice pick. Ice-pick scars may be shallow or deep, and may be hard or soft to the touch. Soft scars can be improved by stretching the skin; hard ice-pick scars cannot be stretched out.

      2. Depressed fibrotic scars are usually quite large, with sharp edges and steep sides. The base of these scars is firm to                 the touch. Ice-pick scars may evolve into depressed fibrotic scars over time.

      3. Soft scars, superficial or deep are soft to the touch. They have gently sloping rolled edges that merge with normal skin.              They are usually small, and either circular or linear in shape.

      4. Atrophic macules are usually fairly small when they occur on the face, but may be a centimeter or larger on the body.             They are soft, often with a slightly wrinkled base, and may be bluish in appearance due to blood vessels lying just under              the scar. Over time, these scars change from bluish to ivory white in color in white-skinned people, and become much less            obvious.

      5. Follicular macular atrophy is more likely to occur on the chest or back of a person with acne. These are small, white,            soft lesions, often barely raised above the surface of the skin or somewhat like whiteheads that didn't fully develop. This                condition is sometimes also called "perifollicular elastolysis." The lesions may persist for months to years.

In summary, scars are caused by the body's inflammatory response to lesions. The best way to prevent scars is to treat them early, and as long as necessary. If scars form, a number of effective treatments are available.

Treatment of Scars

  • Silicone Scar Removal - NuvaDermis is an advanced silicone treatment, clinically shown to flatten the scars' appearance. It helps with most scar types caused by hypertrophic, post-acne, keloid, post-surgery, c-section, and stretch marks.
  • Medical-Grade Ingredient- Scar sheets made of premium medical silicone help reduce the size of scars in 6 weeks for new scars, and 4 months for older ones. Silicone sheets improve the color and texture of scars, making skin smooth and soft.
  • Easy To Apply & Remove - Our scar removal sheets are soft, lightweight, and breathable, allowing comfort wearing for 24 hours. They can be used all day & night with clothes on without leaving any residue behind. Forget about discomfort while wearing and peeling sheets off.
  • At NuvaDermis, they strive to help build self-confidence and enhance skin beauty. Unlike expensive cosmetic procedures, our product is safer and more effective due to high-quality material and surgeons' developed formula.
  • They Value Your Experience - Their customer support team will answer all your questions within 12 hours. Feel free to contact us if our product fell short of your expectations. We will assist you and put all efforts to improve your experience with NuvaDermis

 

2. Pharmacist & Doctor Recommended Mederma Scar Day and Night Creams/Gels

  • Clinically shown to improve the overall appearance, color, and texture of scars
  • The ONLY 1x daily topical gel making it one of the most cost effective products available
  • Works for many types of scars, including acne scars, surgery scars, and scars from burns, cuts, and other injuries
  • From Mederma – the #1 Scar Care brand

 

  • #1 RECOMMENDED BRAND: Mederma is the #1 Recommended Brand of Scar Treatments among Doctors, Pharmacists, Pediatricians, Dermatologists and Plastic Surgeons* (IQVIA ProVoice Survey, March 2021)
  • SPECIALLY FORMULATED to work with your skin's nighttime regenerative activity to visibly reduce the appearance of scars caused by acne, surgery, burns, and injury, all while you sleep.
  • CLINICALLY SHOWN to improve the color, size, and overall appearance of scars, helping them appear softer, smoother, smaller and less visible.
  • UNIQUE TRIPLE ACTION FORMULA, with Cepalin botanical extract & TriPeptolTM, penetrates beneath the surface of the skin to help: Lock in Moisture, Collagen Formation and Cell Renewal.

 

 

3. NATURAL ORGANIC Calendula Scar and Stretch Mark Products -  Contact me directly for special shipping rates!

Made with Natural Avocado Oil: Moisturizes, nourishes, and visibly softens skin.
Tea Seed Oil: Nurtures and helps skin retain moisture without leaving behind an oily appearance.

Calendula Officinalis Flower Extract, Persea Gratissima Oil, Soybean Oil/Glycine Soja Soybean Oil, Tocopherol Oil

For an extremely comforting and moisturizing natural balsam to use along with the oil, I recommend this amazing calendula cream balsam. Contact me directly for special shipping rates

An intense cream that helps nourish and soothe skin while preventing it from drying out. It creates a barrier to protect you against negative environmental factors.

HOW TO USE 

Apply to cleansed skin by gently massaging in circular motions.

HIGHLIGHTED INGREDIENTS 

Avocado Oil- Moisturizes, nourishes, and visibly softens skin.

Vitamin E- Known to provide radiance and protect the skin from damaging environmental with its antioxidant properties.

I love the results of these results of calendula!!!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.Organic Vitamin E Oil for Skin & Scars. Small Batch, All Natural Vitamin E Serum Hand Made in South Carolina Using Sunflower Oil. Nourish & Repair with Our Anti Aging Serum.

  •  Health Priority Vitamin E Enhanced Unscented organic, d-alpha-tocopherol vitamin E oil , hand made in South Carolina, is infused with jojoba, avocado, and rice bran oils. Our oils can be used all over the body, face, lips, and hair to help replenish dry skin, protect and rejuvenate hair, calm itchy skin, and more, providing long-lasting results
  • The vitamin E oil for face wrinkles locks your skin’s natural moisture and contributes to a nourished, smooth, and radiant complexion that keeps your skin youthful looking
  • This all-natural vitamin E oil will give you glowing results no matter your age or skin type. Our vitamin E face oil for dry skin sensitivity is not only a skin-renewing powerhouse, but it also helps improve the immune system and benefits skin appearance
  • Our 15,000 IU vitamin E oil for stretch marks, acne scars, wrinkles, and more promotes collagen and elastin, making your skin smooth and preventing aging lines. A small application daily helps repair dry and damaged skin naturally
  • To maintain our uncompromising quality standards across the entire process of ingredient selection, all Health Priority products are manufactured and packaged exclusively in the USA

5. Dermatologist Recommended Bio-Oil Skincare Oil, Body Oil for Scars and Stretch marks IMPROVES APPEARANCE OF SCARS AND STRETCH MARKS - Clinically proven to help repair skin damage and scars from pregnancy, surgery, injury, acne, C-section, aging, and more. Bio-Oil is non comedogenic and a great acne scar treatment for face.

    • PACKED WITH POWERFUL, NATURAL OILS - Vitamin A Oil promotes the formation of new collagen and assists in skin renewal, increasing skin elasticity. Vitamin E Oil, Chamomile Oil, Sunflower Oil, and Lavender Oil are anti-inflammatory and promote healthy skin.
    • LOCKS IN ESSENTIAL MOISTURE WITHOUT CLOGGING PORES - Uniquely formulated, non-greasy body oil that hydrates skin and helps retain moisture to repair scars without clogging your pores. Effective acne scar healer and anti-aging face moisturizer for women.
    • HELPS SMOOTH UNEVEN SKIN TONES - Works naturally to improve the appearance of uneven skin tones, for light and dark skin tones. Mineral oil, one of Bio-Oil's base oils, works both as an emollient, which keeps the skin soft and smooth, and as a moisturizer.
    • FORMULATED FOR ALL SKIN TYPES - Keep Bio-Oil Skincare Oil on-hand to ensure the whole household is covered. Helps soften skin and repairs damage for all types, tones, textures, and areas of your skin. Bio-Oil is safe to use during pregnancy.

5. Treatment of Scars from Burns and Trauma Book -Ebook and/or Hardcover Available.

 

6. The Keeva Organics Intensive Scar Removal Treatment Cream - claims 7X Faster Results with their Secret TEA TREE OIL Organic Ingredients

 

 

 

 

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