SKIN CARE        SCARS

The word 'scar' was derived from the Greek word eschara, meaning place of fire (fireplace).

Our skin is a seamless organ, like a fine piece of cloth cloaking valuable assets. Any burn, injury, surgery or other trauma to it can cause the formation of 'scar' tissue that can be downright ugly.

Imagine if you had a fine piece of silk: Even one small tear can make a difference in how it looks. But we're human: Throughout our lives, we will have experiences that nip and tear at our skin, either self-inflicted, or completely out of our control.

A scar isn't so bad if it's small or in a location that's easy to conceal. But often you want a way to treat those scars other than hiding them under clothing.

The truth is this: The scar will never completely go away, but there are some methods that can help reduce its size and appearance.

What is a scar?
Scars (also called cicatrices) are areas of fibrous tissue that replace normal skin (or other tissue) after injury. A scar is a natural part of the healing process. Skin scars occur when the deep, thick layer of skin (the dermis) is damaged. The worse the damage is, the worse the scar will be.

Most skin scars are flat, pale and leave a trace of the original injury that caused them.

How your scar looks depends on -

How big and deep your wound is        

Where it is     

How long it takes to heal                

Your age                                   

Your inherited tendency to scar

What are the types of scars?
Two types of scars are the result of the body overproducing collagen, which causes the scar to be raised above the surrounding skin.

Hypertrophic scars take the form of a red raised lump on the skin, but do not grow beyond the boundaries of the original wound, and they often improve in appearance after a few years.



Keloid scars are a more serious form of scarring, because they can carry on growing indefinitely into a large, tumorous (although benign) growth. Keloid scars can occur on anyone, but they are most common in dark-skinned people. Keloid scars can be caused by surgery, an accident, by acne or, sometimes, from body piercing. In some people, keloid scars form spontaneously.

Although they can be a cosmetic problem, keloid scars are only inert masses of collagen and therefore completely harmless and non-contagious. However, they can be itchy or painful in some individuals. They tend to be most common on the shoulders and chest.   



Alternately, a scar can take the form of a pit commonly associated with acne, but can be caused by chickenpox, surgery or an accident. If you've had severe acne, you probably have the scars to prove it. There are many types of acne scars, ranging from deep pits to scars that are angular or wavelike in appearance. Possible treatments will depend on the types of acne scars you have.



Scars can also take the form of stretch marks caused when the skin is stretched rapidly (for instance during pregnancy, significant weight gain or adolescent growth spurts), This type of scar usually improves in appearance after a few years.



Contracture scars. If your skin has been burned, you may have a contracture scar, which causes tightening of skin that can impair your ability to move; additionally, this type of scar may go deeper to affect muscles and nerves.

What are the treatments for skin scars?
No scar can ever be completely removed and treatments will always leave a trace, but a number of approaches have been tried with silicon gel sheeting and steroid injections having the most widely accepted role in general scar treatment.

Needling
Needling is an inexpensive process where the scarred area is continuously needled to promote collagen formation. Once needled the area is allowed to fully heal, and needled again if required depending on the intensity of the scar. Scarring needles and needling rollers are available for home use; however, needling should not be done on parts of the face or areas where major nerves are located without professional medical supervision. Needling at home must also be done in line with hygienic and sterilization requirements.

Pressure garments
Pressure garments should be used only under supervision by a medical professional. They are most often used for burn scars that cover a large area, this treatment is only effective       on recent scars.

Pressure garments are usually custom-made from elastic materials, and fit tightly around the scarring. They work best when they are worn 24 hours a day for six to twelve months.
It is believed that they work by applying constant pressure to surface blood vessels and eventually causing scars to flatten and become softer.

Steroid injections
A long term course of steroid injections under medical supervision, into the scar may help flatten and soften the appearance of keloid or hypertrophic scars.
The steroid is injected into the scar itself; since very little is absorbed into the blood stream, side effects of this treatment are minor. However, does cause thinning of tissue so does carry risks when injected into scars caused by operations into ruptured tendons. This   treatment is repeated at 4-6 week intervals.

Dermabrasion
Dermabrasion involves the removal of the surface of the skin with specialist equipment   and usually involves a general anaesthetic. It is useful with raised scars, but is less effective when the scar is sunken below the surrounding skin. It however has a high complication rate in pigmented Indian skin, and is not the preferred treatment nowadays.

Collagen injections
Collagen injections can be used to raise sunken scars to the level of surrounding skin. Its effects are however temporary, and it needs to be regularly repeated. There is also a risk  in some people of an allergic reaction.

Laser surgery & resurfacing (Co2 Laser and Erbium Laser)
The use of lasers on scars is a new form of treatment. Several cosmetic lasers have been FDA approved for the treatment of acne scars by using laser resurfacing techniques. Vascular lasers have been proven to greatly reduce the redness of most scars 6–10 weeks after the initial treatment. It has been theorized that removing layers of skin with a carbon dioxide or erbium laser may help flatten scars.

The Esthetic clinic specializes in fractional laser resurfacing for scar revision and you must get evaluated by the Dermatologist to find if you should consider it for your scar treatment.

Surgery
Scars, such as acne scars, can be cut out and stitched up, a process called scar revision - Although this method has been known to result in the new wound healing the same way (as a hypertrophic scar).

Natural remedies
Research shows the use of vitamin E and onion extract as a treatment for scars has been proven somewhat effective, though in some cases it may worsen scar appearance.
 

	Surgical scar		After laser resurfacing of scar

	Acne scars		After laser resurfacing