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Scars 101

Dr. Hilary Baldwin

Scars are an inevitable part of life, but understanding why and how they form can sometimes be a mystery. We expect that scarring will occur with surgery or with a bad cut and wonder why we sometimes scar from seemingly minor wounds.

Scars can form for many different reasons depending on the depth and type of the injury, location on the body, how a wound is treated but especially due to our unique individual physiology. Some scars will be unavoidable, but you can reduce the risk of developing a noticeable scar by understanding more about them. In this column, I'd like to give you a crash course in scars so that you can help yourself avoid noticeable scars in the future, and learn how to reduce the appearance of the ones you already have.

Some scars will be unavoidable, but you can reduce the risk of developing a noticeable scar by understanding more about them.

Simply speaking, scars are the body's response to injury. When the skin is damaged, cells called “fibroblasts” are activated in the damaged area of the skin, producing collagen and other structural parts of the skin to repair the defect. This process causes the newly healed area to have a tough texture and discoloration. Scars can form after surgery, injury and burns, but they can also result from acne, a body piercing or even a bug bite. Picking at scabs or leaving a wound exposed increases the chance of developing a scar. One of the best ways to avoid a noticeable scar, or to reduce the size and appearance of a scar, is to keep a wound clean and covered as it heals.

There are different classifications of scars depending on their appearance. “Atrophic” scars form when fibers below the skin are destroyed due to inflammation from conditions such as acne, and generally have a sunken appearance. On the other hand, “hypertrophic” scars occur when the body's fibroblasts repair the wound too well, causing a raised appearance. Hypertrophic and keloid scars most often occur from deeper, more severe wounds, but they can be caused by seemingly insignificant wounds like acne lesions or bug bites. Hypertrophic scars most often come from burns and tend to occur on moving body parts like across joints. They are generally pinker and contained to the area of the wound. Finally, “keloid” scars result when the body overproduces fibroblasts in thick bundles, creating a very raised bump that can extend beyond the boundaries of the original wound. Keloids are more common in skin of color and can be itchy or painful in some patients. Keloids occur more commonly on the chest, shoulders, back, jaw and ears.

In terms of scar products, there are different options available based on the type of scar and how long the scar has been on the body. Topical products – meaning products that are applied directly to the skin – can be used on all types of scars, though mature keloid scars generally do not respond to them. Mederma® Advanced Scar Gel is one example of a topical product that reduces the scar's appearance with ingredients like onion extract while the process of rubbing in the product actually massages the scar. This massaging action can help soften and smooth the scar tissue. Thick or misshapen scars, however, may require a trip to the dermatologist's office to more effectively reduce their appearance.

Whether you trip walking down the street and scrape your knee or have a scheduled surgical procedure, at some point in your life you will develop a scar. The good news is there are many options that can help. Talk to your pharmacist or dermatologist, or explore the rest of this site to learn more about one option – Mederma®.

All information in the Mederma® Learning Center is intended for informational and educational purposes only. It is not intended to be a replacement for professional medical advice. You should seek professional medical care if you have any concerns about your skin.