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The Science of Scars: Different Types, Their Causes, and How to Treat Them

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Remember that time you had to get stitches?

 

Or finally won that battle with a blemish?

 

Or kept cutting yourself in the same spot while shaving your legs? (Ankles are difficult.)

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Of course you do!

 

Because now you have a scar to remind you!

 

Scars are a normal part of the skin’s natural healing process, but for many of us, those little telltale marks can hang around for a while as an unwelcome cicatrix. (Another word for a scar. Say it out loud. Isn’t it fun?)

 

In a study conducted by professors of reconstructive and plastic surgery, it was estimated that many people are seeking to fix scars.

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And that’s just per year, and it doesn’t even account for the entire global population!

 

Which means, whether it’s from an injury, surgery, burn, or a pimple gone awry, we pretty much all have scars of some kind.

 

As a skincare professional, I’m often asked if it’s possible to fade or diminish scars.

 

Today, I’m going to give you info on the science of scars: different types, what causes them, and if there’s a way to fade those pesky little reminders!

 

What Causes Scars?

Scars occur when the dermis, the second deepest layer of skin, is damaged by injury, surgery, picking at a scab, etc.

 

When a wound occurs, your skin goes into immediate healing mode and starts trying to close it up as quickly as possible.

 

First, a blood clot forms on the skin’s surface (the epidermis) and covers the cut to form a scab.

 

Then, the dermis gets to work below sending out fibroblasts (the cells that make collagen) to start rebuilding tissue.

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Because your skin is in a hurry to repair itself and replenish tissue, the collagen may not get laid out in the neatly-organized lattice pattern that makes up the rest of your skin.

 

This hasty approach can result in a scar. Too much collagen creates a raised scar, while a lack of collagen makes an indented one.

 

Over the next couple years following an injury, your skin will work to replace that messy collagen with neater tissue, so a scar may be reduced, but may never completely fade or return to your skin’s original appearance in that spot.

 

How severe or obvious a scar ends up looking can be determined by a number of factors.

  • Age – Older skin tends to contain less collagen and elasticity, making healing slower and scars more probable.
  • Skin Tone – Those with darker or fairer skin are more susceptible to noticeable scarring.
  • Location of Injury – If you get a cut on a place that takes longer to heal, say on a knee that bends a lot, or a foot that experiences constant friction from shoes, scarring may be more likely.
  • Hormones – Hormone levels can affect your body’s likelihood of incurring scars or hyperpigmentation.

 

Different Types of Scars and Their Causes

Keloid or Hypertrophic

Keloids are those raised scars that look like puffy, dense tissue and might also be pink or darker than the surrounding skin.

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Similarly, a hypertrophic scar may also be raised, but it doesn’t expand beyond the spot of the injury.

 

These types of scars occur when there’s an overproduction of tissue at the site of the wound and collagen collects and is overbuilt under the top layer of skin.

 

What Causes Keloid Scars

When the dermis layer of your skin kicks into aggressive healing mode, it sends in fibroblasts to start distributing collagen to rebuild tissue.

 

However, instead of having time to lay everything out in an orderly, basket-weave style – which is how the rest of your skin is composed – they start throwing down an overproduction of collagen sort of haphazardly to quickly get things closed up.

 

So, you end up with a bunch of unorganized, built-up collagen beneath the top layer of your skin which results in a raised scar.

 

Atrophic Scar

If you had chickenpox as a kid, you may have a parting gift in the form of a little pitted or divot scar.

 

This is where they get their familiar name, “pockmarks.”

 

This is an atrophic scar, which is sunken in and results in a recessed mark on your skin.

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These scars are typical of both chickenpox and cystic acne.

 

What Causes Atrophic Scars

These sunken scars are caused when there’s damage to the skin’s underlying structure – fat or collagen cells – usually as a result of inflammation.

 

The outcome is that there’s not enough tissue to fill out the skin, so it causes a depression in the skin’s surface.

 

Acne Scars

As if battling blemishes wasn’t already a pain, they can leave you with lasting scars.

 

And, I’m not just talking about skin damage from picking and popping pimples.

 

Although, that’s not good for skin either.

 

Hands off, resist the pick!

 

I’m talking about cystic acne.

 

These painful bumps are rooted deep in the skin, and when pus and bacteria collect and sit below your skin’s surface, they can do damage to deep layers and result in scars which can take on a variety of forms.

 

Icepick Scars

These are those deep, indented scars that may resemble a large pore. They occur when inflammation causes collagen below skin’s surface to collapse, leaving a depression.

 

Rolling Scars

Rolling scars are depressions with rounded edges, and there are typically a few of them in one close area making them look like a continuous, undulating scar. These scars are caused when the subcutaneous tissue layer (the layer below the dermis) creates fibrous tissue that tugs the top layers down.

 

Boxcar Scars

These scars are broad depressions with more defined edges. Boxcar scars occur when a cyst destroys fat cells under the skin resulting in an indentation.

 

Hyperpigmentation

These scars cause a dark spot on the skin’s surface that may resemble a freckle. Hyperpigmentation happens when melanocytes (the cells that produce melanin, or pigment) go into overdrive in the production of melanin at the site of an injury or inflammation caused by acne.

 

If you’re dealing with cystic acne, you don’t have to through it alone. I always recommend talking to a dermatologist! There are so many treatment options out there, and they can help you determine which one will work best to care for your skin!

 

Contracture Scars

These scars are the result of a large area of skin being lost (or the kind you’d get from a severe burn).

 

The skin contracts as it heals and scars, forming tight, shiny skin that may inhibit movement in the area.

 

Stretch Marks

Ladies, if you’ve had the pleasure of being pregnant, you may be familiar with these lovely lines (although not all moms-to-be experience them, 90% of pregnant women do!).

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Anyone can get stretch marks.

 

They can occur all over the body and happen when there’s extreme weight gain or growth that makes skin stretch, like during puberty.

 

Stretch marks can appear as indented or raised lines that are either darker (purple) or lighter (white) than the skin tone that surrounds them.

 

What Causes Stretch Marks

While the exact cause isn’t known, it’s theorized that skin stretching causes damage to the elasticity of the tissues in the dermis layer which leads to scarring.

 

It’s also been suggested that high levels of cortisol could play a part in making your skin more vulnerable to stretch marks.

 

Preventing Stretch Marks

In the battle against stretch marks, moisture is your best friend.

 

Imagine a dry, brittle piece of elastic or rubber band.

 

When it’s stretched, it’s more prone to tears and breakage.

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Same goes for skin.

 

Grab some coconut oil, shea butter, or your rich moisturizer of choice and slather on that goodness.

 

Your future skin will thank you!

 

How to Prevent Scars

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If you do find yourself with an injury or damage to your skin, there are a couple things you can do to help heal and avoid making matters worse!

  • Don’t. Pick. – I know, the temptation is almost too much to bear, but if you can avoid picking and just let a scab or a blemish resolve and heal on its own, you’ll reduce the chance of developing a scar. Stay strong, my friends!
  • Keep Wounds Protected – When your skin is healing, moisture and coverage are the keys to helping it along. Keep a wound properly cleaned and covered, and avoid letting it dry out by regularly applying a medicated ointment.
  • Continue Protection – After your skin has healed, keeping the area protected with SPF whenever you’re out will help prevent the scarred area from getting darker.

 

Is It Possible to Minimize Scars?

While there’s no one-size-fits-all method, there are a variety of options for treating scars.

 

Raised scars may eventually resolve and fade on their own.

 

However, they can also be minimized using dermabrasion, steroid injections, cortisone injections, silicone gels or pads, or even through surgery to remove the raised tissue and replace it with a cleaner, more minimal scar.

 

Indented scars can be resolved through in-office treatments including lasers, filler injections, dermabrasion, or chemical peels.

 

Either way, if you’re concerned about physical scarring, you should talk to your doctor or dermatologist about which treatment option is right for you!

 

What About Fading Scars?

Scarring that is caused by hyperpigmentation resulting in dark spots can be lightened up by using certain ingredients in your skincare routine.

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It’s worth mentioning that, when working to lighten and brighten your complexion, patience and regular application is key! You won’t see results overnight.

 

In order for most lightening formulas to work effectively, they require time and consistent use.

 

Practice your routine religiously, and stick with it!

 

Look for These Brightening Ingredients

  • Antioxidants – These help combat free radical damage which cause collagen and elastin breakdown, hyperpigmentation, and thicken your skin’s texture. Antioxidants help rebuild collagen and encourage healing for healthy skin!
  • Vitamin CThis vitamin works to inhibit the skin’s overproduction of melatonin in response to damage or an injury. Plus, since it’s a member of the antioxidant family, it helps rebuild collagen.
  • Retinol – A vitamin A derivative, retinol works by gently exfoliating the top layers of skin to lift away dark skin cells. In turn, it promotes cellular turnover and encourages the production of new, healthy skin cells and new collagen which can help soften scars.
  • Alpha Hydroxy Acids (AHAs) – This ingredient is another one that will help with cellular turnover to renew skin and encourage healing.
  • SPF – Wearing daily sun protection will guard against scars getting any darker or skin incurring any further damage. Plus, it will protect against collagen and elastin breakdown to keep skin looking youthful.

 

My Favorites for Fading and Treating Scars

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iS Clinical White Lightening Serum

Alana Mitchell Night R1 Retinol Facial Oil

 

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M’lis REPAIR Tissue Repair Cream

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Epicuren Glycolic Polymer Solution – 5%

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Dermaquest Stem Cell Rebuilding Complex

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Rhonda Allison Skin Brightening System

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Dermalogica Emergency Spot Fix

 

Final Thoughts

Scars can be unpleasant to live with, but they’re also reminders of experiences and a life lived!

 

Whether you choose to keep your scars or take steps to treat them, it’s a decision you should make based on what’s best for you and your skin.

 

Make sure you’re caring for your skin, scars and all!

Do you have questions about the best way to fade or treat your scars? Ask us in the comments section. We’re here to help!

 

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