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Don’t accept scars for what they are

May 3, 2018

Many of us acquire some unique scars through our lifetime. However, it’s mostly the visible ones that tend to bother us. Some scars can be more obvious and the result of an accident, a surgical procedure or a skin condition such as acne. Scarring that is visible to others are at the very least an annoyance. They can also be socially debilitating – depending upon their severity.

How does scarring form

Scarring forms when the *dermis layer of our skin is damaged (the deep layer of tissue that gives the skin most of its substance and structure – the dermis comprises about 80% collagen). To heal a wound the dermis sends out fibroblasts (the cells that make collagen) to repair the tissue. Scars can appear when the new collagen fibres heal the damaged tissue. Scars result from the difference in formation of collagen fibres found in the normal tissue. The newly formed collagen scar tissue is usually of inferior functional quality to the normal collagen.

Acne scarring

Acne is a condition seen in up to 80 percent of young people and in 5 percent of older adults (El-Domyati,2015). Acne is caused by hair follicles in the pores of skin becoming clogged with bacteria. Acne scars are permanent textural changes and indentations that occur on the skin after severe acne (the term scarring does not apply to the red and brown marks left after mild acne has occurred – these marks will usually improve without treatment).

Raised and depressed scarring

types of acne scars
Acne scarring can be described as raised (keloid or hypertrophic depending upon severity) or depressed and atrophic. Scars are identified by their shape and have names that describe their appearance on the skin. There are ‘Boxcar Scars’ – that feature broad depressions and have sharply defined edges that resemble chicken pox; ‘Ice-Pick Scars’ – that are narrow and deep. These cause the skin to have a pitted appearance and resemble large open pores; ‘Rolling scars’ – have broad depressions and rounded sloping edges. What these specific types of scars each have in common is that they are caused by collagen loss.

Excess collagen and raised scars

Hypertrophic acne scars are raised and less common. These scars have an excess of tissue on the surface caused by too much collagen – making them more difficult to treat. Keloid scars are more common among people with darker skin. Steroid injections made direct into the scar may flatten their appearance.

The professional treatment of acne scarring

Atrophic (depressed) acne scars can be treated through professional techniques such as augmentation (collagen is taken from other parts of the body and injected underneath the scars). Skin needling, laser resurfacing (used on shallow scars) and dermabrasion (removes the top layer of skin). Skin needling, as the name suggests, delivers needles of varying depths (0.5 to 3 mm) into the dermal layers of the skin. Needling breaks down scar tissue and stimulates the formation of new collagen. The best way to prevent acne scars is to begin treatment immediately the acne begins to appear. This will prevent severe acne from developing and reduce the extent of scarring.

Stretchmarks and scarring

Other scars that can be unsightly unless effectively treated include the scars left by stretch marks. Stretch marks are the narrow streaks or lines that can occur during pregnancy. They can also be caused by hormonal changes and through rapid weight loss. Stretch marks affect the stomach, buttocks, breasts, upper arms and thighs. Stretch marks do fade but this can take years. A fresh stretch mark is usually a pearlescent white colour and these are usually fairly easy to repair or reverse. Once a stretch mark changes colour from a pearly white to a blueish purple colour it becomes difficult to make a difference with topical products.

Shielding scars from the sun

Scars are less resistant to UV rays and more prone to sunburn. Prolonged exposure can permanently darken scars. Whether the scar is old or new a product called ‘Remescar Scar Stick’ can help restore skin to its normal colour, and contains UV filters for sun protection. The product uses a silicone film to stimulate collagen production and reduce the redness of scars. The hydrating properties of the Remescar Scar Stick can accelerate the healing process on fresh scars. Clinical studies have also shown that stretch marks can be effectively reduced by up to 50%.

References
“Acne Scars (acne Scarring) – ACD.” n.d. ACD.
https://www.dermcoll.edu.au/atoz/acne-scars-acne-scarring-2/.
El-Domyati, Moetaz, Manal Barakat, Sherif Awad, Walid Medhat, Hasan El-Fakahany, and Hanna Farag. 2015. “Microneedling Therapy for Atrophic Acne Scars.” The Journal of Clinical and Aesthetic Dermatology 8 (7): 36–42.