Scars & scar treatment – causes, symptoms & therapy

A scar is a specific form of connective tissue in the body that replaces the skin’s normal structural surface after an injury. A scar results from the biological process of wound healing in the skin or other tissues of the body.

Except for very minor injuries, every wound (accident, illness, surgery) leaves some form of scarring. Scar tissue is made of the same protein (collagen) as the tissue it replaces. However, the structure of the protein differs . Normally, the collagen of the scar is of reduced functional quality than the other skin tissue. The scarred skin is less resistant to ultraviolet light. Hair roots and sweat glands also do not regress.

Why are scars formed?

A scar occurs when the dermis (a deep, thick layer of skin) becomes damaged. The body forms a new layer of collagen, but different from the original one.

After the formation of this new layer of skin, the healing of the wound is complete. The now newly formed, inferior skin tissue has no sebum or sweat glands.

There are different types of scars. Most scars are light and flat. But if the body produces an excess of collagen protein during wound healing, the scar can ‘grow’. Such hypertrophic scars usually form in young and dark-skinned people.

A scar can also appear as a kind of indentation in the skin. This happens when fat or muscle tissue underneath the skin has been injured.

Good wound healing prevents scarring

The best prevention of scarring is good wound healing. A fresh wound should be treated immediately. Even a small wound can become infected when bacteria become lodged in the open tissue. If the wound was caused by a dirty or rusty object, you should see a doctor immediately.

The same applies to human or animal bites, as well as deep cuts. A tetanus shot may need to be given or the wound may need stitches. If a wound is not properly treated, it can affect the size and shape of the scar. If the scar has already formed, there are a number of ways to reduce the degree of its formation.

Sunscreen reduces the chance of severe scarring, especially the noticeable discoloration. Creams with zinc or titanium dioxide are recommended here, as they block UVA and UVB rays. The sun protection factor should be 30 or higher. Regular massaging of the fresh scar also has a preventative effect against rough formation of the tissue.

Special silicone gel can have a similar effect. This can be purchased in specialist shops or pharmacies and should be used for at least 3 months to produce an effect. There are special creams with a bleaching effect for treating dark scars. Used regularly, they can reduce the darkening of the skin and adjust the scar to the normal skin tone. Some manufacturers offer creams with an increased amount of vitamin E that are designed to treat scars. While these creams are certainly good for regenerating skin cells, they have not been proven to effectively reduce visible scarring.

How can scars be treated?

Even if it is almost impossible to completely eliminate a scar, there are a number of medical procedures that can significantly reduce the visible signs. In collagen induction therapy, small needles are regularly inserted into the scar tissue with the help of a machine in order to change the structure of the collagen tissue. This therapy has proven successful in treating significant scars.

Therapy with a chemical peeling can remove the upper layers of the skin and thus improve the external appearance. This form of treatment is used for acne scars, for example.

By means of collagen injections, it is possible to adapt atrophic scars to the structure of the surrounding skin. Injecting steroids directly into the affected skin tissue can reduce certain scars. The therapy is carried out over several weeks. The effects of this treatment are very individual to the patient and may cause allergies or only be of temporary benefit.

Dermabrasion is a procedure to abrade scarred skin. It can only be used selectively, not over a large area and primarily for smaller scars. The operation is performed under local or general anesthesia . This is followed by a months-long healing process.

Laser treatment works in a similar way to dermabrasion, here too a superficial change (removal) of the skin is caused. Laser treatment is often associated with high costs, which are rarely covered by health insurance. Laser therapy is often used for acne scars and generally shows good treatment results.

The largest intervention is an operation. The scarred skin is removed about 12 months after the injury. This procedure is mostly used in combination with collagen injections to permanently smooth the scars. The scar can be largely removed with this procedure.