Scar tissue doesn’t hurt. It just isn’t very attractive. We collect scars over a lifetime – from playground scrapes to surgical cuts. Most of them we wear with pride, but some scars can cause embarrassment or shame.
BSA reader Nina Verwey has this question: I was in a car accident and now I’m rocking a facial scar. I think I have to slather on more SPF than ever. Is that right? I’d love to read what the experts say about taking care of scars not caused by acne.
Skin renewal founder and expert, Dr Maureen Allem, replied:
When you damage your skin, the body heals itself by forming a scar. Scars are areas of connective fibrous tissue that replace normal skin after injury. These new fibres form a protective barrier and appear as a scar. Most scars fade over time, but they never go away completely. Scar tissue is more pale and dense than surrounding tissue. Although it takes the place of damaged tissue, its function is limited. Apart from minor cuts or scrapes, every wound causes scarring. Numerous factors influence scarring, such as how deep, how large and where the wound is. Age, heredity, gender and ethnicity also play a role in how your skin will react.
Scarring may be inevitable, but certain scars are more problematic than others:
* Keloid scars are thick, firm, itchy and often painful people with darker skins are more prone to these.
* Hypertrophic scars are raised and red.
* Contracture scars will contract and tighten in the skin, which restricts movement in the affected area.
Four steps of care
Looking after your wound is the first step to minimising scarring.
- Clean it. Soothe and clean the wound with water and wash with a suitable diluted soap.
- Keep it covered. This keeps out bacteria. A moist wound also heals faster, which reduces the appearance of scars. An antibiotic cream or ointment also helps.
- Don’t pick! As tempting as it is to pick at scabs, it just reopens the wound. That lets in bacteria and can cause a larger scar.
- Use sunblock. Once the wound has healed, get a sunblock that preferably contains zinc or titanium dioxide. Use it regularly to prevent hyperpigmentation (PIH) around injured areas on your face. Look for one with an SPF of 30 or higher.
There are many ways to deal with scar tissue. These techniques can be used initially to prevent problem scars or after they’ve formed:
Micropore tape: This adhesive tape is ideal for delicate skin as it is very gentle. Use it when the wound needs to be treated and dressed frequently as surgical tapes are harsher and can cause irritation. The tape is porous, allowing the skin underneath it to breathe. This means the skin has a better chance of healing than when covered with non-breathable tape. When put on a wound for six weeks or more, this kind of tape can stop thick, hard scars from forming.
Steroids: To reduce a thickened scar, steroids can be used as a topical cream or injected directly into the scar. Injections are more effective than creams, but several might be required.
Compression garments: The constant pressure of a compression garment can prevent scars forming or flatten raised scars. They are used over large scars such as burns.
Silicone gel sheets: These prevent scars from rising, but you must place them over the wound while it’s healing to keep the area flat. Gels with a silicone base are also an option.
Chemical peel: This process is used to smooth the skin. It can remove small scars by taking off the top layers so that when the skin heals again, the scars are smaller and less obvious. A surgical option is dermabrasion which is especially effective on pockmarks usually caused by acne.
Collagen injections: Sunken scars are best dealt with by injecting collagen, as it helps to raise them.
Laser peel: Non-invasive Fraxel lasers produce thousands of tiny, deep columns or channels in your skin and can resurface damaged skin, without damaging surrounding healthy tissue.
Healing at home
There are natural ingredients that can help reduce the appearance of scarring. Some of them you might have at home already. Tissue oil is the best-known remedy. Made with omega oils found in plants such as flax, marula and rosehips, it can boost elasticity by keeping the skin hydrated and soft, reducing scarring. Aloe Vera gel can prevent permanent scarring if rubbed on the wound during the healing process. Lemon juice and coconut oil are recommended for older scars. Also consider cocoa butter and olive oil. There are many anecdotal reports on the wonders of vitamin E, but no proof. In fact, several studies have shown that applying vitamin E does nothing to improve the appearance of scars.
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Scars tend to leave one insecure but it’s part of who we are. Thanks for the great advice.