Forming a scar is a normal part of the healing process as it is the body’s natural way of repairing and strengthening damaged skin. When an injury to the skin goes deeper than the top layer of skin (the epidermis) into the middle layer (the dermis) a scar may be formed as part of the healing process. Anything that can damage skin can lead to the formation of a scar such as:
- Infections, for example following chicken pox
- Trauma or injuries, for example following an accidental cut, a fall, burns or surgery
- Inflammation, for example due to acne
- Stretch marks are another form of scar that appears after rapid growth of skin, as can occur during pregnancy.
The more the skin is damaged and the longer it takes to heal, the greater the chance of a noticeable scar being formed. Also the more tension or pulling there is around the damaged skin the higher the chance of a scar forming. This is common if the damaged skin is on or near a joint that is always moving such as a knee or elbow.
A scar is different to normal skin. It is made of different materials (mainly collagen) and has a different structure to normal skin. This makes the scar less flexible and weaker than the original skin. Other structures that are normally found in the skin such as sweat glands and hair follicles are not found in scar tissue which is why scars look different to normal skin.
When scars are first formed they can appear red, thick and raised. Even though scars are permanent, during the healing process (that can take up to 2 years to complete) the scar may gradually become smoother, softer and paler.
Problems with scars
While scars are often considered as trivial by some people, some scars can cause additional medical issues. Unfortunately some scars are disfiguring and unattractive to look at and this can be very distressing. In addition to how some scars make you feel, scars can also cause unwanted physical issues. Some scars can be very tender, painful and itchy. As scars are less flexible than normal skin, some scars will limit the person’s ability to move and in severe cases can be disabling.
Types of scars
- Flat, pale scars: These are the most common type of scar, occurring as a result of normal healing. At first these scars may be red, dark and raised, but over time (up to 2 years) they will tend to become paler and flatter.
- Hypertrophic scars: Are usually red or purple and are raised above the surrounding skin. These scars are due to an over production of collagen and normally form along the site of the wound, for example following surgery. These scars sometimes fade and become flatter over time, but can remain discoloured and raised for a number of years.
- Keloid scars: These are very elevated red or dark scars that form when the body produces too much collagen. They often spread larger than the area of the original injury and can continue to become larger even after the original wound is fully healed.
- Contracture scars: These types of scars are caused by the skin shrinking and tightening during the repair process. Contracture scars often happen after a burn and end up pulling the skin in towards the site of the injury. This can make the skin look puckered around the wound.
How to treat scars
Platelet Rich Plasma (PRP) can effectively treat scars. Platelet rich plasma is the portion of blood which contains a high concentration of platelets. Platelets stimulate the release of growth factors which assist in collagen regeneration.
During the PRP procedure, 8-24ml of your blood is collected in a similar way to a blood test. The blood is spun down in a centrifuge using a specially designed tube that separates the PRP from the red blood cells. The PRP portion of the tube is then drawn up into a syringe ready for re-injection and/or microneedling into the skin. Topical anaesthetic cream is applied to the skin prior to injection or microneedling to keep discomfort to a minimum.
There is very little to no downtime following a PRP treatment. Injections can cause minor bruising and swelling. Some patients report a tingling sensation after injection.
Typically, at least 3 PRP treatments spaced 4-6 weeks apart will be needed to treat scars although many patients may need up to 6 treatments.
First results are usually visible 2 weeks after the first treatment and full results around 3 months after the final treatment.
Skin microneedling can also help reduce the appearance of scars by harnessing the body’s innate ability to re-grow and repair the skin as a response to damage. A small, hand-held device delivers over 1000 micro-punctures per second into the skin causing a controlled skin injury thus stimulating the skin to produce collagen. The process generates new healthy skin cells to replace aged or damaged ones and can improve the appearance of scars.
Generally, 4-6 treatments, spaced 4-6 weeks apart are recommended for optimal results. Some patients may require additional treatments.
Results can be seen after the first treatment. Lasting and more significant results will occur after 4 to 6 treatments. Your skin will continue to improve over the next 6-12 months after a course of treatments.
For minimum needle depths microneedling treatments are painless. Treatments for scars is usually performed at deeper depths and may require a topical anesthetic cream to be applied for several minutes before the procedure. This will render the treatments virtually pain free.
Patients may experience redness at the treatment site for 12-48 hours after the treatment but are able to return to normal daily activities immediately after the treatment.