Quick Facts About Internal And External Scars

• A scar is born when skin is overruled by fibrous (scar-forming) tissue as a result of an injury on the skin.
• As soon as skin is wounded, healthy cells rush to protect the wounded area by proliferating fibroblasts, which are specialized cells that produce collagen. Collagen fills up and closes the wound. The collagen fibrils in scars are disorganized unlike in unhurt skin where the collagen fibrils run according to the natural crease lines.
• A scar is also a mark in the flesh made by an ulcer and what remains after the ulcer has healed.
• Tissues around the body when injured or attacked will also form scars.
• Stretch marks are fine streaks caused by the rapid expansion of the skin (dermis layer). They are actually tiny tears on the connective tissue due to over-stretching and then overtaken by scar tissue. They tend to form in fatty areas like the thighs, tummy, butts, breasts and upper arms.
• When over-zealous multiplication of connective tissue cells over supply the required quantity to cover up the wound, the scar that forms is either a hypertrophic (overgrown) scar or a keloid.

  A hypertrophic scar is thick, smooth and raised above the skin. It diminishes over time and will not be as big as a keloid.

  A keloid is a scar that is thick, raised above the skin and spreads beyond the original wound site. Certain people have genes that program the cells to react this way when the skin is broken while others may never form keloids. Keloids may be often be prevented by using a pressure dressing, silicone gel pad or paper tape over the injured area. These are left on for about 24 hours a day.

• A keloid is mainly a cosmetic worry though it is considered a benign tumor that will never become malignant. Treatments include cryosurgery (freezing with liquid nitrogen), excision, laser, x-rays (electron beam radiation) and steroid (cortisone) injections.
• A sunken or atrophic scar is left behind by chickenpox or acne. It is formed when the healing process is interrupted and there is a lack of fibroblasts.
• A hypopigmented scar (e.g. an old scar/stretch mark) is whitish, silverish or pale in color due to a lack of the skin pigment melanin when pigment-producing cells were damaged by the broken blood vessels and inflammation.
• A hyperpigmented scar (e.g. a new scar/stretch mark) is red or purpish in color caused by the dilation of blood vessels and inflammation.
• Most scars fade with time.
• Older skin takes longer to heal than younger skin.
• An infected wound can delay healing and affect the ultimate appearance of the scar.
• Scars located over and near muscles of active areas like the joints, shoulders, back and legs tend to be more outstanding than scars on less active areas.
• A contracture is a permanent shortening of the muscle, tendon or scar tissue which results in deformity or distortion. It is form when a large area of skin is lost and the scarring pulls tightly the edges of the remaining skin together. Hence, a contracture can restrict normal body movements.
• Silicone breast implants may run into the risk of capsular contracture, which can occur when the scar that normally forms over the implant tightens, making the breast feel hard and the squeezing the implant can cause pain.
• An autoimmune disease produces antibodies that attack the body’s own cells and tissues causing scar tissues to form. Examples of this disease are rheumatoid arthritis, lupus, multiple sclerosis, scleroderma, juvenile-onset diabetes, Hashimoto’s thyroiditis and vasculitis.
• The autoimmune disease scleroderma (meaning hard skin) is a disorder of the connective tissue where the formation of scar tissue (excess deposits of collagen) in the skin or organ makes the affected area thick and firm. Scarring can be:
  Localized- affecting the skin of the fingers and face and the musculoskeletal system
  Systemic- affecting the esophagus, lungs, liver, kidneys and heart, cause arthritis and inflame muscles.
• Desmoplastic refers to the formation of fibrous tissue. ‘Desmo’, a Greek word means a fetter or band and ‘plastic’ which is borrowed from the Greek word ‘plassein’ means to form.
• A keratoacanthoma is a skin growth that is round, firm and usually flesh-colored with a scaly crater at the center. It is considered a non-cancerous tumor and grows usually on the face, earlobe, forearm and back of the hand. It grows at a fast rate (up to 1″ wide in 1 or 2 months) and usually disappears on its own within 6 months, leaving behind a scar.
• Abdominal adhesions are the result of an internal scar tissue that can develop after abdominal or pelvic surgery. These adhesions can bring about chronic abdominal pain to people who had undergone this type of surgery and they are also the leading cause of obstruction in the small bowel.
• Cirrhosis is a liver disease characterized by irreversible scarring of the liver tissues, where the destruction of normal liver tissues results in nonfunctioning scar tissue surrounding areas of functioning liver tissue. Alcohol, Non-Alcoholic Steatohepatitis (NASH), viral hepatitis B and C are causes of cirrhosis.
• Peritonitis is the inflammation of the lining of the peritoneum (a thin clear membrane that houses all abdominal organs and the inner walls of the abdomen). An infection is normally the cause of inflammation which encourages scarring in the form of bands of tissue (adhesions) that may in due time obstruct the intestine.
• Scarring alopecia is hair loss on areas where the skin is scarred from burns, severe injury and x-ray therapy.
• Other scarring causes include skin cancer, systemic lupus erythematosus (SLE), lichen planus (flat-topped lilac or violet spots), persistant bacterial or fungal infections, sarcoidosis (inflammation of tissues on almost any body organ, but most often in the lungs or lymph nodes) and tuberculosis.
• Hair growth is unlikely on badly scarred skin.
• Some believe that dark soy sauce should not be taken when a wound has not healed. This is to avoid having a dark colored scar.
• Scar is also referred to as a mark left upon a stem or branch by the fall of a leaf, a protruding isolated rock and a bare place on the side of a mountain or other steep slope.

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