Whenever skin is damaged due to an accidental cut, surgery, bum, or other traumascar tissue forms as part of the healing process. Such tissue is composed of special cells called fibroblasts, which make the affected area stronger, thicker, and tougher than usual and cause it to stand out from surrounding skin. Usually, such scars tend to shrink slightly with age, becoming less noticeable or even invisible. Sometimes, however, a scar continues to grow even after an injury has healed. It forms a keloid, a growth composed of connective tissue, which is raised, shiny, and pink or red in color. In some cases, keloids resemble small tumors; in others, they have claw like extensions around the growth. The keloid itself may be tender or itchy. It is not known why some people develop keloids, but genetic factors are probably involved. For example, keloids are far more common among people of African descent than Caucasians. Repeated injuries or stretching of a wound during healing can promote keloid growth. They may result also from ear piercing, bums, severe acne, or ingrown hairs. The earlobes, chin, neck, shoulders, breastbone area, and upper trunk are especially vulnerable to keloid development. While some keloids stop growing or even disappear on their own, others continue to enlarge and may eventually require treatment.
Diagnostic Studies And Procedures
Scars and keloids are diagnosed by a physician based on their characteristic physical appearance.
Treatment depends on the extent of the disfigurement, including the size and location of the blemish. Corticosteroids, such as prednisone, are the primary medications for treating keloids. A doctor may inject them directly into the keloid and also prescribe topical steroid salves for home use. Sometimes, a dermatologist will freeze a keloid with nitrogen before such an injection. These treatments are likely to be repeated at monthly intervals for six months or longer to flatten and lighten the coloration of a keloid. In general, surgical removal of keloids is not advised because it may result in an even larger growth. In some cases, however, surgical removal followed by steroid injections can reduce the visible scar. Other techniques include laser surgery or freezing (cryosurgery) to remove small keloids, and radiation therapy for larger, more severe ones. Topical applications of tretinoin CRetin A), a derivative of vitamin A used to treat acne, also may be helpful. Plastic surgery can often minimize disfiguring scars that have not formed keloids. In such cases, the surgeon reduces the blemish by cutting out the scar tissue and realigning the surrounding skin. Although this surgery will also leave a scar, it is likely to be a far smaller and less visible one when healing is complete. Scars that form following a severe bum may require skin grafts, in which patches of healthy skin are removed from one place and transplanted to the burned area.
Appropriate nutrition is essential to assure that the body repairs itself after injury. In particular, you may need extra protein, vitamins A and C, and zinc to support skin repair. Vitamin C is vital for the synthesis of collagen, a major supportive protein in the skin, and daily supplements of 100 to 300 milligrams may be recommended. For their anti-inflammatory effects, vitamin E supplements may also be helpful. In addition, vitamin E oil applied directly to the skin may speed healing and minimize scarring.
Avoid exposing any skin area that has recently been cut or otherwise damaged to sunlight, which may impair normal scar formation. Use sunscreens that contain titanium dioxide, which forms a mechanical barrier against the sun’s rays. To avoid irritation, do not apply any cosmetics to a scar until it is completely healed. If you have a tendency to develop keloids, be careful not to scratch or squeeze pimples. Avoid all unnecessary surgery, including chemical facial peels or dermabrasion. If surgery is needed, ask your doctor about preventive steps that may minimize keloid formation, such as a pressure bandage or steroid applications during the healing process If the appearance of a scar or keloid is upsetting even after treatment and healing are complete, consult a cosmetologist, preferably one recommended by a plastic surgeon. Such experts are knowledgable about products and techniques that can be quite effective in hiding scars.
Other Causes of Scars
Acne and rashes that have become infected can leave scars.