What is a scar?
Scars are the natural closure of a wound.
Visible scars occur when the deeper layers of the skin are compromised, therefore, most everyday injuries such as lacerations, cuts, abrasions or burns do not pose a danger.
How does a scar form?
The process of scar formation occurs in three phases: inflammation, cell proliferation and matrix remodeling.
- The first phase takes place within 48-72 hours, during which the injury automatically closes with a blood clot and new tissue growth factors are activated.
- During the next three to six weeks, we face the cell proliferation phase, in which connective tissue is formed to close the wound.
- The last phase of scar generation can last several months or, in the most severe cases, several years, as the formation of new tissue and the healing of deeper skin conditions require this period of time.
What can influence scar formation?
The formation of a scar varies from person to person and is influenced by many factors: it is therefore not appropriate to rely solely on the size and depth of the wound.
Age, for example, is very important: the older the person, the slower the healing process of the injury. However, even between the ages of 10 and 30, overproduction of connective tissue can make scar formation difficult. In addition, people with very light or dark skin will develop much more noticeable scars than others, as will people with a particular hormonal balance, such as teenagers or pregnant women. The position of the lesion is also very relevant in this process, so scars will form in areas of the body where the skin is subjected to greater tension.
If a lesion is complicated, such as chronic inflammation (acne), the risk of scarring is greater.
How many and what types of scars are there?
Scars can be classified mainly into hypertrophic scars, keloid scars and atrophic scars.
Hypertrophic and keloid scars develop due to intense hyperproduction of connective tissue, which causes the scar to grow beyond the wound and over healthy skin. Keloid scars are much larger than the original size of the injury and have greater invasiveness and persistence than hypertrophic scars. Keloid scars develop mainly in areas where the skin is under greater tension, in genetically predisposed subjects and up to 10 times more frequently in dark-skinned subjects.
Atrophic scars are characterized by a sagging due to a lack of collagen. In this case, therefore, not enough tissue is produced to cover the entire damaged area. This type of scar is especially common after acne or chickenpox.