Motorbike accidents, caesarean sections or tumours can all leave scars.
We don’t always want to recall the tales they tell.
Here are five facts about scars and ways to help them fade over time.
1) How do scars form in the first place?
Whether a scar forms depends primarily on the depth of the injury.
Our skin is made up of three layers.
“If we only have a small abrasion, a skin defect in the uppermost layer of skin, then it heals without any consequences,” says dermatologist Dr Steffen Emmert, director of the Clinic for Dermatology and Venereology at Rostock University Medical Centre, Germany.
The situation is different if the injury extends into the second or even third layer of skin.
Then scarring always occurs.
Wound healing follows a fixed pattern.
Immediately after the injury, the vessels close.
An inflammatory reaction occurs.
“Our body has thought this through quite sensibly,” says Nils Bringeland, physiotherapist and author of a book about scar treatment.
The inflammation is not caused by an infection.
Instead, it serves the purpose of making it as uncomfortable as possible for germs.
In the next step, the destroyed tissue is broken down and removed.
From day three or four after the operation or injury, the body begins to rebuild tissue, which can also take a few days.
“Once the wound is closed, it enters the final remodelling phase, in which the scar tissue is then adapted to the needs of normal everyday life,” he says.
This means that our body gradually replaces the tissue that has formed during wound healing with more stable tissue.
2) Can scar formation be influenced?
Yes.
However, wounds are individual, so it is advisable to consult a doctor to clarify exactly what needs to be taken into account to ensure that everything heals well.
And as early as possible, Dr Emmert suggests discussing scar formation with the surgeon before planned procedures.
This is because some areas of the body present challenges.
Young people have particularly high skin tension on their upper body, for example.
“In this area of skin, there is simply a greater risk that the scar will not heal well or that excessive scarring will occur, known as a keloid,” says Dr Emmert.
In general, it is important not to interfere with your body’s healing process.
For example, you should not put weight on a scar on your foot too soon by walking on it.
This puts tension on the scar, which impairs wound healing.
3) What mistakes should be avoided in the early stages to ensure that the wound heals well and scarring is minimal?
”Stress is a very important factor because stress hormones can have a negative effect on wound healing,” says Bringeland.
This increases the risk of pathological scar formation – all the more reason to take care of yourself and slow down.
It is best to avoid smoking and alcohol.
“Anything that impairs the body’s processes in any way can potentially have a disruptive effect,” he says.
Bringeland says excessive cooling with ice and anti-inflammatory drugs cause further problems.
“It’s good that we have these medications, but they can severely impair wound healing, especially if the dosage is inadequate.”
Another well-known tip is to avoid ultraviolet (UV) radiation.
It can have undesirable effects, such as pigmentation changes, says Dr Emmert.
The scar then becomes slightly browner or lighter.
“Once the upper skin has formed again, you can apply sunscreen as normal,” says Bringeland.
4) What constitutes good scar care?
After surgery or in the case of injuries, it is important to reduce tension on the skin surface to a minimum.
“This will ensure the best possible scar,” says Dr Emmert.
“You can do that with a compression bandage or plaster.
“After the operation, we often apply strip plasters at a 90-degree angle to the scar.”
Such wound closure strips remain on the skin for 14 days.
If the wound is completely closed and there is no longer any scab on the skin, you can treat the scar with special gels or gel pads.
They counteract itching and feelings of tension and are said to improve the appearance of the scar.
It is also good to massage the scar.
“Simply apply gentle pressure to the scar and move it carefully without tension. This promotes the maturation of the new tissue and has a positive effect on the pain,” says Bringeland.
You can also use massage rollers designed for scar treatment.
5) What to do about painful and itchy scars?
Itching, burning and scar pain in older scars are signs that something is wrong.
If the symptoms occur repeatedly, have them checked by a doctor.
This also applies to scars that appear particularly raised.
“Scar treatment by a physical therapist may help, through massage and other specific techniques,” says Bringeland.
Dermatologist Dr Emmert likes to use cold treatment for raised scars.
”We perform cryotherapy, where I spray liquid nitrogen over the scar twice for 10 seconds.”
The tissue is briefly frozen and then thaws again.
“This softens the scar and reduces symptoms such as pain,” he says. – dpa
