Scarring: Part 1

A scar, quite simply, is a mark on the skin where a wound has healed. It’s highly probable that the majority of people have at least one scar (unless you’ve been swaddled in bubble wrap your whole life). A scar is made up of tissue bound together by healing hero, collagen. They are permanent, but they can fade significantly over 2 years, sometimes until they are barely visible.

How do they form?

  • Step 1.  Skin is wounded
  • Step 2.  Your body releases a protein called collagen directed at the broken tissue which speeds up healing*
  • Step 3.  As collagen forms, blood supply increases around the new tissue (the scar may become raised, lumpy or red during this time)
  • Step 4.  Collagen levels begin to break down
  • Step 5.  Blood supply begins to decrease
  • Step 6.  Slowly, the scar levels out and becomes smoother and paler.

*Without collagen, the healing process would take longer –that’s why as you get older wounds take longer to heal, because collagen levels decrease with age.

Why are scars permanent?

A scar is permanent because when your skin is wounded, your body switches to emergency mode – it wants to heal the wound as quickly as possible. But whilst the response is fast, it’s also haphazard, directing collagen to the wound in a way which can look messy.

Over time, the old scar cells die and fall off, but the DNA of the scar remains the same. The cells dividing at the bottom of the scar will eventually rise to the top, and this process is repeated over and over. Hence deeper wounds can result in the most enduring scars.

Why do scars linger?

Scars can be a nightmare for our “on demand” generation, as the healing process can last between 3 months and one year, so you have to be patient.

The main reason scars tend to outstay their welcome is because of collagen loss.

This loss is far more likely if you inflame the wound, which typically happens when you pick or squeeze it.

How can I prevent them?

Remember when you got your first spot and your parents, teachers, neighbours, etc told you not to pick them? Well, it turns out there’s some serious truth in their words.

Attacking blemishes increases inflammation, which adds to discoloration and scarring. You’re essentially causing your skin unnecessary trauma. Often, the bacteria you’re trying to remove can actually cause more bacteria to filter deeper into the skin and damage collagen production. Then because collagen levels are damaged, tissue can’t be formed quickly, which prolongs scarring.

Wounds are likely to become less stubborn scars if you let your natural defences work their magic. If you try to interfere by picking, prodding or squeezing, you run the risk of alienating that essential collagen needed for optimum healing. The deeper the wound, the more difficult the healing process, so try not to give your skin a hard time if you can help it.

Next up: how best to treat scars

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