Makindo Medical Notes

Scarring is the natural part of the healing process after an injury or trauma to the skin and underlying tissues. It occurs when the skin repairs itself from cuts, burns, surgeries, or diseases like acne. While scarring is a necessary part of healing, it can sometimes result in aesthetically undesirable or functionally limiting outcomes.

Types of Scars

• Normotrophic Scars:
  • Flat scars that result from uncomplicated healing.
  • Aligned with surrounding skin and blend in over time.
• Hypertrophic Scars:
  • Raised, red scars that form due to excessive collagen production during healing.
  • Remain within the boundaries of the original wound and may decrease in size over time.
  • Common after burns or surgical procedures.
• Keloid Scars:
  • Thick, raised scars that extend beyond the original wound boundary.
  • More common in individuals with darker skin tones and often develop on the chest, shoulders, ears, and back.
• Atrophic Scars:
  • Indented or sunken scars resulting from the loss of tissue, commonly seen after acne or chickenpox.
  • Appear below the surface of the surrounding skin.
• Contracture Scars:
  • Scars that cause tightening of the skin, often as a result of burns.
  • May limit movement if they occur over joints.

Factors Affecting Scar Formation

• Wound Depth: Deeper wounds are more likely to result in significant scarring.
• Location on the Body: Areas under constant tension (e.g., shoulders, chest) are more prone to forming hypertrophic scars or keloids.
• Genetics: Some people are more prone to developing keloids due to genetic factors, particularly individuals with darker skin tones.
• Infection or Delayed Healing: Wounds that become infected or take longer to heal can result in larger or more pronounced scars.
• Age: Older skin tends to heal more slowly and may result in more visible scars.

Treatment Options for Scars

• Topical Treatments: Creams containing silicone, corticosteroids, or onion extract (e.g., Mederma) may help improve the appearance of scars.
• Laser Therapy: Laser treatments can reduce the redness, texture, or size of scars, particularly hypertrophic or keloid scars.
• Cryotherapy: Freezing the scar tissue may help reduce the size of keloid scars.
• Injections: Corticosteroid injections can reduce the size of hypertrophic or keloid scars by limiting collagen production.
• Surgical Revision: In some cases, scars may be surgically revised or excised to improve their appearance.
• Pressure Therapy: Using pressure garments to flatten hypertrophic or keloid scars, often used after burns.