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Posted at: Oct 5, 2019, 12:44 AM; last updated: Oct 5, 2019, 12:44 AM (IST)

Don’t be scarred for life

Dr Vikas Sharma

Skin wounds are something that we’ve all had to deal with at some point in life. We have all experienced wounds that vary from tiny nicks to large cuts and gashes that need to be stitched.

One of the most dreaded wounds can be a facial scar, whether small or big. Although scars are a natural part of the skin’s healing process, these can cause pain, inconvenience and make affected person self-consciousness.

Many problems like acne, surgical procedures, sports injuries and viral infections such as chicken pox, herpes, etc. can lead to permanent facial scarring.

When you injure your skin, your body naturally repairs the damage. How the body repairs this damage depends on how deeply the injury has penetrated your skin. To repair damage that goes deeper than the first layer, the body makes a tissue that’s thicker than normal skin. When injury/cut affects the deeper layers of the skin, cells make collagen to repair the wound. Because the body makes this collagen rather quickly, it’s thicker and less flexible than the rest of the skin. This thicker, less flexible tissue is a scar.

Scars come in many shapes and sizes and can happen due to many factors.

Cause (accident, acne, burn, surgery, etc.).

Wound (size and how deeply the wound has penetrated the skin).

Body part (where the wound is located on skin).

Care (When and how the wound has been treated).

Knowledge of wound care is, thus, necessary to minimise the chances of wound turning into a scar. Scars are fibrous tissues that replace normal skin after an injury or inflammation. A scar is also formed by collagen tissue, the tissue that provides structural support to skin. But in a scar, the alignment of collagen fibres is different than the normal tissue. This scar tissue alignment is usually of inferior functional quality. For example, scars on the facial skin are less resistant to ultraviolet radiation and sweat glands and hair follicles do not grow back within scar tissue.

In severe cases, facial scars can even limit a person’s mobility. The extent of scarring is based on the severity of the original skin lesions, the delay in treating the skin disorder and also on inter-play of hormones and genes.

Prevention and precautions

You can’t completely prevent scarring but some steps can minimise your chance of developing scars.

  • How your skin heals after an injury depends on how you treat and give aftercare to a wound. With right care, it’s possible to minimise the resultant scarring. Sometimes, one can even completely prevent a scar from forming. 
  • Treat facial skin disorder as soon as it develops. An early diagnosis and specific treatment is of paramount importance to prevent or minimise any scar.
  • Reduce Inflammation.  Your goal should always be to reduce inflammation and avoid doing anything that will further irritate your skin. Any kind of scrubbing and harsh skin-care products should be avoided.
  • Don’t squeeze, pop, or pick at skin lesions. Doing so can force debris deeper into the skin layer and worsen inflammation.
  • Don’t pick at scabs. Picking at scabs should strictly be avoided. A scab is the skin’s natural “bandage” which protects the wound as it heals. Picking a scab off a wound before it is ready prolongs the healing process and increases chances of scarring.
  • Know if you are prone to scarring. Some people are more prone to scarring while others may be healed after a severe facial skin disorder without a scar in sight. If you are prone to scarring, an early and specific treatment is of utmost importance.
  • While smaller lesions can still scar the skin, it’s the big ones that usually do the damage. Because these extend deeper into the skin, deep cysts or nodules are more likely to destroy skin tissue and leave scars. Self-medication, over-the-counter products or home remedies may not be of much help.
Erasing the scars

  • Fortunately, most scars are treatable. The type of scar treatment will depend on the cause of the scar.
  • After analysing the type of skin scar and the phototype of the facial skin, the treatment for facial scars can be decided.
  • The various treatment options include surgical scar revision, laser scar reduction, Intralesional injections, pressure therapy, injectable collagen, fat transplant, multi-needle radiofrequency, fillers and silicone gel are among the many choices for facial scar management. A technique called punch technique can be used to remove deepest and unsightly acne pits.
  • Laser scar reduction air another option that offers a non-invasive solution that uses fractional laser technology to deliver rapid, reliable scar reduction with minimum risk and pain and minimal downtime. Raised and reddened scars can be treated using a pulsed dye laser, while acne scars are best treated using fractional laser skin resurfacing. 
— The writer is a dermatologist, National Skin Hospital, Mansa Devi Complex, Panchkula.

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