It’s Time to Talk About… Scarring

Whether caused by surgery or trauma, scarring is something that affects over 20 million people in the UK. Although a lot of people aren’t affected by their scars, they can be a source of distress for just as many others. Almost a quarter of people living with scarring have said that it has been the source of short term emotional problems, and one in ten have experienced long term emotional problems as a result of their scars, but many people still do not understand the physical and emotional impact of scarring.

At Juvea Aesthetics, we believe that this can only be changed through education, so we’ve put together a quick guide to scarring, including scarring types, treatment options and available support networks.

How Scars are Formed

When we suffer an injury that breaks the skin, our body will naturally produce lots of collagen and granulation tissue to quickly repair the damage. This might sound great, but there’s a catch – our body’s priority is to heal the wound, not to return the wounded area to exactly how it was before. This means that although some scars might be almost invisible, others can be raised, pigmented or bigger than the original injury.

Types of Scarring

Atrophic Scarring:

Atrophic scarring is formed when not enough tissue is produced during the wound healing process. These scars are typically sunken below the level of the surrounding skin and are particularly common amongst acne sufferers, who can be left with boxcar or icepick scarring years after the acne itself has cleared.

Normotrophic Scarring:

Normotrophic scars are the most ‘harmless’ scar in terms of physical appearance. They are caused by an appropriate response by our body to the injury, and over time the scar will flatten until level with the surrounding skin, become thin and lighten in colour, and will not cause any discomfort once fully healed.

Hypertrophic Scarring:

Hypertrophic scarring is caused by the body producing too much collagen during the wound healing process. This leaves scars which are still within the boundaries of the original injury but are raised, thickened, and often pigmented. These scars may thicken for up to six months after the injury, however the appearance of the scar should gradually improve over the course of two or three years.

Keloid Scarring:

Like hypertrophic scarring, keloid scars are caused by too much collagen production and are raised, thickened and pigmented. Unlike hypertrophic scarring however, keloid scars do not stay within the boundaries of the injury and can in fact be much larger than the original wound, with the scar continuing to grow even after the injury has healed. These scars can be tight, itchy or painful, and can restrict movement if they are near a joint.

Scar Contractures:

Wound contraction is a normal part of the healing process, and naturally reduces the amount of damaged tissue that needs to be repaired by our body. Sometimes though our body can go a bit over the top in the contraction process, and the resulting scar can be incredibly tight and painful, restricting range of movement alongside often being very noticeable. Scar contractures are particularly experienced by those who have suffered burns.

Scarring Treatment Options

Skin Camouflage Make-Up:

Make-up can sometimes be the first line of treatment we reach for to cover a scar, but there are more permanent options than what can be found on the shelves at Boots. Specialised skin camouflage products use highly pigmented creams and powders to create a waterproof, long lasting result that blends your scars with your surrounding skin. A free face-to-face pigment matching service is available through Changing Faces.

Camouflage Tattoos:

If you’ve had success with skin camouflage make-up but find the application process takes too long, then camouflage tattoos are the next step. Pigments specially blended to match your skintone are tattooed directly onto the scars to help them blend with the surrounding skin.

Silicon Gel and Sheets:

Medical grade silicone gel and sheets can work well in reducing the appearance of problem scarring, particularly when combined with pressure and massage. It’s been shown that silicone may help soften and hydrate scar tissue, reduce collagen fibre production, make the scar flatter and paler, and reduce redness.

Steroid Injections:

Although steroid injections won’t make scarring completely disappear, they can help improve their appearance. Injections are made into the bed of the scar and help to slow collagen production and flatten scarring.

Microneedling:

Microneedling is also known as collagen induction therapy, and has an aesthetician or dermatologist rolling or stamping thousands of microscopic needles up to 2mm long into the area needing treatment. These needles cause microscopic wounds in the scar tissue, triggering a healing response in the body and increasing the production of collagen in the affected area which can help to improve the appearance of scarring.

Non-Ablative Laser Scar Removal:

Non-ablative laser scar removal works by using photothermal energy to create a controlled injury under the surface of the skin (the dermis). This stimulates collagen production and promotes the growth of healthy new cells in the scarred area. Although it will not ‘remove’ the scar as such, it can help to flatten raised scars or to improve the look of pigmentation. At Juvea Aesthetics, we use our non-ablative ICON Laser to treat a range of scar types. Please get in touch with us if you would like to find out more.

Fractionated Ablative CO2 Laser Scar Removal:

Unlike non-ablative laser treatment, fractionated ablative CO2 laser scar removal works on both the outer layer of skin (the epidermis) and the layer below the surface (the dermis). An intense laser beam is broken up into very narrow shafts of light, each of which breaks through the skin to form column-like controlled injuries. Although there is recovery time for this treatment, the results can be incredible. At Juvea Aesthetics, we have used our Deka SmartXide CO2 laser to great affect on deep or pitted scarring, particularly those caused by acne. Please get in touch with us if you would like to find out more.

Scarring Isn’t Only Skin Deep

Scars can go deeper than just the skin. They can be a constant physical reminder of difficult or traumatic moments in our lives – moments that we don’t necessarily want to share with strangers, which means that it can be difficult to seek treatment.

At Juvea Aesthetics, we’ve seen a lot of scars – whether from accidents, assaults, self-harm, skin conditions, or surgery; and we know they can be hard to talk about. If you’re considering scarring treatment, then please know that for most (if not all) clinics, the top priority is helping you feel more at ease in your own skin, and that you only need to share what you feel comfortable sharing.

Scarring Support

If scars have left you frustrated, angry, or embarrassed; it can often be a relief to speak to someone who understands what you’re going through. Here are some links that might help:

Battle Scars – UK support for individuals with self-harm scarring

British Association of Counselling and Psychotherapy – A UK network of confidential counselling that can help with adjustment to physical change or painful feelings.

Changing Faces – UK support for individuals with visible differences

Dan’s Fund for Burns – Practical and comprehensive help for burns survivors

Skin Support – Support for those with skin disorders

Let’s Face It – International support network for people with facial disfigurement.