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Scars will fade
Your Health - Dr. Gita Mathai
The skin covers our body, like a well-fitted, elastic garment. It does not normally have any cuts or breaks. If the skin suffers an injury, just like material which is torn and darned, an obvious blemish forms. It may be due to a fall, surgery, trauma, burns or just boils or pimples. This is a scar.
Initially, damage causes bleeding, followed by the formation of a blood clot. This dries, and then new granulation tissue forms over the wound. Then a scab forms which may itch. New skin forms over the wound. This is smaller in size than the original skin so the edges of the wound pull together. Over the next two to three years, the scar may fade completely.
While scar tissue has the same composition as skin, it is inferior in quality and often, of a different colour or texture. It also does not have hair follicles or sweat glands, unlike skin.
Unsightly scarring can occur even with mild trauma, especially if the injury has occurred where the skin is taut, if the person is young or if there is a familial tendency to develop severe scars.
Acne causes severe scarring in one per cent of the population. It may appear as pits or waves. Since 90 per cent people suffer from acne at some stage, it is a severe cosmetic and social problem. Scars are less if acne is treated as soon as it develops. Pricking or squeezing the pimples can lead to secondary infection and severe scaring. Also, if there is no improvement after a couple of months of home treatment (wash the face twice a day with mild cleansers and apply OTC anti-acne medication), a dermatologist should be consulted.
Burns, (water, chemical or electrical) can extend deep into muscles and even bones. As they heal, the edges of the skin pull together causing disfigurement. They produce contracted scars. If scarring occurs over joints, mobility can be affected.
Some scars are "hypertrophic". Although they appear to rise above the wound, they do not extend beyond its boundaries. They do not pain or itch but can be disfiguring.
Scars which extend beyond the margins of the wound, are red or brown in colour and are itchy or painful are called Keloid scars. It can be due to acne trauma, ear piercing or surgery. They can grow slowly over months or years. They are cosmetically unappealing and the symptoms can be very troublesome.
To prevent scar formation, as soon as injury occurs, stop any bleeding by applying pressure. Then clean the wound with soap. Topical antibiotic creams reduce the risk of infection. Clean bandages should be placed on the wound. These should be changed as soon as they become soiled. Gaping wounds need suturing.
Scars tend to fade over time. So it is best to wait a year before opting for aggressive treatment. Advertised OTC creams to treat scars are usually not very effective. Dermatologists and surgeons can offer a variety of options like skin grafts, dermabrasion, chemical peels, laser surgery, skin grafts or filling the scars with collagen.
Applying an ice pack for 20 minutes, several times a day, can relieve the symptoms of mild keloids. The keloids should be moisturised. Steroid creams and oral antihistamines can relieve the itching. Mix a teaspoon of baking soda with three teaspoons of hydrogen peroxide and apply it to the keloid. Keep it on for 15-20 minutes and then wash it off. Do it three times a day to see results.
Non responsive symptomatic keloids require specialised treatment with steroid injections, silicone gel sheets, laser treatment and cryotherapy (freezing), or as a last resort, radiation.
Most scars usually fade away, but it takes time.
Dr Mathai is a paediatrician and author of Staying Healthy in Modern India. Mail your questions to yourhealthgm@yahoo.co.in
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