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While a scar is formed as part of the natural healing process following trauma to the skin, this can be problematic for some patients.
Collagen builds up where the tissue is damaged, helping to heal and strengthen the wound. New collagen continues forming for several months and the blood supply increases, causing the scar to become red, raised and lumpy.
The healing and scar maturation process can take anywhere between three weeks and two years. Once matured, the scar differs from normal skin in that it will never attain the normal strength of the surrounding skin. Hair follicles and sweat glands will not grow back.
Types of scar
Atrophic
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Atrophic
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Atrophic
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Atrophic
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Atrophic
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Caused by skin conditions such as acne and chickenpox, atrophic scars can have a sunken or pitted appearance
Hypertrophic
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Hypertrophic
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Hypertrophic
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Hypertrophic
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Hypertrophic
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Take the form of red lumps raised on the surface of the skin and may continue to thicken for up to six months. Can be itchy and painful but remain in the wound site
Keloid
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Keloid
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Keloid
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Keloid
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Keloid
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Occur when too much collagen is produced at the site of the wound. The scar keeps growing, even after the wound has healed. Keloid scars are raised above the skin and are red or purple when newly formed, before gradually becoming paler. They are often itchy or painful and can restrict movement if tight and near a joint.
Scar contractures
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Scar contractures
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Scar contractures
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Scar contractures
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Scar contractures
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Often caused by burns and occur when the skin ‘shrinks’, leading to tightness and a restriction in movement
Stretch marks (striae)
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Stretch marks (striae)
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Stretch marks (striae)
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Stretch marks (striae)
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Stretch marks (striae)
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Caused by sudden stretching of the skin, causing the dermis to break and deeper layers to show through. Linked to periods of rapid weight gain, pregnancy and growth spurts in puberty.
Healing process
The four stages:
Haemostasis
Lasting on average for a few hours and leading to blood clot formation to limit the loss of blood.
Inflammation
Lasting between three and seven days, this is the immune response process to remove bacteria, dead tissue and foreign bodies. This phase causes wound symptoms such as oedema, swelling, changes to skin colour, temperature, burning and itching
Proliferation
Lasting for around two weeks, this phase is where the wound shifts to tissue repair.
Maturation and remodelling
This is when scar formation occurs. Depending on the size/site of the wound, this can take up to two years.
How can pharmacies help?
Pharmacy teams are ideally placed to give self-care guidance. A large number of wound dressings are available, varying in size, adhesion, conformability and fluid-handling properties. Patients may need to use different dressings at different stages of the healing process or different dressings for different types of wounds. It is useful to speak to local specialist wound nurses and regional units to find out which products they are currently recommending.
Products available to help minimise the appearance of scarring include:
- Moisturising oils, creams and ointments
- Silicone gel sheets or gels
- Camouflage products.
For optimal results, silicon gel/gel sheets should be used for at least three months. Regularly massaging oil or moisturisers into the scar can also help boost skin hydration and soften scar tissue. Practical advice around lifestyle and preventative measures can also be offered covering:
- The use of sunscreens and protection. Scars lack melanin and may become bigger, harder and darker in colour if they are exposed to the sun, so it is important to make sure they are protected
- In the case of stretch marks, measures such as a healthy diet/lifestyle, not “eating for two” in pregnancy and avoiding diets that cause rapid weight loss/gain can help prevent their development.
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