Let’s talk about scars. Are you still dealing with the emotional scars of the global coronavirus pandemic? Perhaps, like so many, you’re still creating new emotional scars as the worry, fear, upset and confusion continues? Emotional scars are tricky to deal with. They’re not tangible, we can’t see them. They come and go, and have different triggers.
But physical scars are different. We can see them. Some of us wear them as badges of honour, as a physical reminder of the things that make us, well, us. To show the world what’s happened to us, sometimes with pride.
For others, physical scars cause upset, embarrassment and even resentment. They serve as a reminder of the things we’ve experienced, that we’d rather forget. Whether caused by accidents, youthful tomfoolery, skin conditions such as acne or eczema, abuse, self harm, surgery or any other factor, some of us would rather not have these scars as a visible reminder of events gone by.
So can we get rid of scars on our skin? Do they fade? Does their cause impact how well they might disappear? How about our skin colour and type?
Here we’re going to talk about how scars form and how we might be able to get rid of them.
What are scars and how do they form?
According to the NHS, a scar is a “mark left on the skin after a wound or injury has healed”. As you’ll probably recall from childhood, most scars fade. Think back to falling off your bike as a child, and those cuts and scraped knees heal and over time, the scars left behind, fade.
Scars are all part of the healing process that goes on within the skin when we injure ourselves. Depending on how we’ve injured ourselves, scars will either be linear (as in from a clean cut), a “pitted hole” in the skin or a rough patch of abnormally thickened skin (which can be the result of skin conditions such as eczema).
All types of scars form as a result of damage to the dermis, which is the thickest part of the skin, underneath the epidermis, or top, thinner layer of skin. Superficial cuts and grazes that only affect the epidermis tend not to leave scars.
When the dermis is damaged, the body naturally begins to form more collagen in the area. Collagen is a protein, and you may know of it as the substance that keeps our skin youthful. It plumps up the skin, and helps to keep the skin firm.
This extra collagen helps to fix the damage caused by the wound or trauma. In doing so, scar tissue forms, which is generally thicker and shinier than the surrounding skin, hence why scars are often so visible.
Are there different types of scars?
Many scars, particularly those that form as a result of minor damage to the dermis, gradually flatten out and fade over a couple of years. They may always be visible, but only if you look closely.
However, some scars, such as those from major surgery or trauma, may become raised and stay that way. These are called keloid scars, and can occur as a result of too much collagen at the wound site. They may also continue to grow even after the wound has fully healed.
Keloid scars can become very visible and raised above the skin, they can form different shapes and can appear pink, red or darker than the surrounding skin. They can also cause the skin to feel tight, restricting movement. Keloid scars are also more common in those with darker skin types.
Another type of raised scar is a hypertrophic scar. These appear similar to keloid scars, but unlike keloid scars, they don’t continue to grow and may flatten over time.
Scars caused by skin conditions such as acne, particularly moderate or severe acne, can cause pitted scars. These will appear as sunken scars, more rounded than fine line scars, and are also known as atrophic scars. These can also be caused by chickenpox and are usually as a result of losing tissue underneath the area of scarring.
What can cause scars?
Any kind of damage to the lower layers of skin can cause a scar. This can be anything from cuts, wounds, burns and surgery, plus skin conditions that affect the surface of the skin including acne, eczema, chickenpox and allergies that cause itching and the urge to scratch constantly.
Do scars disappear on their own?
As we mentioned above, superficial scars caused by minor cuts and scrapes will eventually fade.
But deeper scars won’t disappear. They will fade over time, but they may always be visible. Therefore some people may choose to take steps to help to minimise their appearance.
Getting rid of scars
It’s important to keep in mind that some scars, especially those that are deep, raised or large, may not be able to be removed or reduced fully.
That said, there are treatments and things you can do that can help to minimise the appearance of scarring. Most are available from your doctor or skin specialist, and they can advise you which treatment may suit you best.
Topical products are those that are applied directly to the skin. These include silicone gels and sheets that are available from doctors, pharmacies and skin specialists called dermatologists. They’re designed to be placed on the skin over a scar for around 12 hours a day for three months. They help to soften scarring and flatten them out.
Another option is a series of corticosteroid injections. These are administered by a healthcare professional to help treat keloid and hypertrophic scars. How many injections you may need and how often will depend on your level of scarring.
Keloid scars can also be reduced by a type of freezing therapy called cryotherapy using liquid nitrogen.
Laser treatment can be particularly useful for the atrophic scarring caused by acne. This kind of treatment helps to resurface the skin, reducing the appearance of pitting and scarring. Dermal fillers can also help to plump out pitted skin. Laser resurfacing and the use of dermal fillers should only be carried out by a trained healthcare professional.
Other types of skin resurfacing include skin needling that helps to plump up the skin and chemical peels using alpha hydroxy acids (or AHAs) that gently smooth the skin.
For severe scarring, some people may benefit from having surgery to surgically reduce the size of the scar. This will cause scarring in itself, but it can reduce the overall size of some scars such as large keloid scars. Your doctor will be able to discuss the pros and cons of such surgery given your unique circumstances.
Covering up scars
Of course, there may be times when you’ve tried all you can to get rid of your scars, but to no avail. Or you might not want to get rid of them, and would prefer to simply cover them up.
Covering up scars on your body can simply be a case of wearing clothing that covers the appropriate area or areas. This can be done with varying degrees of difficulty, depending where your scars are.
Long sleeved tops, long skirts and trousers will obviously cover up scars on your arms and legs. In the warmer months, if you still wish to carry on wearing long sleeved tops and longer bottoms, opt for lightweight, loose fabrics that keep you cool.
Natural fibres such as cotton, hemp and linen are often less irritating and allow the skin to breathe more than manmade fabrics such as polyesters and nylon.
Other, more visible areas, such as the face and neck are more difficult to cover with clothing, unless for religious or cultural purposes.
In these cases, there are makeup brands available that specialise in cover up products. If you have visible scars that you’d like to cover up with makeup, speak to your skin specialist or GP who may be able to recommend some cover up makeup.
Sometimes, these products are called camouflage makeup. You can also find many great camouflage brands with a quick Google search.
When to see a doctor about a scar
If you have scars that are causing you pain and discomfort, then you should see your GP. They can suggest different treatments that can help you. Changing Faces is an excellent charity that can also help you come to terms with scarring and help you find ways of covering up your scars.
Similarly, if your scars are causing you to feel low or depressed or are causing you to avoid social situations or going about your normal daily life, then you should also speak to your GP or another healthcare professional.
We wish you all the best with fading or making peace with your scars.