Scar tissue is a collection of cells and collagen that covers the site of the injury. People can develop scar tissue on their skin as the result of an injury, surgery, or acne. Other areas of the body can also develop scar tissue, such as the heart muscle after a heart attack.
Scar tissue can present in a variety of ways, including:
A keloid is a raised, red-skin colored plaque of scar tissue that can form on tissues after an injury. Keloids often appear on the upper chest, shoulders, and upper back.
A hypertrophic scar is a more common form of scar tissue. People with hypertrophic scars may notice that they fade over time.
A contracture scar usually occurs in tissues that have had a burn injury. These scars can impair the movement of the affected area.
Causes and prevention
Although doctors remain unsure of what causes scar tissue to form, they do know that hypertrophic scars and keloids can result from burns, insect bites, acne, chicken pox, piercings, tattoos, and surgery.
Researchers have also found that keloids develop more often in people with darker skin.
Both keloids and hypertrophic scars tend to occur more frequently in younger people between 10 and 30 years old.
The most important guideline for scarring is prevention. People who have risk factors for developing abnormal scars should avoid elective surgery when possible and treat conditions that can result in scarring, such as acne.
Sometimes, surgery is necessary.
People may experience itchiness and pain at the location of the scar. Other scars can restrict movements. Some people may experience emotional and psychological distress from the appearance of scars.
Doctors can prescribe treatments to reduce the appearance of scarring, but they must also address the psychological impact and physical restrictions a scar can cause.
Treatment
Researchers estimate that scar treatments in the United States cost over $20 billion every year.
There is a variety of treatments available for scars, but they may not all be successful for everyone. It is important that doctors explain the limited effectiveness of these treatments and set reasonable expectations for people managing their scars.
Treatment options include:
- topical
- injectable
- cryotherapy
- radiotherapy
- laser therapy
- mechanical
Laser therapy
There are two types of laser therapies for treating scar tissue: ablative and nonablative. A doctor will use ablative laser therapy to flatten scar tissue. Nonablative laser therapy can disrupt the blood supply in the scar tissue, which will eventually kill off the abnormal tissue.
Overall, researchers have shown that laser therapy demonstrates good results for surgical scars, hypertrophic scars, and keloids.
When a doctor chooses the appropriate type of laser therapy, people may notice improvements in the thickness of the scar, redness, itchiness, and texture
Silicone treatments
Doctors sometimes recommend silicone treatments for scar management. After using silicon-based treatments, people may notice an improvement in the volume, elasticity, color, and firmness of hypertrophic scars and keloids.
Different silicone treatments are available, such as silicon gel sheet and creams that people can apply to the scar for 12 hours a day. People may need to use the treatments for 12 to 24 weeks before seeing any results.
Scar massage is a technique that healthcare professionals use in hospital burn units to improve the function and appearance of scarring caused by burns. The evidence is weak, but some experts believe that scar massage helps to improve and maybe even prevent hypertrophic scars.
Anyone considering massaging their scar should discuss it with a doctor first, particularly if they have had stitches or other surgery.
One study evaluated the evidence supporting scar massage. Although scientists need to carry out further research to confirm these results, researchers state that scar massage on hypertrophic burn scar tissue may improve the following:
scar height
pain
depression
itchiness
There are no standard scar assessment tools for researchers, and massage techniques may differ from one study to the next. Researchers need to conduct controlled, clinical trials on the effectiveness of massage for managing scar tissue.
Takeaway
There are several different treatments that doctors can use to prevent and treat scar tissue. However, no treatment is universally successful.
Doctors have many options to choose from when treating scar tissue, but some treatments are more effective for certain types of scars. Doctors should also address the psychological effects and movement restrictions that scars can affect some people.
Doctors should make people aware of the often limited success rates of scar tissue therapy and set realistic goals with them.