Scar Tissue

scar_tissueThe scar tissue is the skin formation which residues after the skin damage. The skin tissue can be injured under the influence of many causes such as an inflammation, a cut, burn or even some fungal infection or acne. The fibers in a scar tissue are differently organized when compared to the fibers in a skin tissue. This is the reason a scar looks different. It can be more or less visible, but it remains present on once healed surface of the skin. There are ways of minimizing the scar, thus it is important to act from an early age of healing. The treatment or prevention of scarring can be done during the process of healing the wound or after it has been healed.

The Forming of Scar Tissue

The skin consists out of three layers called epidermis, which is the top layer, dermis, the middle one, and hypodermis. Dermis contains tiny blood vessels which can be injured during skin damage, after which the blood pours out. The clot is quickly formed on the surface of the wound to protect the body from hemorrhage. The forming of a clot is the trigger for fibroblast proliferation. Affected tissue synthesizes collagen much more than usual and the fibroblasts set under the collagen matrix creating protein fibers. These protein fibers are organized in one direction, unlike regular skin protein which goes in all directions. This type of fiber organization impacts a density and appearance of scar tissue. Because of this, the scar tissue is much less elastic than the skin tissue. The density of the scar tissue is the reason why blood supply is not present as well as the sweat glands and hair follicles.

Types of Scar Tissue

The scar can be more or less accentuated, it can be longer or shorter, wider or narrower, lighter or darker, flat or irregular shape. The characteristics of the scar depend on the color of the skin, places on the body where the scar is located, the state of the skin before the injury, the way of injury, the depth of the wound, and the length of healing. It is very important to know the age of the patient and personal skin’s ability to heal during a certain period. The features of the scar determine what type of scar it represents.

Hypertrophic Scar Tissue

Hypertrophic scars are the result of the excessive synthesis of connective tissue over the surface of the skin but in line with a scar. They develop during the first weeks after the injury. They can be red, often painful and itchy. Over time, this type of scarring is matched with skin and the redness is lost. Their appearance naturally improves after one or more years.

Atrophic Scars

Atrophic scars are small circular depression of the scar tissue. They usually remain after acne and chickenpox. They are formed due to poor wound healing after surgical removal of the skin and muscles or after excessive connective tissue synthesis. The scar prevents the skin structure to renew and it creates a sunken area of tissue. They can occur on the back after surgical removal of moles and among people with weakened connective tissue.


These scars go beyond the limits of previously incurred injury or incisions. A keloid is thick, red and painful. It occurs most often behind the ears, the neck, and chest area. Over time it does not get smaller and often requires a treatment. Pathological analysis of the scar’s sample shows no significant difference between the hypertrophic and keloid scar. Nevertheless, keloid scars still require treatment because they are very elevated and strikingly red. They are thought to be benign tumors and since they can grow big, it is advised to treat it. They are also more likely to appear on the darker skin, although the reason is still unclear.

Contracture Scars

When the skin gets tightened by the healing process towards the injury, it can create a puckered look inside the healthy tissue. The cause of this scar is a burn. During the healing period, the tissue retreats toward the center of an injury. This results in wrinkles and scar tension.

Other Types of Scars

A Linear scar is formed after the operation. The widened scar is a large area of a scar tissue, formed after burns. The smooth scar is at the level of the health skin. It appears after superficial burns.

Preventing Scar Tissue

Each scar should be treated immediately after the healing process and after removing sutures. Proper treatment of scars is based on regular, everyday application of certain creams, gels or silicone coatings. This reduces visibility and adds a better look to the scar, although the scar can’t be removed completely. Most scars are reduced without any treatment. Keloid scars are not one of those. It is important to know how the healing of the wound goes since it depends on it how the scar will form. It is necessary to clean the wound and wrap a bandage around it.

The most important thing is to keep the wound clean and prevent infection. When the wound heals we can massage with gels that contain Vitamin E. It softens the top layer of the skin, so the scar will get more resilient.

Anti-itch cream can prevent irritation of the place where the scar is located.

Putting pressure bandage on the damaged place during intense collagen synthesis can help a scar to be lower on the skin.

Medical Treatment of Scar Tissue

Use of steroid injections is one way of preventing the formation of hypertrophic and keloid scars. The steroids prevent hyperproliferation of granulation tissue. Collagen injections are used for filling in atrophic scars. Massage with creams and gels are also one of the medical treatments.

In the treatment of keloids and hypertrophic scars is used cryotherapy. The cryotherapy consists of freezing the surface of the scar and reducing of the hypertrophy of the tissue. The surgical intervention is one of the methods. It is recommended for the keloids which are ineffectively treated by other methods.

Why is Important to Treat a Scar?

It is important to know that scars can create different problems. Functional problems interfere with everyday functions. If the scar tissue is tight, it can restrict some movements of the extremities. Scars can be the cause of psychological problems. Some patients are particularly sensitive and the opinion of others, about their appearance, is very important to them.

Successful medical treating can improve many aspects of patient’s life. It is, therefore, important to devote full attention to its treatment and reduction.


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