Why Scars Heal Differently on the Body

Have you ever noticed that you can have scars on different parts of your body and they look dissimilar? When an injury breaches the layer of the skin, the skin cells and blood vessels become damaged and the body sends excess collagen to quickly repair the region.

Healing Rate of Different Types of Scars

This is the body’s way of forming a barrier to protect it from bacteria and germs. Depending on the amount of collagen sent, it can cause the wound to heal differently and result in scar tissue that looks and feels unlike the rest of the skin. Other factors that impact how a scar heals include:

  • Genetics
  • Age
  • Lifestyle
  • Size and depth of the wound
  • Treatment methods
  • Location of the wound

Below is a quick rundown of different areas of the body and how scars normally heal in these regions.

Knees and Elbows

The knees and elbows are prone to heavy scarring since they are constantly being stretched. Therefore, the skin cannot properly regenerate and heal. The scar tissue may constrict mobility over the joints since the tissue becomes tight and less pliable. Severely limited mobility or pain may require scar revision surgery to improve functionality.

Chest and Shoulders

Per the National Institutes of Health, the chest and shoulder regions have the poorest results when it comes to extensive scarring because areas of tension produce thicker scars which appear more noticeable.

Legs

Scars tend to be thicker and more prominent on the legs since the skin is normally tighter and tougher than other parts of the body. Scars on the legs are inclined to be hypertrophic scars. Hypertrophic scars can be red in appearance and are raised above the surface of the skin.

Abdomen and Stomach

Scars on the abdomen and stomach generally heal well leaving a thinner, flatter scar. Surgical scars can usually be placed below the waistline or bikini line and are rarely seen while wearing everyday clothing. Additionally, this placement keeps the scar protected from the sun for optimal healing and to avoid hyperpigmentation.

The Mouth

When it comes to scars, the inside of your mouth is the best at healing. The intraoral tissue stays moist and can regenerate quickly. However, it is critical to keep the area clean to avoid infection. An infection will slow down scar formation and may generate a larger, denser scar.

Ears

A scar on the ear is generally thick and more prominent than others. This type of scar is generally a keloid scar. Keloids can be found on any part of the body but are common after an ear piercing. Like hypertrophic scars, keloids are red and raised. Unlike hypertrophic scars, keloids extend beyond the edges of the wound. Keloid scars can be minimized with pressure and topical scar treatments.

Preventing and Treating Scars

To keep scars at bay, you should keep the wound clean and moist until it has healed. Serious burns or deep cuts should be evaluated and treated by a doctor. Post-op instructions should be followed as directed to help minimize scarring. Silicone scar treatments can minimize scarring or reduce scars that have already formed. There are many different types of scar treatments available and each type of scar may respond differently to certain treatments. Consult with your doctor about which treatment might be right for your scar.

-SP

Scar Revision Guide

How Can I Treat Scars?

Scar revision surgery minimizes the appearance of a scar by making it blend with the surrounding skin tone and texture. Patients often seek the help of a plastic surgeon after they have exhausted non-invasive treatments such as creams, ointments and silicone sheets. Since there are several types of scars, a doctor will need to evaluate the scar to determine which surgical method is appropriate. The treatment will be determined by several factors including:

  • The anatomical location of the scar
  • Type of scar
  • Skin quality
  • Skin type
  • Availability of surrounding tissue
  • Current functional impairment
  • Possibility of decreased functionality after surgery

Scar Revision with Excision

The most common form of scar revision is excision and primary closure. In fact, scar excision is the most effective method to improve deep, wide or long scars. Excision may be necessary if the scar has healed in an unusual way. This method of scar improvement involves cutting the scar out and then rejoining the skin with layered sutures to close the wound. Although it will create another scar, the new scar will be straight and thin and have a chance to heal more discreetly.

In some cases, the closure may require some tissue arrangement. After cutting the scar away, the surgeon will realign the scar with geometric rearrangements such as a z-plasty to elongate or change the direction of the scar. If a patient does not have enough healthy tissue to suitably close the wound, the surgeon may need to use a skin graft. A pharmaceutical tissue substitution can be used to cover a large area, if needed, in cases such as a patient having large scars caused by burns. After healing from scar revision surgery, the patient generally ends up with a scar that is less noticeable than before. It can take six months before the patient sees an improvement and up to a year to see the final results.

Alternative Treatments

There are many methods for treating scars including non-invasive and natural remedies. However, not all scars will respond to minimal treatment.

Laser therapies are often restricted to treating a recent scar, scars that are persistently red in color and light skin resurfacing for scars.

During scar revision with laser treatments, the surgeon uses a laser light beam on the scar and the surrounding skin. The laser removes the outer layer of skin by burning it off and this begins the regeneration of new skin. After it has healed, the new scar will look smoother as well as lighter in color. It may take multiple sessions to gain the desired appearance. Although laser therapy can make mild improvements, it is not an effective solution for most scars. Deep laser resurfacing and dermabrasion may work well for wide, raised scars that are not appropriate for excision.

Follow Post-Op Instructions

Scar revision is about improvement and not about “erasing” a scar since scars can never be completely removed. Furthermore, the lifestyle of a patient after scar revision surgery can impact the long-term outcome. Following post-op instructions and limiting sun exposure can help the scar heal better. Patients should cover the scar or apply sunscreen SPF 30 (or higher) before going outside to maximize the healing process.

-SP