Skin Color and Scarring
Increasingly in pluralistic social cultures in the western societies people’s outward appearance may not be the best indicator of the inherited ethnicity. Ethnicity plays a significant part of how skin heals from injury or after surgery.
According to a national report in treating skin of color (SOC), expert physicians necessarily should consider not only patients’ desires and skin color. Additionally, and of prime importance is also the consideration of the patient’s ethnicity and history of scarring, post-inflammatory response, hyperpigmentation (PIH) and tanning.
Dr. Elliot Battle is CEO and President of Cultural Dermatology and Laser Center, Washington, and clinical instructor of dermatology, Howard University College of Medicine. He emphasizes that skin color and ethnicity are separate factors. He comments that out of 1,000 people with the identical skin color, “We would most likely have 1,000 different combinations of African, Caucasian, Latin, Spanish, Indian and Asian ethnicities,” he continues, adding that along with skin color, “Those combinations of ethnicities determine how one’s skin reacts to lasers and skin products.”
Understanding this it is important that your dermatologist to cultivate the habit of asking about a patient’s ancestral history — the ethnicity of their parents and grandparents. “We see many patients who might appear to be Caucasian, but one of their parents or grandparents might be a person of color,” he says. “The future of skin treatments will add ethnicity to the criteria for choosing parameters.
When concerned about scarring for any type be certain that your chosen physician has a good understanding of ethnicity and how it effects scarring.
The role of scar revision is to restore self-esteem and improve the quality of life. The skin is actually the largest organ of the body and vital to not only our physical health but also it’s health and beauty important to our emotional well-being. Scars have a natural process or progression towards a mature scar. This represents the completion of the healing process.
There are individuals who heal with very little scars and others who scar from the slightest of skin injury. Any injury to the the skin, that is a rupture to the integrity of its’ surface or that results in an opening or damage to the dermis, will heal with a scar.
Life changes that effect our hormones can effect the way our skin heals. Childhood to puberty, adulthood and finally to old age can represent significant changes in how our skin heals. Predicting how a person heals cannot be done with medical certainty. It is a persons observation of their own healing history and familial history that provides the best indicators.
However through observation of certain skin types that we understand their tendencies to produce abnormal scarring and formation:
Pigmented skin and Celtic skin have a higher risk of Hypertrophic and Keloid scarring
the chest and shoulders, eyelids, lips or labia heal with inconspicuous scarring
The goal of scar revision surgery is to make the scar to blend or making it inconspicous. Scars that result from injuries, burns or cancer excision can have a major psychological impact. This impact from the scarring can be profound adversely effecting self-esteem, self-confidence and social interaction. If you suffer from such issues a cosmetic surgeon can often help.
Why Do We Have Scars?
“Human wound healing appears to have been optimized for quick healing in dirty conditions,” Mark W. J. Ferguson, Ph.D., University of Manchester.
Anthropologists and science have yet to explain why humans develop larger and thicker scars than other animals. Our response to scars reaches back through the eons of human evolution. A physically weaker structure than most mammals; humans live longer than any other mammal it perhaps is our species wound healing that allows us to thrive. When we’re injured; cut or burned, the immune system is immediately activated to close the wound and heal it.
Surgeon N. Scott Adzick, M.D., researches and studies scarring at the Center for Fetal Diagnosis and Treatment at the Children’s Institute for Surgical Science in Philadelphia, he notes:
“If you’re a caveman or cave-woman running around, and you get bitten by a saber-toothed tiger, it makes sense to patch that wound together as quickly as possible in order to survive, as opposed to devoting the body’s energy and resources to healing perfectly”
The result is that our bodies’ rapid immune response to inflammation leads to the larger and thicker scabbing and scarring. Some social anthropologists theorize that scars served as sexual attractors. Heavily scarred early men would be more attractive because it indicated there bravery and strength in survival.
No matter the theory or culture scars are part of human life; if you know someone who is experiencing anxiety from scars. Today’s cosmetic medicine may have the answers.
According to American Osteopathic College of Dermatology, a keloid is scar tissue protruding from the skin at the site of an injury. It is caused by fibroblasts (connective tissues) being overactive in the healing process and producing extra tissue. Some people are genetically prone to keloid formation and people with dark skin types are often more at risk, notes the NHS website. For these people, skin damage as small as a pimple or piercing can cause keloid formation.
Apply steroid-impregnated tape to the injury site. If you are at risk of developing keloids, preempt their development by applying a dressing doused in a natural steroid like cortisone to the wound for 12 hours a day, notes the NHS website. Alternatively, AOCD notes, use a pressure dressing pad or tape containing silicone gel and where for 24 a day. This also can stop the development of keloids.
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Schedule an appointment with your dermatologist to discuss laser treatment for the keloid scar. A heated laser can help reduce skin redness and improve texture of the skin, according to AOCD, but it will not help flatten out the keloid in any way.
Consult your dermatologist about a method called cryosurgery to help reduce the keloid. This involves freezing the scar with liquid nitrogen and subsequently stopping the swelling. It can be applied via cotton ball and sprayer. It is good for use on new and small keloids as it can prevent them growing further, notes AOCD. As Acne.org notes, the liquid nitrogen can also cause the scar tissue to die completely, allowing for removal.
Get cortisone injection treatment for your keloid scars. This natural steroid is a corticosteroid produced in the adrenal glands of the body and is said to help reduce swelling and inflammation, notes Acne.org. AOCD advises to inject the cortisone directly into the keloid once a month. A noticeable flattening of the scar may begin to occur within three to six months.
Attempt to remove the keloid via surgery. In the most extreme cases, the keloid can be sloughed off, then the site exposed to electron beam and orthovoltage radiations to prevent any regrowth. AOCD states that exposing the wound to X-rays has stopped regrowth in 85 percent of cases.