The Future of Scar Healing – What Scientists are Predicting

Following an injury or surgical procedure, scars often form on the body. These serve as reminders of the physical trauma the body has endured. Not only do people not like the look of scars, the scars on the body can also heal incorrectly and cause further damage. Scars can cause tissue to contract which can limit the mobility of that area of the body, induce pain and cause basic functional problems soon after.

Scar Treatments are Highly Requested

Many experts agree that seeking treatment for scars is one of the most requested treatments in the world. “It’s an astronomical burden on our healthcare system,” says plastic surgeon Steven Moran, chair of the Division of Plastic Surgery and Reconstructive Surgery at the Mayo Clinic’s Center for Reconstructive Transplant Surgery.

As long as people can remember, they have wanted to make their scars disappear. Whether it is because of a painful memory or just an unsightly scar in a very visible spot, people have looked for any way to get rid of scars for centuries. They have gone to extreme lengths to try and remove them including surgical removal and freezing scars with liquid nitrogen. These procedures have produced middling to unsuccessful results. For years people have spent large amounts of money for their scars to only look marginally better.

What if there was a way, instead of trying to get rid of scars after they form, to prevent scars from forming at all? While there is no magical fix to make scars disappear forever, medical experts have discovered ways to prevent them all together. Two recent studies have shown researchers discovering new ways to do exactly that. While it may sound like something straight out of a movie, topical or injected medicines may actually cause tissue to grow back. This tissue can also grow back complete with hair follicles, sweat glands, skin oil and even pores. It may sound like science fiction, but it might soon become a reality for many. Before looking into the future, let’s discuss different types of scarring as well as the current treatment methods for dealing with them.

Scar treatments to heal scars

Types of Scarring

When the layer of skin, called the dermis, is injured or damaged, the tissue usually heals improperly. This forms a scar. Scars can also form when, during surgery, muscle is stitched together. Another common cause of scarring is when a ligament or tendon is torn.

Cells are arranged in a highly organized fashion in healthy, non-injured tissue. But when that tissue becomes damaged, collagen can flow in to fill up the wound. Collagen is of the utmost importance to the proper healing process. However, the body will sometimes send in too much collagen. When there is too much collagen in a small space of skin, as is the case with many different scars, there may be visible side effects on the surface of the skin. These include raised tissue or reddened tissue.

The scars caused by too many proteins like collagen are called hypertrophic scars. These often appear red in color, elevated and hard to the touch. They will look quite different compared to the surrounding tissue. In other cases of different scar types, collagen and other proteins can accidentally move outside the boundaries of the wound, causing bumps in the surrounding skin called keloids. This is another type of scar. These may become noticeable months or even years after the original injury. This type of scar can also cause intense itching and discomfort. The likelihood of developing a severe scar such as keloids mainly depends how well the wound was treated. However, ethnicity and genetics also play a part in their formation.

Present-Day Treatment Methods

Doctors currently have many different ways to treat scars. Dermatologists apply tape to relieve the tension around, or on, the wound which lessens the chance of developing a scar. They also use silicone gels, sheets and other products that can prevent scars by keeping the injury properly hydrated. Some medical providers also inject cortisone or other steroids to reduce the thickness of an incoming scar. Other treatment methods include laser therapy, freezing, onion extract, and even radiation therapy! Currently, the best way to prevent an injury from turning into a severe scar is to keep the wound clean and wet, avoid more trauma to the impacted area and apply sunscreen.

Scar Treatment Methods in the Future

Recently, scientists have discussed studies that indicate injecting a drug into the surrounding edge of a skin injury could prevent keloid and hypertrophic scars from forming into severe scars. In the discussed study, scientists were able to induce the regeneration of cells. When the body starts regenerating cells, it also naturally starts to produce more skin cells and hair follicles. If this treatment continues to show success, any tissue that was once a wound or a scar can actually operate like normal, healthy tissue.

Discover Scar Surgery Options for Patients

The appearance of a scar on the skin can cause a person to have less confidence in their appearance as well as worry about how to remove the scar or at least revise its overall appearance. Some of the medical options available to surgeons include removing excess scar tissue or reconstructing the skin that surrounds the scar as well as other soft tissues that are located near the scar. Here are some of the most popular surgical methods used by doctors across the country to address the appearance of a scar on the skin.

Scar Revision Techniques

Techniques for scar revisionScar revision surgery is performed to minimize the look of a scar as well as help the scar better blend-in with the skin that surrounds it. Scars can be the result of a surgical procedure and they can also appear after an injury or accident occurs to a person. Once an injury or wound appears on the skin, the soft tissues that surround the wound or injury can change shape or become uneven, sunken or raised in appearance as the wound heals.

If the scar is the result of a surgical incision, the sutures or stitches used to close the incision can alter the look of the scar. Stitches need to be removed before the top layer of the skin heals around them or the entry point of the stitches might become a permanent feature on the body. This is often referred to as a “railroad scar”.

If a scar forms after an injury occurs, it might heal in an uneven manner which can cause the skin on the side of the scar to be higher in appearance as opposed to the skin on the other side of the scar. If this type of scar occurs, it is often referred to as a “trapdoor scar”.

The decision about the extent of the revision surgery, as well as the scar revision technique used, depends on the size and location of the scar as well as the type of scar that is being treated. The surgeon can reposition the scar so it is in an area that is less visible on the body, reduce the size of the scar or smooth the contour of the skin and other soft tissues to correct the look of scars that are dimpled or sunken in appearance.

When it comes to repositioning a scar on the face that was caused by the closing of an incision, the surgeon can remove and reposition the scar so that it heals along a natural fold in the skin. The surgeon can also “break up” the appearance of the scar so it is not as noticeable to others. If the scar is a large scar from burns, the surgeon can realign the scar tissue so that it follows the natural body contours.

Patients that do not want to have surgical scar revision can have fat placed in a sunken scar area to fill-in the sunken portion of the scar. The fat is typically removed from the body of the patient so there is little chance of an infection occurring after the fat is placed in the targeted area.

Scar Removal Techniques

There are times when the surgeon feels that the best option for treating a keloid or large hypertrophic scar is to remove it. There are times when keloids go beyond the margin found in the original wound. In these cases, keloids will require removal so the surgeon will be able to reconstruct the surrounding tissue and skin and also restore some of the underlying structure of the damaged area. A large hypertrophic scar can also be removed which gives the surgeon the ability to create a new scar that is thinner and much less noticeable in appearance.

Scars from a burn frequently cover a large area of the skin. The surgeon can use a technique known as skin expansion to replace the scar from the burn with normal skin. During the skin expansion process, the surgeon will implant a small balloon beneath the healthy skin of the patient (located next to the scar). In the weeks before the surgery, the balloon is filled slowly with saline water when the patient visits the office of the doctor. The purpose of filling the balloon with saline water is to expand the healthy portion of the skin. During the scar removal surgery, the surgeon will be able to use the expanded skin to replace the skin that has been burned. The new skin will then heal naturally on the body of the patient.

Scar Surgery – What to Expect after the Procedure

Once the surgery is over, the surgeon will place a bandage over the wound and the stitches (if applicable). There will be a follow-up appointment about a week after the procedure so the doctor can evaluate the healing process and remove any necessary stitches.

Over the next few months, the skin will heal and the new scar (that is smaller in appearance) will start to flatten and fade so it matches the surrounding skin. It can take up to a year for the healing process to finish.

If it looks like a keloid or a hypertrophic scar is starting to form after the surgery, the doctor can administer a corticosteroid injection to lessen its appearance. It might take several injections into the new scar tissue to prevent any recurrence of the keloid or hypertrophic scar.

Patients that have any questions about scar revision surgery or scar removal surgery should schedule a consultation appointment with a board-certified, experienced surgeon to examine the scar tissue and determine the best option to address the appearance of the scar. Whether it be for a mole, a hair transplant scar, or another type of surgery, consult with an experienced surgeon in person for the most accurate assessment.

MA