Tag Archives: Scar Healing

Scar-Free Healing – Will it be a Reality Soon?

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Scar tissue is often the result of an accident or a surgical operation and is also usually an unwelcome addition to the appearance of the body. Researchers at Stanford University have decoded the physical and chemical signals that work to trigger a certain type of skin cell to produce scars. In addition, the research team also have found a way to reprogram these cells in order to transform them into another type of cell that is able to regenerate intact tissues.

Research Team Results from Study on Mice

The team from Stanford University reported that mice that received the skin cell “trigger” were able to heal from wounds without the appearance of any scars. The mice regrew glands, hair, and other critical structures to the point that an image-classifying algorithm was not able to tell the difference between the area where the wound healed and the healthy part of the skin that was not damaged.

The research team says their next step is to try and achieve a similar type of skin regeneration in animals such as pigs (because they more closely resemble humans and have tighter skin). The Stanford team is optimistic these findings can lead to scar-free treatments becoming readily available in the future.

Scarless healing for wounds

Scarless Wound Healing – A Goal that has been Years in the Making

It has been estimated that around 100-million patients gain scars each year after a surgical procedure. In addition, there are also millions of people that have some sort of injury or accident that results in a scar.  The study by the team at Stanford represents the culmination of medical discoveries that date back to the 1970s.

In 1971, a Chicago pediatric surgeon discovered when he performed operations on fetal lambs, their wounds were able to heal without any type of scarring. Over the next two decades, the same healing ability was found in animals as varied as mice, sheep, pigs, and rats.

The early 1990s saw Michael Longaker, whose Stanford lab conducted the new research, working under Michael Harrison, a pediatric surgeon at the University of California, San Francisco. Harrison was performing surgeries on the unborn by removing a fetus from the uterus of the mother with the umbilical cord remaining intact. Once the medical issue or defect was addressed and resolved, the unborn child was returned to the womb.  Once the baby was born, there would be some redness around the surgery site but there were no scars after the procedure.

Harrison asked Longaker to determine why this was happened and Longaker has spent the past three decades attempting to answer that question.

For a good portion of that time period, the research on the subject has almost always focused on stem cells AKA the cells that make all of the mini organs of the skin. Longaker incorporated the work of other scientists that studied fibroblasts (a cell located in connective tissue that produces collagen as well as other fibers) and were able to identify that there are different types of fibroblasts.

In 2015, his Stanford team amassed an inventory of the multiple types of fibroblasts that live on the skin located on the back of a mouse. The team found there was only one fibroblast subset (EPFs because they expressed a protein by the name of engrailed-1) that was responsible for the creation of most scar tissue. When this cell line was knocked out, the mice had less scarring along with a slower recovery period.

Their next task was to determine how the EPFs worked and if they could be turned off with a drug. If so, medical personnel might be able to stop scarring in humans. Longaker and his team have been working on this task for the past 3.5 years.

Scar-Free Healing and the Study of EPFs

The first step in the process was using fluorescent markers to track the origination of the EPFs. The research team learned scar-producing cells arise from another type of fibroblast, that regenerates healthy skin, and is “turned on” when the animal being studied was wounded. Longaker said the group hypothesized the trigger might be mechanical in nature such as the force of the skin being split apart.

The group then studied how fibroblasts respond to a number of different mechanical cues. When they were grown in soft substrates, they did not flip on engrailed-1. The group also studied the tension of wounds in mice and made the same discovery. They noticed that the application of more tension resulted in the production of a greater amount of a protein known as YAP.

In order to determine if YAP was the main chemical signal that started the scarring process, they blocked YAP with verteporfin (a YAP-disrupting chemical) and by genetically modifying the mice they were testing so they did not express YAP in their fibroblasts. In both cases, the cells that flooded into the wounds of the mice were not the EPFs that produced scars. Instead, they were the fibroblast that told the skin to regenerate instead of simply repairing the damaged area.

The mice that were treated using the YAP-blocker were able to recover their normal collagen structure as well as grow back their hair follicles and glands within a period of 30 days. In addition, their mechanical breaking strength was comparable to normal skin.

Scar-Free Healing – What the Future Holds

Even though the group led by Longaker was able to show the return of some skin structures, it was not a complete list so more work will need to be performed by the research team. The additional research is needed to see if YAP-blockers are able to turn on all of the necessary signals to regrow all of the needed elements for healthy skin to be able to function.

Surgery Scars – Steps to Reduce or Prevent Them

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Surgery scars can be reduced or prevented in a variety of ways. If you are planning on having surgery, it is a good idea to understand how to prevent or minimize your scarring. Of course, one of the first things to consider is good incision care. Taking care of your incisions post-procedure is the first step in minimizing long-term scarring.

Surgical Scar Causes

There is the possibility of scarring anytime the skin is damaged. Most of us have a few scars from childhood from skinned knees or elbows. No matter the skill of your surgeon, any surgery results in damage to the skin. A surgical incision causes damage through all of the layers of the skin and can result in scarring no matter where the incision is on the body or what type of surgery is performed. Of course, surgery performed by a less-skilled surgeon can result in greater scarring but, in most cases, the skill of the surgeon has little effect on the amount of long-term scarring. Any surgeon is unable to control all of the multitude of factors that determine your risk for long term scarring.

Surgical Scars how to avoid them

Scarring Risk Factors

Many of the risk factors for scarring are beyond your control. Your ability to heal without scarring depends on factors that cannot be changed. The information below can help you determine your likelihood of post-surgery scarring.

  • Age – The skin becomes less elastic and thinner as we age. The fat layer under the skin thins out and collagen production slows down. When you combine these two facts with sun exposure and other environmental and lifestyle issues, older skin does not heal as quickly or as well as younger skin. There is a silver lining, though – sun damage and uneven tone to older skin can help to hide scars that would be more visible on younger skin.
  • Race – Some skin tones are more likely to scar than others. Keloid scars and hypertrophic scars are much more common with African American patients. With both of these types of scars, there is an overgrowth of scar tissue at the site of an injury. With more fair-skinned races, scars are generally thinner and the color will stay near the color of the surrounding skin. These scars tend to be red or pink when they are new but they will fade with time. Patients with darker skin may experience scars that remain darker than the surrounding skin.
  • Genetics – If your parents have the tendency to scar badly, you will most likely exhibit the same tendency. If you know that you have a family tendency toward scarring heavily, you may want to discuss this with your surgeon ahead of the procedure.
  • Type of Incision – A larger incision is more likely to cause a lasting scar than a smaller incision. The width and the depth of the incision directly affects the length of the healing process and the opportunity for deep scars. Another thing to consider is that a longer incision in the skin may be exposed to more stress with body movements which can delay the healing process in many cases.
  • Skin Healing – Some people are just lucky in that their skin heals quickly and easily with minimal to no lasting scarring. Others are not so lucky and their skin tends to heal more slowly. Sometimes this is due to underlying medical conditions. Having a disease like diabetes can cause your skin to heal more slowly. How quickly the skin heals varies from person to person and can change over time depending on illnesses or current medical conditions.

Scarring Prevention

Even with all of the factors listed above, it is possible to prevent scars by focusing on the factors that you can control. They include:

  • Not Smoking – If you smoke, go ahead and stop as smoking increase the risk of scarring as well as slows down the healing process. Many plastic surgeons will not operate on patients that do not quit smoking for at least two weeks before surgery.
  • Avoid Alcohol – The consumption of alcohol dehydrates your body which causes slower healing. While your incision is healing, you should avoid alcoholic beverages.
  • Stay Hydrated – During the healing process, you should make sure your body is hydrated properly. Dehydration diminishes your overall health and healing can be impacted.
  • Weight Management – Overweight patients are at greater risk of scarring. The fat deposits under the skin can work against the efforts of the doctor to close your incision seamlessly. Watch your weight as much as you can leading up to your procedure.

Scarring and Wound Care

One of the best ways to prevent scarring after surgery is to perform good, consistent incision care. Follow these guidelines:

  • Get plenty of rest
  • Perform incision care consistently
  • Watch for signs of an infection
  • Avoid excessive sun exposure
  • Minimize stress on your incision

Treatments for Scars

There are available treatments for scar minimization that can be performed in the office of a doctor or at home. If you are concerned that you might not heal as well as you would like, consider discussing these treatment options with your surgeon. The doctor can likely recommend options such as silicone wound treatment or prescription medications to help the healing process.

The Future of Scar Healing – What Scientists are Predicting

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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.