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

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

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.

Keratosis Pilaris

Keratosis pilaris are rough, small bumps that appear on a person’s upper arms and thighs. This condition comes from a buildup of the protein known as keratin. When this protein builds up, it plugs the hair follicles. These bumps are the size of a grain of sand and in most cases are not itchy.

If you are wondering whether or not you have keratosis pilaris, it is best to see a doctor. Most of the time the doctor can tell if it is keratosis pilaris just by looking at it, without needing any further tests. It is known that keratosis pilaris can worsen during dry seasons; humidifiers can be used to add moisture to the air. Family history is the first question that you may be asked, as this is a genetic condition and can affect you at any age, but worsens during puberty.

Scarring after having keratosis pilaris Keratosis pilaris is not harmful, so medical treatment is not necessary. However, scarring may occur as a result of this condition, so it is recommended to exfoliate with a mild soap and moisturize skin at least twice a day. Over-the-counter creams and lotions are what most people use to treat this condition. The effectiveness of these creams is very limited. There have been a few cases that it was treated by laser therapy, however research is still being done to find out the best treatment for this condition.

Medication usage on a regular basis can improve the appearance of one’s skin. Even with medical treatment, keratosis pilaris can continue for years.

Healing Veterans Wounds

Scars for Freedom

We cannot even begin to repay the price veterans pay in service to our nation. Veterans are on of the most effected groups from scarring. Fortunately there are organizations and projects out there who demonstrate and honor our veterans with action. Take a moment to watch the video below and spread the word on helping our veterans who return home. Many of the scars of war remain invisible and are often the most difficult to heal. The least we can do is help heal some of the scares. Thank a veteran today and share this video.

Scars & Wound Healing

Scars are the evidence of injury and the preexistence of a wound. The wound can be minor or traumatic either way a malformation and marking of the skin can occur leaving a scar. Understanding wound healing is important if one wishes to reduce scarring.


Scars

Wound Healing

Any trauma to the skin can create a wound can create a wound which leads to the potentiality of scarring. There are many physiological processes that effect wound healing. The process is a delicate one in which many various factors can affect the outcome. The outcome can be minimal to severe scarring. Wounds are made of collagen. Collagen is produced by the body to hold the wound together.

3 Phases of Wound Healing

1. The inflammatory phase, this phase begins upon injury, immediately when the wound is sustained and it lasts 2 to 6 days. During this period the injured area is usually warm and red. The wound is often swollen at this time and painful. The inflammatory phase is characterized by:
a. The cessation of bleeding
b. The proliferation of white blood cells to the wound area to fight bacterial infection
c. The formation of collagen begins. In this phase, the wound is usually warm, red, swollen, and painful.

2. The proliferative phase begins next and continues approximately 3 to 4 weeks. Collagen production increases rapidly drawing the borders of the wound together facilitating wound closure. The body also produces new capillaries to aid in healing. The proliferative phase is characterized by:
a. The skin edges of the wound become visibly thicker.
b. Granulation tissue is formed this is often represented by new red, bumps in the shrinking wound
c. Cells that help to keep the wound clean and fight infection can cause the wound to be wet, weeping, and white or yellow in appearance. (However if thicker white pus presents; it is a sign of an infection and should be treated.)

3. The maturation phase follows the proliferative phase and continues for a period from several weeks to several years. This phase involves the formation of even more collagen to strengthen the wound, and the development of scar tissue. This is the body’s form of “remodeling” to lessen excess collagen in the scar. This can be observed by example of a thick, red, raised scar to a thin, flat, blended scar over a period of months to years.

Treating Scarring from Ingrown Hairs

How To Avoid Scarring from Ingrown Hairs

In grown hairs can leave scarring. This scarring for some people can become troublesome and become more severe overtime. Areas frequently shaved are more susceptible to ingrown hair though they can occur any place where hair grows on the body. Place where hair has been shaved and there is friction from skin rubbing or at times clothes can be more vulnerable to the nuisance and at worse scarring from ingrown hairs.

Shaving, waxing, tweezing, electrolysis, and other hair removal methods can often irritate the hair follicle to the point of causing pain, heat, redness, swelling and eruption like skin reactions. These reactions appear as irritating red bumps which at the very least are an embarrassing sight if not a stinging reminder lasting many hours or days. Coarse, curly or wiry hair has a greater tendency to become ingrown because of the curl pattern.

Men often experience ingrown hairs on the face, back, chest, legs and arms. Women tend to get ingrown hairs on the bikini area, legs and armpits. At times the epidermis surrounding the ingrown hair can become swollen and form puss as part of the bodies healing process. People often pick or squeeze ingrown hairs, this activity repeated over time may damage the skin permanently. Scars from ingrown hairs are common. There are a number of good grooming practices that can reduce the appearance of ingrown hair scars and mitigate the reoccurrence and further scarring.

Grooming Preventions for In Grown Hairs

1. Exfoliate the area, Exfoliation removes dead skin cells and nurtures new skin cell production. Less damaged skin cells will be more apparent sooner when you exfoliate regularly. Over a period of months scars often lessen and in some cases become unapparent to the naked eye.

2. Wear sunscreen on the scarred area. Wear sunscreen period. Let’s not worry about environmental controversy and the ozone layers. Many cosmetic companies produce good skin moisturizers with sunscreen so that’s a two for one. The sun can often worsen the appearance of ingrown hair scars. The higher SPF rating is preferable to prevent further damage from harmful sun rays.

3. Cocoa butter has been shown to fade scars and encourage healthy skin. You could find a moisturizer with cocoa butter and sunscreen on the open market.

Professional Medical Treatment

1. See a dermatologist. Some may recommend apply a bleaching cream to the scars. Ingrown hair scars usually have darker pigmentation than surrounding skin. A bleaching cream will lighten the scars, helping them to blend in with the rest of your skin. You’ll need to apply most over-the-counter bleaching creams need to be applied twice a day for several weeks before you see results.

2. A dermatologist may recommend getting laser treatment on the ingrown hair scars. Laser light will target the hyperpigmentation in the scars, thereby lightening the area. Laser treatments also advance collagen production so your skin will look healthier. This is a more costly alternative that generally requires multiple sessions to achieve satisfactory results.

3. Another alternative a dermatologist can suggest is a chemical peels to lighten the ingrown hair scars. Depending on the severity of the scars, you can opt for light, medium or deep chemical peels. Your skin will be burned by the chemicals, but after it heals, younger skin will be revealed. If you opt for a series of peels, you’ll generally have better results.

4. Consider microdermabrasion on the scarred area. The top layers of your skin will be buffed away by a mini sandblaster-type device. The skin below will be younger and less damaged so the scars will not be as apparent.