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Scarring: the story of our lives told on our skin

Forget wearing your heart on your sleeve, one wears the story of ones life on their skin. The skin is the body’s largest organ, which is subjected to many traumas over a lifetime which leave enduring marks, such as bites, burns, rashes, acne attacks and surgical incisions. By protecting your skin and treating it well you can help stop a disfiguring scar from becoming inevitable and permanent.  Dr Joshua Fox founder and director of New York & New Jersey-based Advanced Dermatology, PC & the Centre for Laser & Cosmetic Surgery states “We now have some keys ways to help prevent scars, and even treat existing scars so they’re much less noticeable.”

How scars form

There are many contributing factors that determine the formation of a scar. These can include:

  1. The depth of the injury. The deeper the impact of the trauma on the skin increases the risk of scarring. If you suffer a deep cut or burn on your face, it is wise to consult a doctor for stitches to decrease the chance of scarring.
  2. Trauma Location. There are areas of the body that are more prone to scarring than elsewhere, such as the middle of the chest, the earlobe and the tip of the shoulder. Scars that form on the joints are often more visible due to the stretching and movement during the healing process.
  3. Age. A person’s age is a major contributor that determines the formation of a scar. The older you get the less capable your cells are at efficiently carrying out the wound-healing process and the skin takes longer to heal.
  4. Family history and skin tone play a vital role in your proneness to an overly aggressive healing process. When this occurs, you can develop elevated keloid scars. The NHS describes this process “Collagen gathers around the damage and builds up to help the wound seal over. The resulting scar usually fades over time, becoming smoother and less noticeable. However, some scars don't stop growing. They 'invade' the surrounding healthy skin and become bigger than the original wound. These are known as keloid scars”. You have a greater risk of developing keloids if you have darker skin.
  5. Infection. Ensure you thoroughly clean the wound at the time of trauma and ensure that all foreign bodies, for example glass and dirt particles, are removed from the area. If the wound becomes infected, more white blood cells disburse to the trauma site and are more likely to leave traces of their presence in the form of more severe scarring.
  6. Hard Scabs. It is essential not to pick¸ this will not only remove the scab but you are also stripping away new skin cells which delays healing, doubling the risk of scarring.

 

What’s happening beneath the skin

Scars are caused as a result of burns, surgery or injury and form as part of the healing process. New skin collagen fibres are rapidly produced to mend this damage and they form a dense network of bound fibres in the area of injury, resulting in scar tissue, which has less elastin and hyaluronic acid incorporated and hence has a different texture to the surrounding skin.
Collagen fibres in the lower levels of the skin along with soft keratin in the upper skin layers provide skin strength and shape. Collagen exists in different forms, but the important ones related to the ageing process and skin damage are Collagen Type-III and Collagen Type-I.

Skin cells called fibroblasts produce new Collagen Type-III fibres, which are single stranded and flexible. These strands are linked together by elastic fibres called elastin, which together create a network that can bend and expand and then contract back to normal, so skin maintains its shape.
Elastin (and fibronectine) gives the skin elasticity and works in conjunction with collagen to provide skin structure and ‘springiness’. Loss of elastin leads to reduced elasticity, so when skin creases it takes longer for these creases to expand out again.

Hyaluronic acid is a sugary long-chain fibre which attracts and holds water, forming a jelly-like filler which provides skin plumpness and firmness, and keeps the collagen and elastic network in place. As we age, hyaluronic acid levels reduce causing the skin to lose plumpness, leading to lines and wrinkles.

Scar prevention and over the counter remedies

Although it is not possible to prevent a scar from occurring, it is possible to help your scar heal better and become less visible. It is essential to thoroughly clean the wound with water and a mild soap to reduce the risk of infection. Applying a thin layer of an antibiotic ointment over a clean cut helps new skin cells to migrate to the site of trauma as the wound closes, which kills the bacteria that could cause infection. Creating a moist environment to facilitate the healing process can be done by covering the wound with a nonstick bandage. To prevent infection, clean the wound and replace the bandage daily until the wound is fully healed. If the wound becomes warm or painful to touch, oozes yellow puss, redness extends beyond the site of the wound or you develop red streaks, it is possible that you have developed an infection and it is wise to seek medical advice.

Silicone sheeting can be applied for at least 12 hours a day once the wound has healed to reduce the risk of scarring. Silicone sheets hydrate and soften the scar, puts pressure on the wound and in doing so mimics your skins natural barrier, which compels the scar to soften and fade. These can even be used to treat a pre-existing scar. There are also other ways of speeding up the healing process.

Terproline® stimulates fibroblast activity, while providing the raw materials for new collagen and elastin. Terproline®  improves the elasticity and extensibility of the skin, accelerating tissue repair by triggering removal of old/scar collagen and increasing production of new collagen and elastin, promoting faster, more uniform healing and recovery. Terproline® has remarkable properties in promoting the skins rejuvenation response, by sustaining results for longer and by increasing collagen and elastin development.

How medical advice can help

Not only can scarring have a devastating effect on an individuals’ self-confidence, it can continue to cause pain. In these circumstances it is wise to seek medical advice, as there is now a wide range of treatments available. Dr. Fox states “The good news is that there are so many options for scar treatment today, and we can individualise each case to the best therapy depending on where the scar is located, what type of scar it is and its colour”.

Some of the most difficult scars to deal with, especially emotionally, are keloids and hypertrophic scars; because the scar will be raised and red. There are treatments available to reduce the inflammation and the redness, such as steroid injections and laser treatment. These treatments to have what is referred to as ‘downtime’, where a client feels they cannot go out in public after invasive treatments due to redness and swelling. Dr Fox states “You need to stay home after these procedures since your skin can be raw.” If you are looking for a non invasive treatment, with no added downtime, Terproline Professional®, a clinic strength product, has been shown to reduce keloids and hypertrophic scarring. It is also an excellent product to use if you choose to have invasive treatments. It’s best to use this product before and after many cosmetic procedures that cause skin trauma, such as chemical peels, lasers and injections due to its protective and recuperative properties. Terproline® has remarkable properties in promoting a much better response from rejuvenation procedures, reducing complications and sustaining results for longer by increasing collagen and elastin development. When used in conjunction with Fillast®, these products achieve a high hyaluronic acid environment by promoting a more youthful Collagen Type-III environment.

 

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