A scar is the pinkish or brown patch of skin that grows in the place where you once had a wound or sore. They are areas of fibrous tissue that replace normal skin tissue after destruction of some of the dermis. A scar is thus the skin’s natural way of repairing itself from injury. Most people have scars.
The word scar is derived from the Greek word eschara, meaning fireplace.

Every skin injury or wound heals with a scar. The appearance of a scar however depends on the type and extent of the wound, as well as how an individual’s body heals.

Scar tissue is not similar to the tissue that it replaces and is usually of inferior quality. There is no hair growth on the scar tissue, and the skin there becomes less resistant to ultraviolet radiation.

How scarring occurs?

Scarring occur when the deep dermis layer of skin is damaged. The deeper the damage, the worse the scar.

Many skin scars are pale and leave a trace of the original injury that caused them. The time that a scar takes to form may range from a few days to, in some serious and rare cases, several years. Various treatments can speed up the process in serious cases.

To repair the damage, the body has to lay down new collagen tissues As the body cannot re-build the tissue exactly as it was, the scar tissue will have a different texture and quality than the surrounding normal tissue. An injury does not become a scar until the wound has completely healed.

Factors affecting scar formation -

Many factors affect the severity of scar formation, such as -

- The size and depth of the wound.

- Location of the injury on the body.

- The blood supply to the area.

- Age of the person

- The thickness, type and colour of the person’s skin.

- The direction of the scar.

Once a scar forms, it is permanent. However, it may be made less visible or displaced surgically.

Can scars be completely removed?

There is no way to remove scars completely. However, a skilled surgeon can definitely improve the appearance of the scar by disguising it, relocating it, or minimizing its prominence.

Skin colour and type, age, and the size of the scar, are important factors that go on to decide the outcome of a surgery to remove a scar.

Different types of scars respond to different plastic surgery techniques. Timing of the surgery is another important factor. The younger the scar, the more satisfactory is the result of the surgery. Therefore, if you want to have your scar removed, do not wait, until as advised by the doctor.

Types of scars -

1. Keloid scars:

Keloids are itchy clusters of scar tissue that grow beyond the edges of the wound or incision. They occur when the body continues to produce the tough, fibrous protein known as collagen after a wound has healed. They are more common in dark-skinned people.

Keloids are treated by injecting a steroid medication directly into the scar tissue to reduce redness and itching. However, the disheartening fact is that keloids have a tendency to recur, sometimes even larger than before, thus requiring repeated procedures.

2. Hypertrophic scars:

These scars, unlike keloids, remain within the limits of the original wound. They often improve on their own, though it may take a year or more. They may also require steroid applications or in some cases may have to be improved surgically.

3. Contractures:

Burns or other injuries that result in the loss of a large area of skin may form a scar that pulls the edges of the skin together, a process called contraction.

Improving a contracture usually involves cutting out the scar and replacing it with a skin graft or a flap. In some cases, a procedure known as Z-plasty may be used.

4. Facial scars:

Mostly, facial scars are cut out and closed with tiny stitches, leaving a less noticeable scar. Some facial scars can be softened using a technique called dermabrasion, that leaves a smoother surface to the skin, but does not completely erase the scar.

Scar treatment procedures -

No scar can be completely removed. They will always leave behind a trace, but a number of procedures can improve their appearance.

Surgery -

Surgery will never completely remove a scar but can be used to alter its location or shape to make it less noticeable. Surgery is at times necessary to remove a scar on skin near a joint where it restricts movement, but it will leave another scar.

Laser surgery & resurfacing -

The use of laser on scars is still on an experimental phase, as the safety or effectiveness has not yet been proven.

Steroid injections -

A course of steroid injections into the scar may help flatten and soften the appearance of keloid or hypertrophic scars.

Z-Plasty -

Z-plasty is a surgical technique used to relocate a scar so that it more closely matches to the natural creases of the skin, where it will be less noticeable. In this procedure, the old scar is removed and new incisions are made on each side, creating small triangular flaps of skin.

Skin grafting -

Grafting involves the transfer of skin from a healthy part of the body to cover the injured area. All grafts leave some scarring at the donor and recipient sites.

Make sure that your expectations from any surgery are realistic. You cannot expect that old scars will completely disappear; however, they will always turn flatter, paler and softer.

Home remedies to lessen scars -

o A mixture of sandalwood paste and black gram paste helps reduce the intensity of scars if started early.

o Rubbing your skin with ice cubes helps to tighten the skin.

o You can use cucumber and lemon juice on your scars.

o Vitamin E oil when applied on the scarred skin may do wonders for your skin.

o To prevent deepening of the scars, apply aloe vera gel, cod liver oil or vitamin E oil.

o Applying cocoa butter is also a good remedy in getting rid of the scars.