Each of us at least once in our life has encountered problems with scars and marks on the skin, whether they are small and almost invisible or large, protruding above the skin level, painful scars that make life difficult. In addition to an aesthetic defect, these changes, although rare, can be accompanied by changes in functions, for example, the formation of contractures (restriction of passive movements of the joint), if it is located above the surface of the joint, changes in facial expressions and phonation when localised on the face. But, of course, most often scars are characterised by aesthetic changes, which drag with themselves self-doubt, shyness and a constant desire to hide the visible defect.
So what are scars and how do they occur?
Scarring is nothing more than a protective mechanism that allows us to maintain the integrity of our skin, to avoid constant bleeding and secondary infections of the wound.
The scar is the final natural stage of wound healing, which is a section of connective tissue. New tissue replaces the previous defect on the skin and is the manifestation of its regeneration.
Why do scars occur?
– Surgical operations;
– Injuries, cuts and other types of damage;
– Frostbite and burns;
– The use of non-cosmetic seams when stitching the edges of the surgical wound;
– Use of non-atraumatic suture material and needles;
– Performing incisions not along the lines of skin tension (Langer`s lines);
– Chronic skin diseases;
– Endocrine disorders.
What scars are there?
There are different types of scars: normal trophic, hypertrophic, atrophic and keloid.
– flat, inconspicuous;
– light colour;
– with normal or reduced sensitivity;
– elasticity close to normal tissues;
– look like a thin thread, there is no rise above the skin;
– in the same colour as the skin or lighter;
– are located below (deeper) than the level of the surrounding skin;
– brightly coloured;
– rise above the level of the skin in the form of a roll;
– elastic consistency;
– bright crimson colour;
– uneven, slightly wrinkled surface;
– significantly protrude above the surface of the skin;
– itching, burning, pain.
Scar tissue will never again have the same appearance and the same functions as surrounding normal tissue. Since in an injury not only the skin but also the sebaceous and sweat glands, hair follicles, nerves and blood vessels that are nearby are damaged.
The most effective treatment is for young scars, in which the nutrition of damaged tissues is still preserved (they have purple, pink or red color), older white scars are more difficult to treat with conservative and less invasive methods of treatment.
Today in modern medicine there are 4 main methods of scar correction:
How to prepare?
The operation takes place under general anaesthesia. Surgeons sometimes use local anaesthesia, but this is the case for small operations.
How does the operation go?
Large postoperative scars resulting from injury are subject to skin-plastic correction.
The most common way is to excise scar tissue with further cosmetic suturing. With a large scar width or a large lesion surface, an autograft can be used. This method is based on the transplantation of a person’s skin grafts from other areas so that the skin takes root well since foreign tissues in our body are perceived as foreign and rejection can occur.
Injections allow you to adjust the volume of connective tissue in the area of the scar and smoothen its surface.
Specially selected medications (usually enzymes or steroids) are introduced into the scar tissue, which destroys the scar from the inside, soften the connective tissue of the formation, and make the skin in the problem area more even and elastic.
For each patient, the technique and depth of injection, as well as the type of drugs, are selected individually. Several factors are taken into account, such as age, depth and prescription of the scar, type of location, etc.
The use of filler medications helps to raise the skin of the scar if it was previously recessed inside (in case of atrophic scars).
Most often, to achieve the desired result, it is necessary to undergo an injection course.