Why not tan scars

scar (Cicatrix, Wound healing)

In principle, the human body has the ability to close skin defects that have arisen again on its own. The resulting tissue defect is replaced by scar tissue. The quicker and less complicated the wound healing process, the less aftercare is necessary for the scar.

Short version:

  • Superficial skin defects that only affect the top layer of skin (epidermis) usually heal without leaving scars.
  • In all deeper wounds, a scar marks the end of the wound healing process.
  • The new connective tissue does not correspond in appearance and function to the original tissue. Scars remain that can still be seen years later.

It is difficult to predict what form of scar will occur. On the one hand, predisposition plays a role, on the other hand there are a number of factors that influence wound healing:

  • Localization of the injury
  • Pressure and lack of immobilization
  • Infections, necroses, foreign bodies, bruises
  • Condition of the wound edge and surroundings
  • unfavorable wound dressings
  • Age of the wound
  • Age (regeneration processes slow down with increasing age)
  • Comorbidities like diabetes
  • Nutritional status and immune status
  • Taking medication (e.g. cortisone, anticoagulants)
  • psychosocial factors such as stress, smoking, alcohol and drugs

Why do scars look different?

Ideally, scars are flat, pale, and soft. What all larger scars have in common is that they lack hair, sebum and sweat glands. The melanocytes responsible for the skin color are also reduced in the scar tissue, so that a scar is always lighter than the surrounding healthy tissue and no longer tans. However, sometimes scars are more pigmented.

Scars can interfere with everyday life in a variety of ways

  • Look
  • Adhesions with the underlying tissue
  • Restriction of movement in everyday life
  • Hypo- or hypersensitivity
  • Memory of the trauma

Forms of wound healing

Primary wound healing

Clean, smooth and low-germ wounds such as cuts usually have good wound healing properties with little scarring. The scar is less red and heals quickly.

Secondary wound healing

If wounds go deeper or are infected, wound healing is usually disturbed. Granulation tissue forms here, which closes the wound and makes it more resistant. At the beginning the scar is still very soft, sensitive and can still tear.

After a few weeks, the scar tissue rebuilds, becomes less sensitive, more stable and is ultimately a third less elastic than the intact tissue. The more protracted and complicated the wound healing process, the more likely it is to create unsightly scars.

Different types of scars

Hypertrophic scars

The bulge-like scarring is limited to the area of ​​the actual wound and can regress within six months to three years.

Keloids

Keloids are growths that grow beyond the actual injury and show no spontaneous regression tendencies. Favoring factors are dark skin color, young age and location on the back or on the chest.

Atrophic (sunken) scars

In the case of atrophic scars, too little connective tissue is produced, the scar is then below the skin level. A typical example of this are dented acne scars.

Tips for optimal wound healing

  • Always clean and disinfect wounds immediately.
  • Do not apply ointments or powders to open wounds.
  • With moist wound healing with gel compresses or ointment dressings, wound healing takes place faster and with less complications.
  • Ointments are suitable for treating wounds that are already covered with a crust.
  • Patience: Scar tissue is poorly supplied with blood and grows more slowly!
  • Allow wound healing to proceed as undisturbed as possible: no tension, no pressure, no strain, no stretching

++ More on the topic: Scar treatment ++

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Authors:
Astrid Leitner
Medical review:
Univ. Prof. Dr. Andreas Steiner
Editorial editing:
Nicole Kolisch

Status of medical information:

ICD-10: L90.5