Scars: Make Them Go (Mostly) Away


How sunscreen, over-the-counter creams and lasers can fade your scars.

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What do a vengeful fly ball, sizzling stove, tummy tuck and car crash have in common? They can afflict you with scars that will outlive hairdos and diets and cling to you for, well, forever.

The look of this scar depends on many factors, including the type of initial wound, placement on the body and genetics. Surgery will produce a different scar than a burn, which will produce a different scar than severe acne, which will produce a different scar than a skinned knee.

Parts of your body with powerful, dynamic muscles layered below thick skin – your back, chest, arms and legs – will typically scar more severely than thin-skinned areas like your eyelid, says David Bank, founder and director of The Center for Dermatology, Cosmetic and Laser Surgery in Mount Kisco, N.Y. And finally, there’s a genetics role in scar formation: Some bodies are simply better at replacing thick scar skin with the normal kind. For example, people with darker skin are more likely to get keloid scars, which are raised, because the body produces too much thick scar skin.

Each of these factors plays a part in determining the size and color of the scar, as well as if it’s indented or raised. No scar will ever totally go away, but it can certainly improve in appearance, if you treat it right.

Learn about why we get scars (that ugly replacement skin was just trying to protect us!), and you may start to appreciate them. Learn how to treat scars, and you may significantly fade them.

Why does our body form scars?

When there’s a break in the skin, your body sees it as a potential portal for bacteria and infection, so its first job is to seal the break – pronto. But, because your body aims to seal the area as quickly as possible, “Mother Nature really, honestly doesn’t give a darn about the aesthetics of the situation,” Bank says. The skin collagen produced in this “slap dash effort” is thicker than normal skin, he adds. “As time passes, some of that close-the-opening collagen gets reabsorbed by the body once the risk of infection is gone, and it’s replaced and replenished by more natural skin collagen,” Bank says. But there will always be at least a little bit of that emergency-fund scar collagen on the wound site, he says, which is why the scar will never be 100-percent normal.

How can we minimize the appearance of scars?
Well, before scars are scars – when they’re fresh wounds – the decision to stitch or not to stitch will affect the aesthetic outcome, Bank says. A wider, gaping abrasion likely warrants an emergency room visit and stitches. (This Kids Health article gives a breakdown on scenarios that require stitches.) The wider the area of the wound, the more quick-and-ugly collagen your body will need to deposit, ultimately leading to an unpleasant-looking scar. Stitches will help decrease the area needed to be sealed by scar collagen.

Whether you wind up getting stitches or not, the most important step is to protect the area from sunlight, Bank says. Sunlight is one of the last things your body wants as it tries to remodel that scar collagen and replace it with the fresh kind. “You’re going to have inflammation, free radical formation and all sorts of things we know UV light does,” Bank says. “And all that inflammation is going to further disrupt the deposition of pretty new collagen.”

Smoking, too, can disrupt scar recovery. “In order for a wound to heal in the best way possible, it needs maximum blood supply and maximum oxygen,” Bank says, and smoking majorly slows those two essentials from getting to the wound. (As if you needed another reason to stay away from tobacco.)

What about over-the-counter creams?
Bank pegs Mederma as one of the best anti-scar creams, and it’s also the scar treatment that 70 percent of pharmacists recommend in U.S. News’ Top Recommended Health Products. The silicone in Mederma and other products helps reduce excess collagen formation, he says, adding to gently rub the cream into your scar a couple times a day. “The mechanical rubbing and massaging even by itself can also help keep the newly formed collagen sort of smooth and soft and supple and prevent it from thickening up and getting firm and ropy,” Bank adds.

What other treatments are there?
“Once you get beyond Mederma and sunblock, it depends now on what the scar looks like,” Bank says. “Now you’re moving into the realm of lasers.” If you’re committed to battling a particularly nasty scar, talk to your dermatologist about laser treatment. Typically, a red, raised scar would be treated with a pulsed dye laser, which Bank describes as a “very delicate, gentle laser that will work to get the redness out and work with the tiny cells that produce collagen to produce normal collagen instead of more scar collagen.” This laser is “quick and easy,” he says, with no skin breakage and no anesthesia. Depending on the severity of the scar, patients would likely receive three to five monthly treatments.

An indented scar – maybe one produced by a surgical cut – would be treated by a Fraxel laser, which also works with cells to make less of the ugly repair collagen and more of the pretty kind. These treatments, too, would typically require a few monthly treatments, depending on the scar.

Even with laser treatment, the scar won’t ever be “gone-gone,” as Bank puts it, but “it’s absolutely going to look better.”

The opinions expressed are solely those of the author and do not necessarily reflect the views of Comcast.

US News
The opinions expressed are solely those of the author and do not necessarily reflect the views of Comcast.

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