Scars

Scars represent abnormal tissue with inferior cosmetic appearance and result from an abnormal wound healing process. Trauma or injury to the skin (including skin surgery) will lead to the initiation of a wound healing response. The ultimate outcome of the wound healing process is to normalise the injury and get the skin to function normally. The clinical outcome is a scar and depending on the degree of wounding and wound healing the scar appearance may vary from almost invisible to very severe. The severity of the scarring therefore relates to a number of factors including the nature of the trauma or injury as well as the wound healing response. An example is the appearance of burn scars as a result of an intense injury and abnormal wound healing pattern.

Scars appear in different forms clinically such as thick or thin scars and scars with redness or brown discolouration or simply white. In dermatology scars are broadly differentiated into different groups: surgical, burn, hypertrophic, keloid and atrophic scars.

Surgical scars result from surgical procedures and if performed meticulously with the use of the appropriate sutures and aftercare then the outcome in most occasions is cosmetically satisfactory. Laser treatments can improve on the appearance of surgical scars. 

Burn scars represent the most challenging group of scars as they tend to be heterogeneous and associated with symptoms and poor function. There are a number of treatments ab=available including fractional laser treatments to improve the scar function and appearance.

Hypertrophic and keloid scars represent a group of scars associated with thickness and height and appear typically after surgical procedures or trauma. In some individuals with a strong family history these scars can appear with minimal injury.

There are a number of treatments available for scars such as surgical scar revision, laser treatments which include vascular and fractional lasers, topical silicone gel or sheets, microneedling, botulinum toxin and fillers. The choice of treatment depends on the type and severity of the scar. In some cases multiple treatments are required and might be in combination of 2 or more scar treatments.

Professor Firas Al-Niaimi is an international scar expert and has published many articles on scars. These articles can be found in the publications section of the website.