How Do Scars Form, and Can I Prevent Scars?

Understanding the scarring process can help you prevent scars before they form.

Life is full of injuries, both major and minor. We often carry the memories and lessons of those injuries with us for a lifetime.

That doesn't mean you want to live with the physical reminders of your injuries forever. Whether they're the tiny scars of mild acne, the deep craters of cystic breakouts, or various marks and abrasions from old wounds, most people have at least a few scars.

So how do scars form? Why do some injuries scar over whereas others leave nary a trace? Understanding the answers to these queries can help you craft a plan to eliminate as many scars as possible.


How Do Scars Form, and Can I Prevent Scars?

How Do Scars Form?

Any injury, from the tiniest paper cut to the most massive dog bite, produces a natural inflammatory process in the body. Platelets—blood cells that aid clotting—rush to the area to reduce bleeding, followed in short order by white blood cells that fight infection. As the body fends off germs and other foreign invaders, you may notice some swelling, pain, or itching.

After the immediate threat of infection fades, the body goes to work healing the area. This is when the scarring process begins.

To fill in the wound, the body produces more collagen. This skin-building protein helps the injured area develop new capillaries and a fresh blood supply.

But when the wound is deep, or when the body produces a lot of collagen to address the injury, a scar may form. Layers upon layers of collagen—a necessary part of filling in very deep wounds with connective tissue—tend to fill the skin unevenly, resulting in a bumpy surface.

Scars tend to fade in the first two years after formation. A scar associated with a small wound might disappear entirely, but a larger scar might change colour, shape, or texture. The healing process is the major determinant of the scar's ultimate appearance.

Doctors differentiate between a number of scar types:

Keloid scars: These large, bumpy, angry-looking scars may feel hard and scratchy. Keloids may also extend into hard lesions beneath the skin's surface. They develop when the body produces too much scar tissue at the wound, causing the scar to grow beyond the original wound's boundaries. Keloid scars commonly occur at the site of piercings and other puncture wounds.

Pitted scars: When the body doesn't produce sufficient collagen to fill a wound, the scar takes on a sunken appearance. Severe acne, particularly cystic acne, tends to produce pitted scars.

Hypertrophic scars: Often red and raised, hypertrophic scars tend to have jagged edges that extend beyond the original site of the wound. A number of wounds, ranging from burns to scrapes, can cause hypertrophic scars.

Contracture scars: Common amongst burn victims, contracture scars occur when the skin shrinks and tightens. These scars may change appearance depending on body position. For example, when you extend a scarred limb, the skin may pull and look tight; when you contract the muscle, the scar may look wrinkly.


How Do Scars Form, and Can I Prevent Scars?

What Can I Do to Prevent Scarring?

The odds of scarring increase with the severity of the wound, since more severe wounds have a longer healing process. No magic cream can completely eliminate the risk of scars, and scar-removal creams only work after the wound has healed.

There are, however, some steps you can take to reduce the risk of scarring. Try the following:

  • Keep the wound clean and dry while it is healing. Keep the area covered when you wash, and pat it dry when you get out of the shower.
  • Apply a triple antibiotic ointment or use the wound cream your physician recommends.
  • Don't pick at the wound or scab, and never pop pimples.
  • Contact a physician if the wound is very painful, continues seeping blood or pus, smells bad, or is very itchy, since these signs and symptoms may signal an infection.
  • Keep the wound moist once the scab falls off and the wound is no longer seeping. Apply a salve such as Dr. LeWinn's Multi-Moisture Balm. Cover the wound with a bandage, and change the bandage when it becomes dirty, soiled with blood, or when the wound dries out.
  • Apply sunscreen to the wound after the scab falls off and the wound closes. Alpha-H Protection Plus Daily SPF 50+ is an excellent formulation for all skin types.