Treatments/Scar Assessment & Advice/Types of Scars

As a natural part of the healing process, scars appear on the skin following injury, wounds or trauma. There are a variety of different types of scars resulting from different types of injuries and conditions. Commonly, scars are left on the skin following burns, acne, surgery, trauma and accidents.

Burn scars

Burn scars appear on the skin following damage to the skin caused by burns. Burns can affect different layers of the skin and therefore produce different types and severity of burns. First degree burns affect only the outer layer of skin (epidermis) and these types of burns will not usually produce permanent scarring. Second degree burns impact on both the outer layer of the skin (epidermis) and the lower layer of the skin (dermis), these types of burns can leave scars but they will usually not form raised scars but this depends on each individual case. Third degree burns penetrate both the epidermis and dermis of the skin and therefore will leave a scar on the skin. Finally, fourth degree burns destroy both the layers of the skin as well as the deeper tissue such as muscle. Similarly, to third degree burns, these will also lead to scarring on the skin. Any scarring resulting from those burns impacting the outer layers of the skin will begin to fade overtime and usually not leave any permanent scarring, however, burns which effect the deeper layers of the skin will usually lead to more permanent scarring on the skin which may lead to you seeking treatment.

There are three different types of scars which can form as a result of burns, these are known as contracture scars, hypertrophic scars and keloid scars. Contracture scars present themselves as thickened areas of tissue where the skin is tightened around the area impacted. Hypertrophic scars present themselves as a raised area on the skins surface, they are usually pink, red or purple in colour. Finally, keloid scars present themselves as raised and shiny bumps on the skin which will appear both on and around the area that received the burn.

Acne scars

Acne scars are a very common form of scarring which affect a huge number of people. There are a variety of different types of acne scars, and these can be categorised into depressed (atrophic) scarring and keloid (hypertrophic) scarring. In terms of atrophic acne scarring, there are three main types – ice pick scars, rolling scars and boxcar scars. Ice pick scars present themselves as small indentations on the surface of the skin. They tend to be wider on the surface on the skin and begin to narrow into a point as they extend to the deeper into the skin. Rolling scars can be identified as scars with sloping edges which leads to the skin looking uneven. They are typically found on thicker areas of the skin such as the jaw. Rolling scars tend to have the appearance of hills and valleys and can appear as shadows on the skin and can vary in severity. Boxcar scars present themselves as indents in the skin which bear sharper edges which are quite deep into the surface of the skin. Boxcar scars tend to be less deep with sharper shoulders and are often rectangular or round in shape. Hypertrophic scars describe those scars which lie on the skins surface with a raised texture.

Surgery scars

Following surgical procedures, scarring can be common. The most common form of scarring that can occur post-surgery is known as fine line scarring. Fine line scars occur following a straight wound which has clean edges therefore explaining why these scars are common post-surgery. Fine line scars usually present themselves as lighter or darker than the surrounding skin. It is unusual for fine line scars to disappear completely however they will begin to lighten over time. Usually these types of scars are not painful however they may cause some itching on and around the area.

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