The formation of a scar is a natural part of the healing process following an injury to the skin as the body repairs the wound. The appearance of the scar after the area has healed depends on several factors, including the type of injury, the area of the body affected and the healing process.
The type of injury is a significant determining factor for the formation of a scar. Large incisions from surgical procedures or injuries from serious accidents are understandably more likely to result in the formation of a scar than minor cuts or scrapes to the skin. Some body areas, such as the skin over the knee and elbow joints are more likely to be affected by scarring.
Phases of Wound Healing
It is important to understand the wound healing process
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Re-epithelialization proliferative phase involves remodeling of the wound with the aid of enzymes and fibroblasts. The level of moisture in the area limits the rate of this phase.
4. Neovascularization proliferative phase involves angiogenesis and the formation of granulation tissue.
5. Collagen deposition proliferative phase involves the deposit of type III collagen.
6. Maturation or remodeling phase involves the deposit of type I collagen, which leads to a reduction in the size of the scar and increased strength of the skin.
TGF-β is a mediator of the hemostatic inflammatory phase that plays a significant role in wound healing and the development of scars. The transition from an immature to a mature scar takes place approximately six months to one year after the injury.
Prevention of Injury
The most straightforward way to prevent the formation of scars is to limit injury to the skin.
Some people may wish to limit participation in activities that carry a high risk of injury or to wear adequate protective gear. For surgical procedures, there should be adequate planning for the size and type of incision, as well as how to close the area while minimizing skin tension.
Promoting the Healing
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This is important because it helps to reduce the depth and size of any scarring, as well as reducing the likelihood of scab formation, which can lengthen the healing process.
The wound should then be covered with an adhesive bandage to promote healing in the area and to prevent further injury or the entry of bacteria. The bandage should be changed daily.
Massaging the area is often recommended to help minimize scar formation through optimization of the molecular environment. This is usually recommended from 10-14 days after the skin injury. The mechanical movement of the surrounding skin leads to the expression of enzymes, which help to degrade fibrotic tissue and increase the scar flexibility. Massage is also useful to reduce pain associated with the injury, due to the release of beta-endorphins.
Reducing Appearance of Scars
After the healing process is complete and a scar has appeared, there are several things that can help to reduce the appearance of the scar on the