The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 30 Aug 2011 11:07 PM PDT A scar forms as a result of the healing process instituted by the body. I HAVE a really ugly scar over my BCG vaccination site. I don't know what happened, but after my vaccination, the scar grew and grew. It didn't happen to my classmates. Why did it happen to me? I believe you are referring to a keloid scar. To understand scars, we have to understand the healing process. Our skin is the largest organ in our body, which serves to protect our other organs and tissues against the environment. Our skin has the epidermis, which is the outermost layer, and the dermis (inner layer). The topmost layer of the skin is completely renewed every 28 days. Once this protective barrier is breached in any way – such as through a cut, abrasion, burn, surgery, skin diseases like acne, or injury of any sort – the process of wound healing immediately begins. Explain wound healing. Wound healing begins with hemostasis. Within minutes after the injury, platelets swarm to collect around the injury site to form a fibrin clot. This stems the bleeding. Naturally, this is just a temporary measure. The area becomes inflamed as the body's natural defenses like phagocytes and lymphocytes come into play. They kill bacteria that attempt to get in, and remove dead cells and debris. Factors are released from cells around the area to begin the process of proliferation. Here, new blood vessels are formed and collagen tissue laid down. This all forms a mass called granulation tissue. Your epidermis cells replicate and "crawl" on top of this bed, providing new cover. The wound then contracts through myofibroblasts, which pull the wound edges and make it smaller (in the way muscle cells contract). It doesn't stop there. The wound continues to be remodeled and matured. Some cuts heal completely and there is very little scarring to be seen. Others leave a scar through this healing process. A scar usually takes 12 to 18 months to mature. Why do I have scars and my friends don't for the same kind of 'injury'? Many factors can influence scars. The depth and size of the wound matters. Needless to say, the deeper and larger the wound, the more difficult it is to heal and the more likely it is to leave a scar. Even where the scar is matters. Your age, genetics, sex, ethnicity, and presence of diseases like diabetes all add to affect wound healing or influence the tendency to form certain types of scars, like keloids. A scar looks the way it does because the new fibres that the body lays down after the injury is not as functional as your original skin. Scar tissue is thicker because it contains more collagen, and paler because it has a limited blood supply. It also does not have as much function as the original tissue because it has less nerves (leading to reduced sensation in that area) and less sweating (due to fewer sweat glands). It also does not have much hair in it. When your body produces too much fibrous tissue on your wound site, that results in a thick or raised scar. What types of scars are there? A keloid is the result of over-aggressive healing. Keloids are called "scars that don't know when to stop". It's tough and it rises abruptly above the rest of your skin. It has a smooth top and is usually purple or pink in colour. It tends to be irregular in shape. The worst thing about a keloid is that it tends to progressively enlarge over time, unlike other scars. It also tends to be itchy and tender to the touch. No one quite knows why certain people are more prone to keloid formation than others, but Africans seem to be more affected, and it does run in families. Another type of scar is the contracture. This happens when you have been burned. A contracture scar causes tightening of the skin, and is sometimes so severe as to restrict movement, especially if it happens near joints like the elbow, shoulder or knee joint. Hypertrophic scars are similar to keloids, but do not go beyond the boundaries of the wound. And there are acne scars, which can range from pits (holes) to deep scars that are angular in appearance. Is there any hope for me to reduce the size of my scar? Certainly, though everyone will experience varying degrees of success. There are some creams, ointments and gels that can be used. It's always best to ask a surgeon which one to use because many of these contain corticosteroids, which may have side effects like hypersensitivity or itching. You can use pressure or silicone gel sheetings. A popular method is to use steroid injections, especially for keloids. Collagen injections or "fillers" can be used for acne pits. At the top of the line is surgical removal – skin grafts (especially for burn scars, where skin from another less visible part of the body is transplanted to cover the scar in a more visible part of the body), surgical excision (removal of the scar), dermabrasion, and laser surgery. Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. |
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