Causes and forms of scarring


The scarring is a Reaction of the body to a severe skin injury. It represents the Protective function of the body restores the destroyed collagen network of the affected skin area with replacement tissue (Fibrosis) is replaced. The collagen of this replacement tissue is arranged in parallel and no longer complexly intertwined like that of healthy skin.

This inferior scar tissue is therefore often less elastic. Therefore, a scar (Latin cicatrix) cause the surrounding skin to become distorted. Sometimes this even results in restricted movement.

Problematic and stressful is the amplified Scarring.

It can have several causes: a particularly large and deep wound, a Inflammation in the wound area, irregular wound edges, Scarring at a younger age (from 10 to 30 years of age), hormonal influences such as during pregnancy or a genetic disposition. The body location also plays a role. If skin tension is increased, such as on the décolleté or shoulders, the risk of bulging scars or keloids increases.

The different forms of scars

1. unstable scars

An unstable scar, which simply does not heal, occurs as a result of a impaired wound healing. Unstable scars can also develop at sites with severe skin tension or at stressed joints with increasingly recurring ulcers and tears form. If these do not heal for a long time, they may develop into a Cicatricial carcinoma, a form of skin cancer, may develop. Therefore, surgical removal with subsequent skin grafting or flapplasty is often necessary for this form of scarring.

2. functionally and cosmetically disturbing scars

Functionally disruptive or highly visible scars also often need correction. For example, scars crossing the normal skin tension lines may interfere with the function of the joints or skin in that area. Especially the shrinkage scar (sclerotic scar) with its inelastic, hard tissue can be up to a Immobilization lead. Such scars are cosmetically disturbing, for example on the face.

3. atrophic scars

In atrophic, sunken scar are used during wound healing in the sclera not enough new connective tissue fibers is formed. Possible causes include inflammation in chickenpox or acne. As a result, the skin area contracts and shrinks, so to speak. This results in a dimple-like scar lying below the level of the skin.

4. hypertrophic scars

In hypertrophic scarring, the opposite effect occurs: the scar does not sink in, but rather curves cord-like and thickened in reddish color on the surface. This scar form usually develops in the first six weeks of wound healing. After about two years, it has reached its final form, which rarely recedes spontaneously.

5. keloids

A keloid is a bulging, pink or red tissue overgrowth, which forms in the scar tissue and often proliferates beyond the borders of the wound edges for several years. Keloids often develop after Burns, at piercing injection sites, in acne, in surgical scars. or at injection sites of vaccinations. If the familial clustered occurrence occurs at several house sites, one speaks of Keloidism.

Treatment options for scars

scarring on the hip

Scars can be treated and made less noticeable with surgical and non-surgical procedures.

A non-surgical standard therapy is the Injection with corticosteroids.

The Injection with own fat regenerates scars and often makes them less noticeable.

Also Laser Treatments have proven effective in scar therapy. They reduce the oxygen supply in the scar tissue and thus reduce scar thickness. In addition, the skin can be stimulated to form new tissue through targeted, tiny injuries.

In the surgical scar correction the scar tissue is completely removed. The wound edges are sutured together again without tensioning the skin, if possible. If the scar areas are very large, tissue expansion of the surrounding skin areas using a silicone balloon is often necessary. In most cases, surgical scar correction can be performed on an outpatient basis under local anesthesia.

For effective scar treatment, the following are often used Combinations of different therapies are used. Very good results can often be achieved with these. However, the complete elimination of scars is still not possible.