Scars and Wound Healing- what really happens?

healthy skin keloids scarring scars skin surgery wound care wound healing Oct 03, 2022

Who hasn’t been afflicted with a scar at some point in their lives? Our scars tell a story on our skin, perhaps of an injury during childhood, a traumatic event, or a remnant of a surgical procedure. Unlike starfish, who can undergo injury without leaving a scar, humans will universally develop scar tissue in a response to tissue injury.

What is a scar?

A scar is your body’s response to injury. And while our skin is quite adept and amazing when it comes to wound healing, the scar tissue will never be exactly like the original skin it is repairing. The tissue left behind after wound healing is typically thicker, with color changes, and not as strong as the skin it is replacing.

It’s important to know that wound healing is a process and not an event. Wound healing has several steps that take time to occur, thus a scar will remodel and change for many weeks to months, even a year!

While research is ongoing to develop ways to help the skin heal with minimal or no scarring, the science isn’t there quite yet.

What factors affect scar formation?

You may intuitively know that there is variability in how people with scars heal. Did you know that there are many factors that can affect and influence wound healing? Here are some top examples:

1. Genetics: Some people are naturally great healers, while others tend to develop thick and noticeable scars, and even keloids. We don’t fully understand the genetics surrounding this but in someone with a strong genetic predisposition to poor wound healing, minimizing elective surgeries may be suggested.

2. Body locations: Some areas just naturally heal well like the lips and mouth! Have you ever bit your lip or tongue? This area heals with as close to scarless healing as we can get!

Other areas are harder to heal like the lower legs as the blood supply is not as robust.

Areas with a lot of movement or under tension like the legs, arms, and back will also heal more slowly, and at times with the scar spreading out.

3. Age: The age of an individual can also affect how the scar will heal. Younger patients heal quite well and robustly, while wound healing slows as we age, especially when compounded by other medical conditions like diabetes.

What can you do to minimize a scar:

Be sure to seek care from your dermatologist early on in the course of your wound healing to maximize your results and minimize your scar.

For newer scars, be sure to apply an occlusive ointment to the wound to help retain moisture and allow it to heal well. (no it doesn’t need to ‘air out!)

Sun protection…always and especially for a new scar!

For thicker scars, often times you just need a little time and patience. Massage, certain lasers, silicone sheets and injections can also be helpful and you'll want to discuss this further with your dermatologist.

Check out my podcast #9 on Scars and Wound Healing with wound care expert, Dr. Jennifer Powers.


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