Why scarring occurs

They want to find out more about how scarring occurs, as well as how it might be stopped. Cut the skin and it will bleed. And then it will heal. Initially, a clot forms to staunch blood flow, which kicks off a massive inflammatory response.

Next, the wound begins to fill. Spindle-shaped cells known as fibroblasts migrate to the damaged area and churn out collagen and other proteins that provide tissue with structure. Within three weeks of the injury occurring, the wound has healed.

But such speedy healing has a major downside. These quick repairs often result in scars, particularly when the wound is deep. In healthy skin, collagen fibres form a lattice.

But during wound healing, fibroblasts lay down collagen fibres parallel to each other, which creates tissue that is stiff and weak.

But large scars can be life-changing. That can be especially problematic when scars cover joints. Imagine, Gibson says, not being able to hold a fork or to raise your arms to wash your hair. But scarring might not be inevitable. Fetal skin begins to scar only late in gestation, which suggests that human skin possesses at least some regenerative capabilities.

All researchers have to do is to work out how to unlock them. Fetal wounds are not the only wounds that are resistant to scarring. Thomas Leung, a dermatologist at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, noticed that older people often develop thinner scars than do younger adults. To understand why, Leung turned to mice. In one-month-old animals, such wounds healed with a thick scar and never closed fully — similar to earring holes in people, Leung says.

In month-old mice, which are roughly equivalent to year-old people, healing took longer, but the holes closed completely, and with less scarring.

The same observations held for wounds on the backs of the mice. Fluorescence micrograph of human skin fibroblasts. Leung and his colleagues wondered whether a component of the blood of young mice promotes scar formation.

To test the idea, they joined together old and young mice, giving them a shared circulatory system through a surgical technique called parabiosis. The team found that exposure to the blood of young animals caused wounds in elderly mice to scar 1. Further experiments revealed the probable culprit: Cxcl12 , a gene that encodes a protein called stromal cell-derived factor 1 SDF1. When the team knocked out SDF1, even wounds in young animals healed with minimal scarring. This discovery suggests a route towards scar-free wound healing in people: suppressing the activity of CXCL The drug is used to mobilize stem cells from bone marrow in people with certain types of cancer.

Leung and his colleagues hope to test whether plerixafor can minimize the recurrence of keloids — thick, raised scars that tend to keep growing — in a clinical trial. The team is also looking at how SDF1 promotes initial scar formation. Scarring is a complex process, and SDF1 is only part of the story. Fibroblasts are another prominent player. These cells have long been blamed for scar tissue. But research in the past five years has revealed that fibroblasts comprise a diverse group of cells, and that some seem to have a larger role in scar formation than do others.

When they created a wound on the back, they found that only one of two lineages of fibroblast — expressing homeobox protein engrailed-1 — was responsible for the formation of most scar tissue. And when the team disabled those cells in mice, wounds healed more slowly but also formed less scar tissue, similar to what happened in mice that lack SDF1. Keloids aren't…. Depending on appearance, some people may want to get rid of the keloids they have. Pyogenic granulomas are common skin growths that mainly affect children and pregnant women.

Here are 16 of the best sunscreens on the market in spray, lotion, and solid forms, and for different needs. They're tried and true. Everyone can benefit from a good facial cleanser, and many products are specially formulated for dry, sensitive skin. Blue lips are most often caused when something is preventing you from getting enough oxygen into your body. Read on to discover some of the causes of….

Congested skin refers to skin that becomes bumpy, irritated, and acne-prone. Learn what causes it and how to treat it. Health Conditions Discover Plan Connect. Treatments for Hypertrophic Scars. Medically reviewed by Catherine Hannan, M. Treatment Hypertrophic vs. How are hypertrophic scars treated? Hypertrophic scars vs. Preventing hypertrophic scars. Scars may be treated with a variety of different lasers, depending on the underlying cause of the scar.

Lasers may be used to smooth a scar, remove the abnormal color of a scar, or flatten a scar. Most laser therapy for scars is done in conjunction with other treatments, including injections of steroids, use of special dressings, and the use of bandages.

Multiple treatments may be required, regardless of the initial type of therapy. Pulse dye laser is a good choice to use for keloids. Hypertrophic scars are similar to keloid scars. But their growth is confined within the boundaries of the original skin defect and may be more responsive to treatment.

These scars may also look red, and are usually thick and raised. Hypertrophic scars usually start to develop within weeks after the injury to the skin. Hypertrophic scars may improve naturally. But this process may take up to a year or more. In treating hypertrophic scars, steroids may be the first line of therapy. But there is not 1 simple cure. Steroids may be given as an injection. Or they may be directly applied to the scar, although topical application may not be useful. These scars may also be removed surgically.

Often, steroid injections are used along with the surgery. The injections may continue up to 2 years after the surgery to help maximize healing and decrease the chance of the scar returning.

Like keloids, hypertrophic scars may respond to topical silicone dioxide application. Contractures are an abnormal occurrence that happens when a large area of skin is damaged and lost, resulting in a scar. The scar formation pulls the edges of the skin together, causing a tight area of skin. The decrease in the size of the skin can then affect the muscles, joints, and tendons, causing a decrease in movement.

There are many different surgical treatment options for contractures, including the following:. Skin graft or skin flap. Skin grafts or skin flaps are done after the scar tissue is removed. Skin grafts involve replacing or attaching skin to a part of the body that is missing skin. Skin grafts are done by taking a piece of healthy skin from another area of the body called the donor site and attaching it to the needed area.

Skin flaps are similar to skin grafts, where a part of the skin is taken from another area. But with the skin flaps, the skin that is taken has its own blood supply. The section of skin used includes the underlying blood vessels, fat, and muscles. Flaps may be used when the area that is missing the skin does not have a good supply of blood. That may be because of the location or because of damage to the vessels.

This procedure uses a Z-shaped incision to help decrease the amount of contractures of the surrounding skin. It also may try to relocate the scar so that its edges look more like the normal lines and creases of the skin. A contracture scar usually occurs in tissues that have had a burn injury. These scars can impair the movement of the affected area.

Although doctors remain unsure of what causes scar tissue to form, they do know that hypertrophic scars and keloids can result from burns, insect bites, acne, chicken pox , piercings, tattoos, and surgery. Both keloids and hypertrophic scars tend to occur more frequently in younger people between 10 and 30 years old.

The most important guideline for scarring is prevention. People who have risk factors for developing abnormal scars should avoid elective surgery when possible and treat conditions that can result in scarring, such as acne. People may experience itchiness and pain at the location of the scar.

Other scars can restrict movements. Some people may experience emotional and psychological distress from the appearance of scars. Doctors can prescribe treatments to reduce the appearance of scarring, but they must also address the psychological impact and physical restrictions a scar can cause. There is a variety of treatments available for scars, but they may not all be successful for everyone. It is important that doctors explain the limited effectiveness of these treatments and set reasonable expectations for people managing their scars.

Sometimes a doctor may recommend applying onion extract topically to prevent a scar from forming after surgery or laser tattoo removal. People usually tolerate onion extract well, but researchers have not found consistent evidence that this treatment is effective.

One study found that it was no better than a petroleum-based ointment, such as Vaseline. Mitomycin C is a type of chemotherapy agent that has limited effectiveness for treating keloids.

Most studies have investigated the efficacy of topical mitomycin C when used alongside other treatments, such as radiation therapy and surgical removal of the keloid.

Researchers do not suggest mitomycin C for scar management because there is not enough reliable evidence to support its use. Some doctors prescribe imiquimod cream to people with keloids after surgical removal.

Once again, this topical treatment has not shown consistent results in clinical trials for treating and preventing keloid scar formation. Some doctors might inject bleomycin into the scar to stop the production of collagen at the site of the injury. Only a few studies have tested the effect of injectable bleomycin on improving the appearance of hypertrophic scars and keloids.

Some researchers have found that bleomycin may also reduce redness, itchiness, and pain associated with these scars. Bleomycin is a treatment that doctors use in cancer treatments. It is a toxic substance, but doctors rarely report toxic side effects from injecting it into a scar. Interferon also affects the production of collagen, and doctors can inject it into injured tissue.