A scar is a natural part of the body’s healing process after the skin has been injured. During the healing process, the body produces a protein fiber called collagen to help close and repair the wound. However, newly formed collagen is structured and arranged differently from the original skin tissue. This can result in the formation of fibrous tissue that pulls or tightens the surrounding skin, causing the affected area to appear different from the original skin, with an uneven surface and differences in color or texture compared with normal skin.
The depth of the injury within the different layers of the skin directly affects the formation and appearance of scars.
Characteristics : The epidermis is the outermost layer of the skin and serves as the body’s protective barrier.
Injury : When the injury is minor, such as a superficial abrasion, the body can regenerate new skin cells to fully repair the damaged area. As a result, it typically heals without leaving a scar.
Characteristics : The dermis contains blood vessels, nerves, sebaceous glands, hair follicles, as well as collagen and elastin fibers.
Injury : When an injury extends into the dermis, the body initiates a wound-healing process that can lead to scar formation. The affected area may differ from the original skin in structure, color, and elasticity.
Characteristics : The subcutaneous layer lies beneath the skin and is primarily composed of fat cells and larger blood vessels.
Injury : When an injury extends into the subcutaneous layer, the healing process becomes more complex. This may result in larger scars, raised scars, or noticeable depressed scars.
Pigmented / Dyschromic Scar
Characteristics : The skin surface remains relatively flat and even with the surrounding skin, but its color changes due to alterations in melanin production or distribution.
Hyperpigmentation : The scar appears darker or brownish compared with the surrounding skin, often due to increased melanin production following inflammation.
Hypopigmentation : The scar appears lighter or white compared with the surrounding skin, resulting from reduced or impaired function of pigment-producing cells.
Hypertrophic Scar
Characteristics : A raised, thickened, and often tight scar that may appear red or darker than the surrounding skin.
Key feature : The raised scar remains within the boundaries of the original wound and does not extend beyond them.
Cause : Excessive collagen production during the wound-healing process. Hypertrophic scars may gradually flatten and become less noticeable over time, although this can take several months to years.
Keloid Scar
Characteristics : A raised, thickened scar with a smooth, sometimes shiny surface. It may appear pink, red, or dark and can be accompanied by itching, pain, or a tight sensation.
Key feature : Extends beyond the boundaries of the original wound and typically does not resolve on its own.
Cause : Abnormal and excessive collagen production during wound healing. Genetic factors may play a role. Keloids commonly occur on the chest, shoulders, earlobes, and back.
Contracture Scar
Characteristics : A tight, firm scar that pulls on the surrounding tissue, reducing the skin’s flexibility and range of movement.
Key feature : When located over a joint, such as the elbow, neck, or fingers, it may restrict movement in the affected area.
Cause : Often develops following injuries involving significant skin loss, such as burns, scalds, or severe lacerations.
Atrophic / Depressed Scar
Characteristics : Depressed areas or indentations in the skin that create an uneven surface.
Key feature : Atrophic scars can have several patterns, including narrow and deep Ice Pick scars, wide-edged Boxcar scars, and wave-like Rolling scars.
Cause : Loss of tissue and collagen within the dermis. They commonly develop following severe inflammation or skin damage, such as inflammatory acne or chickenpox.
What Is a Keloid?
A keloid is a type of raised scar that develops when the body’s wound-healing process becomes overactive. Excessive production of collagen and scar tissue occurs during wound healing, causing the scar to grow beyond the boundaries of the original wound.
Grows beyond the original wound: A keloid can continue to grow and extend beyond the boundaries of the original injury.
Raised and firm or soft in texture: Keloids may feel soft or firm and typically have a smooth, sometimes shiny surface. Their color may range from pink and red to darker shades or may be similar to the surrounding skin.
Does not usually resolve on its own: Unlike hypertrophic scars, keloids generally do not flatten or disappear naturally over time.
May cause itching, pain, or tightness: Keloids may cause itching, tenderness, tightness, or sharp pain when the scar is touched or pressed.
Injuries that extend into the dermis: Injuries involving the dermis can trigger excessive collagen production and increase the risk of keloid formation. Examples include ear or body piercings, chickenpox lesions, surgical wounds, vaccination injection sites, burns, scalds, and abrasions.
Genetics and skin tone: People with a family history of keloids or those with darker skin tones may have a higher risk of developing keloids.
Common locations: Keloids are more commonly found in areas where the skin is under greater tension, such as the chest, shoulders, upper back, earlobes, and areas around joints.
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Scar Prevention & Treatment
Scar Reduction Cream
Helps reduce inflammation and
control excessive collagen production
in the skin.
Skin Resurfacing
Helps remove damaged skin cells
and improve the appearance of scars.
Intralesional Injection
for Raised Scars
Helps reduce inflammation and
control excessive collagen production
in raised scars.
Subcision
Releases fibrous bands beneath
the skin that pull the scar downward,
helping improve depressed acne scars
and uneven skin texture.
Pico / ADVATx
Laser treatments for scar
reduction and skin improvement.
eMatrix
Helps improve acne scars
and overall skin texture.
Dermal Fillers
Restore volume to deep
depressed scars and help create
a smoother skin surface.
Minor Scar Surgery
Surgical revision to remove or
reshape scar tissue, including
depressed acne scars or keloids.
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