What is a Scar [DermTV.com Epi #252]



When people talk about scars they often get emotional and they like to say, “I got a scar for life”. They convey that they understand that scars are permanent, and in fact, scars usually are permanent. Now, there are some scars that can be helped by certain skin care products like scar gels and even certain brand name products…and then plastic surgeons and dermatologists can sometimes hide scars, fix scars, remove scars, improve scars, but in order for me to convey to you which scars are suitable to be treated this way and which scars need to be treated by doctors, we need first to explain what is a scar. Very simply, a scar is the tissue that your body makes to replace normal tissue that’s been completely destroyed. And we’re talking about all organs - not just the skin - so whether were talking about the heart or bones or the kidney or skin, scars are the tissue that the body makes to replace the destroyed tissue. Almost all scars are made out of collagen. Collagen is a fibrous tissue that you have normally in the dermis of your skin. The dermis is this middle second layer, and most of the structural or strong material in here that’s holding everything up and supporting things is collagen. It’s the same collagen that I inject into the skin to help fix lines and wrinkles, and this collagen is very fibrous, it’s in strands, so when we talk about scars we talk about fibrous scars. The reality is when the scars are mature they form white material and this white scar is kind of hard or rubbery. When the scar grows after a heart attack in the heart, you get a piece of scar tissue in the heart. When does a scar though, occur in the skin? What’s the nature of the injury that actually happens to your skin that requires the body to replace tissue? If you just get an abrasion when you fall and scrape your knee, you’ll take off a little bit of the epidermis, that heals completely- there’s no scar. When you get a blister - that means the whole layer of epidermis has come off - the body can fix that, it can replace that, there’s no scar. But when you injure or damage a meaningful piece of this dermis or that fat then you’re going to get a scar and as a matter of fact, if you get a cut, a cut like this, and all of that tissue is removed, the body can’t replace all of that tissue, not with normal tissue, so it fills in the gap with collagen and you get a white fibrous scar. Sometimes the body can’t fit enough material in so the scar is depressed and it scoops down and you see a hole or a line or a depressed scar. Sometimes the body makes too much tissue and when it heals it makes a bump above the level of the skin; that’s called a hypertrophic scar. Sometimes we call that a keloid. All of these different types of scars can be treated but they’re treated in different ways. In another video I’ll explain which types of scars are suitable for treatment by plastic surgeons and dermatologists and which types of scars can be helped by skin care products like these.