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1 Scotts Road #04-15/16 Shaw Centre Singapore 228208

Scars

What are scars?

Scars occur naturally as part of your body's healing process following skin damage. When your skin experiences cuts or injuries, it regenerates tissue to close the wound, forming scar tissue primarily composed of collagen.

Scars vary in size and shape and result from accidents, burns, surgeries, acne, or illnesses. While scars often fade with time, their visibility can differ, impacting appearance and even movement, especially with larger scars.

When we assess scars, we generally look at two categories in Singapore: discolouration and texture.

In terms of discolouration, scars can take on the following appearance:

Hyperpigmented Scars

  • Scars are darker than the surrounding skin.
  • Shade of the scar varies from brown, black or grey-blue.

Hypopigmented Scars

  • Scars that are lighter than the surrounding skin.

Red Scars

  • Scars appear red due to increased blood flow in the area.
  • Common in newly formed scars.

In terms of texture, a scar can be:

Atrophic Scars

  • Form due to a loss of underlying structure and insufficient collagen production during healing
  • Dipped appearance in the skin.

Hypertrophic Scars

  • Form due to excessive production of collagen during healing.
  • Raised but stay within the boundary of the wound.

Keloid Scars

  • Form due to excessive collagen production.
  • Raised and tend to grow beyond the boundaries of the wound.

What causes scars?

When the skin experiences an injury, it produces collagen to form new tissue, pulling together the wound and closing the gap. However, when too much collagen is produced, hypertrophic scars are formed. An atrophic scar is formed if fat or structural tissue is lost during the injury and insufficient collagen is produced during healing.

Scar formation can occur following accidents, burns, surgical procedures, acne, and illnesses. The size and appearance of scars vary, ranging from large and painful to barely noticeable. Factors such as skin type and genetic predisposition can influence the type of scar that develops.

It is important to note that not all wounds result in noticeable scars, and many scars fade over time. Not all scars require intervention, but if a scar is causing discomfort or is cosmetically concerning, seek appropriate treatment to make scars less obvious.

What are the common symptoms of scars?

Symptoms of scars include:

  • Changes in skin texture or colour
  • Raised or depressed areas on the skin
  • Itching or discomfort in the scarred area
  • Potential impact on movement or flexibility depending on the scar’s location

Are scars painful?

Generally, scars are not inherently painful, but some individuals may experience discomfort, itching, or tenderness in the scarred area, especially during healing. Pain associated with scars often varies based on factors such as the size, type, and location of the scar. While some scars may cause minimal or no pain, others can lead to sensations of tightness or itching.

Monitoring any unusual or persistent pain or itch in scars is important as it could indicate complications or the formation of keloid scars. Seek medical advice to help address discomfort and ensure proper care for the affected area.

Who is at risk of scars?

Scars form due to skin injury; however, it is important to remember that not all injuries result in scar formation. Several factors increase an individual’s risk of developing scars; these are :

  • Genetics: keloidal tendencies can run in families, and it is important to be aware of them.
  • Age: younger individuals tend to mount a stronger inflammatory response to wounds and are more likely to develop hypertrophic scars due to excessive collagen production.
  • Prolonged inflammation: inflammation can increase the chances of scarring, especially discolouration of the scar. For example, an infected post-surgical wound tends to leave more significant scarring. Acne that has been manipulated by picking tends to leave more of a visible mark.

How are scars diagnosed?

You can self-diagnose most scars by observing the healed skin area after an injury. Scars often exhibit variations in pigmentation, appearing darker, lighter, or pinker than the surrounding skin. If a scar poses any concerns, your dermatologist will conduct a thorough physical examination to assess its size, texture, and colour, determine its type, and recommend a tailored treatment plan.

What are the treatment options for scars?

The approach to scars is multi-fold. At Lumine Dermatology & Laser Clinic, we will properly assess the scar before deciding on the best approach. We have an array of options available to you, which include:

  • Picosecond laser: the Picosure Pro laser helps to target pigmentary issues, lightening dark scars and reducing their appearance.
  • Pulsed dye laser: the Vbeam laser targets redness and hypertrophy, lightening and flattening raised scars.
  • Non-ablative fractional laser: the MOXI laser targets hypopigmentation or pigmentary alterations of scars.
  • Fractional carbon dioxide laser: Deka Smartxide laser aids scar remodelling and reduces texture; it is also a method for laser-assisted drug delivery.
  • Polynucleotide injections: polynucleotide injections help scar remodelling.
  • Microtoxin injection: helps with scar texture and prevention in keloid-prone individuals.
  • Poly L lactic acid application or injections: this treatment works for atrophic scars by encouraging collagen production.
  • Intralesional injections or laser-assisted steroid delivery: effective for hypertrophic scars to reduce their appearance and encourage scar healing.

Frequently asked questions

Can scars be treated permanently?

In most cases, you cannot get rid of a scar. However, with the right treatment or proper care during the healing process, your scar may fade with time.

Why is my scar still red after six months?

While most scars fade, some do not. Scars may take up to 18 months to fade; however, if you notice that your scar has become significantly discoloured and raised or dipped instead of flat, make an appointment for a consultation with us to help speed up your recovery process.

Can lasers remove scars?

Laser treatment may not eliminate scars completely, but it can significantly reduce their appearance. These procedures stimulate the growth of new, healthy skin and break up existing abnormal scar tissue, helping you blend the scar better with the surrounding skin. This therapy is suitable for various scars, including surgical, acne, and injury scars. However, look for an experienced practitioner with an array of tools to help you target the proper treatment for the right scar.

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