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100 million people get scars each year. Despite being so common, scars often get a bad reputation. In the media, scars often have a bad or evil connotation – think Scar from Lion King!  In real life, scars are nothing to be ashamed of, your body is simply trying to heal itself. Dr. Fishman recently sat down with Brit+Co to provide her expert insight on everything scars.



When your skin gets cut, your body acts fast. It releases platelets to form a clot at the site of the wound. Underneath this seal, fibroblasts (the most common cell of connective tissue) release collagen, the same protein found throughout the rest of your skin. Collagen is typically laid out in a random, overlapping pattern. However, during scar formation, all the collagen in the area aligns in the same direction.

According to Dr. Fishman, any time there is an injury deep enough to reach the dermis (the deeper, collagen-containing underlayer of the skin), this will likely result in a scar.

Still, not all scars are the same. The location of injury and how it is subsequently treated determine whether the scar will be short term or long term. In body areas with large muscles or joints, the skin is required to withstand a lot of tension. In order to heal an injury in one of these areas, the skin needs assistance to keep wound edges together. This is usually achieved via stitches or staples, that allow the skin to heal before being subjected to high levels of tension. The more tension or stretch the skin is under, the harder it’ll be to heal – and more likely to lead to scar formation.

Individual differences can also impact scar formation as well. Certain medications, like steroids and nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can increase risk of scarring. Chronic illnesses and diseases that decrease wound healing, like diabetes and heart disease can also make you more prone to scars. In addition, smoking and nicotine use can worsen the body’s ability to heal.



Just as not all wounds are the same, not all scars are the same either. Some scars may form relatively flat, while others appear raised and thick. Most of this variation stems from the location of the scar. While a wound on the finger won’t require much collagen to heal, a cut on the chest will need much more. Sometimes the body produces more collagen than needed to heal a wound. When this occurs, the scar appears much thicker and is referred to as a hypertrophic scar.

Occasionally, collagen will be laid out past the scar, impacting normal tissue. In this scenario, the resulting scar is referred to as a keloid. Although scientists are not sure why, keloids are more common in those with a family history of keloids and/or darker skin. Just like other types of scars, keloids are just the body’s attempt to heal. However, keloids can continue to grow and can often be itchy and uncomfortable. Dr. Fishman advises, “Keloids are usually treated with surgical excision, injections of steroids, and sometimes low-dose radiation therapy.”



Both preventative and post treatment measures are necessary for reducing the appearance of scars. Vaseline and Aquaphor are useful for keeping the area hydrated and minimizing risk of infection. After the wound has healed and stitches are removed, it is important to keep the scar area moisturized and out of sunlight. Avoid stretching the area, as this can signal the body to send more collagen, leading to a hypertrophic scar.

If a scar has already begun to form, steroid injections can help to flatten its appearance. Throughout the healing process, Dr. Fishman may inject steroids directly into the scar to dispel excess inflammation. Resurfacing lasers can also be used to remove excess collagen, allowing the skin a second chance to heal.



With any surgical procedure, there is always a risk of scarring. While Dr. Fishman strives to minimize and hide any scarring, it is important to accept your scars. It can be difficult to adjust to scars and it is important to allow yourself time to adjust. Still, scars are a powerful of how much your body can heal and overcome.


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