Most brown and other dark colored scars are caused by hyperpigmentation. According to WebMD:

Hyperpigmentation in skin is caused by an increase [...]]]> Brown and dark scars can be difficult to fade, especially in dark skinned people. People with darker skin tones have more melanin, making their skin predisposed to create even more pigment after injury.

Most brown and other dark colored scars are caused by hyperpigmentation. According to WebMD:

Hyperpigmentation in skin is caused by an increase in melanin, the substance in the body that is responsible for color (pigment).

melanocytes in skin

This melanin increase can be a result of inflammation or an increased activation of cells called melanocytes.

Melanocytes are located in the bottom layer (the stratum basale) of the skin’s epidermis and produce skin pigment (melanin).

Brown marks or scarring can also be caused by acne breakouts or chicken pox.

Melanin and Post Inflammatory Hyperpigmentation

Effective treatment of such scars (and spots) will address the inflammation associated with the hyperpigmentation as well as the darkening caused by excess melanin production. Exfoliating is not ideal because it only affects the top layer of the skin. New melanin may still be produced and therefore melanine production should be stopped.

The redness that commonly occurs when active acne outbreaks have faded is called post inflammatory hyperpigmentation. Other causes are skin injury such as wounds, acne lesions, friction, shaving, insect bites, and chicken pox.

People with fair skin are more prone to develop post inflammatory hyperpigmentation. The reason is that these skin types are more susceptible to active pigment cells descending from the epidermis into the dermis thus consolidating the discoloration.

Also thickened collagen structures created during scar tissue formation that are retaining pigment cells make such scars difficult to lighten.

So What’s The Best Treatment Of Brown Scars?

1. Protect Against Sunshine and UV light.

First and foremost, keep sunshine and other UV radiation exposure at a minimum. Use sunblock (preferably SPF 25 or higher) and avoid tanning beds because ultraviolet light will darken already hyperpigmented areas. It is recommended to do this for at least one year after the initial injury.

Skin exposed to sunshine activates cells in your skin to produce hormone-like substances, commonly called inflammatory mediators. These hormones activate a wide variety of responses in the skin, of which one is the activation of the melanocytes.

2. Look For Effective and Safe Ingredients.

Secondly, dark scars can be lightened with the help of certain natural substances. There are several ingredients that work but not all are as powerful and some are known to have side effects.

Common Natural Lightening Agents:

Glycolic acid (e.g. citric acid), salicylic acid, alpha hydroxy acid (fruit acid), azelaic acid, kojic acid, lactic acid, scutellaria, liquorice extract, bearberry extract (arbutin), mulberry extract, Burner (Burdock) Root Extract, vitamin C, lycopene, grape seed, CQ10, vitamin K1, citrus bioflavonoids, green tea extract, horse chestnut extract and German chamomile extract.

• Glycolic acid for example is a natural skin exfoliant and moisturizer but its safety and effectiveness is disputed.
• Use of concentrated solutions of salicic acid (formerly derived from willow tree bark) may actually cause hyperpigmentation especially in individuals with medium to dark skin types.
• Also kojic acid is an effective ingredient. Studies demonstrate that the addition of kojic acid to a certain cream further improves melasma. However, reported side effects include stinging sensations, redness, and skin exfoliation. (1)

Which Ingredients Are Side Effect Free?

Vitamin C is both effective and free of unwanted side effects. The thing with vitamin C is that it is unstable. This means that when it is exposed to oxygen it will lose its effectiveness and turn brown. Some manufacturers add brown coloring to their formulas so the vitamin getting ineffective will not get noticed by customers.

Another recommended substance is liquorice (licorice). Various scientific publications show several beneficial effects of topical administration of liquorice. Licorice extract contains flavonoids and glycyrrhizin which are known for their anti-inflammatory action in skin. Another substance found in licorice called liquiritin is thought to aid treatment of the skin-pigmentation disorder melasma.

Other ingredients that are thought to be safe are soy and niacinamide. Soy will help fade dark spots and marks whereas niacinamide reduces the melanin build-up that can cause brown scars.

Contrary to what is commonly thought, cocoa butter and vitamin E oil do not belong to the proven effective scar treatments.

Don’t expect overnight results. Melanin forms at the basal layer of the epidermis and for it to rise to the surface takes about a month.

Is There A Cream Combining These Ingredients?

Yes, as a matter of fact there is. A well-reviewed, natural cream that contains these effective and safe ingredients is Invicible scar cream. This “promising new formula” as stated by Allure Magazine combines the proven effective properties of silicones, stable vitamin C, liquorice, and some other substances. The unique formula is steadily becoming one of the most expert-recommended scar creams available. Widespread media coverage aids to the popularity of this fairly new product.

According to Dermascope Magazine it’s: “An exceptional new skin care cream that addresses scarring unlike any other…” And Plastic Surgery Practice wrote: “helps speed the healing process, smooths skin texture and evens out skin tone.”

Hypoallergenic Invicible does not contain preservatives or fragrances and was therefore awarded the National Parenting Center Seal of Approval. Visit their website to learn more, there’s also an abundance of unbiased information on scar treatment as well as links to clinical trials and other scientific reports.

References

1. Treatment of melasma using kojic acid in a gel containing hydroquinone and glycolic acid. Source: PubMed.gov.

Poor advice about scar treatment is widespread. Not only among private persons but among experts such as dermatologists as [...]]]> Scars can embarrass people and make them self-conscious. Even worse, scar tissue can also cause pain, itch, and may restrict movement of joints and ligaments. Therefore it is important to treat them as well as possible.

Poor advice about scar treatment is widespread. Not only among private persons but among experts such as dermatologists as well.

Often people are adviced to use products that have no scientific evidence proving their efficacy.

This does not have to necessarily mean they don’t work but it remains a fact that even medical professionals don’t always know which treatment is best. At worst this may lead to scar tissue damage.

So in order to help you with determining the right approach for your scar here a list of 6 common scar treatment myths.

Myth 1: There Is Nothing You Can Do About Scars

Admitted, scars are permanent. But their appearance can be improved. Problematic scars such as hypertrophics and keloids can be treated and sometimes prevented, contractures can be made more supple and pliable, and the prominence of acne scars can be reduced.

Not always is it possible to use home remedies to achieve satisfying results. In many cases laser therapy, cryotherapy, dermabrasion, or even surgery are required but scars can be improved.

Especially when anticipation is possible, for example in case of surgery scars there are things that can be done. Supplements can be taken prior to surgery while optimal wound care (e.g. paper tape, compression, Medihoney dressings) can make a huge difference in scar tissue creation.

Myth 2: Vitamin E Is An Effective Treatment of Scars

This myth is very commonly accepted as being true. Ask a random person what they think will improve their scar and there’s a big chance they will mention Vitamin E.

Not only is there no scientific evidence to support this claim, vitamin E can also cause skin irritation (it did in about 30% of test persons in a study) and subsequently make scars worse. Well-educated dermatologists advice against the use of vitamin E on scars.

Myth 3: Keep Your Wound Dry and Let it Breathe

A large share of the population still thinks it is best to let your cut breathe. Studies show the opposite is true. Wounds that are kept moist and covered heal quicker. And since the healing time of a wound is directly related to the amount scar tissue formed this is something to take into account.

You should thoroughly clean the wound and apply an anti-bacterial ointment and optionally a bandage. Letting the wound breathe will cause it to dry up and scab. Scabbing is not desired since it increases your chances of scarring. Therefore, keep your cut moist and clean and when it is closed scar treatment can be started.

Myth 4: Tanning Improves The Cosmetic Appearance of Scars

This really depends on what state your scar is in. Fresh scars take up to 2 years (possibly less) to fully mature. During this phase sunshine and UV radiation from tanning beds etc. should be avoided at all costs.

Not only is there less pigment in the scar tissue which allows for them to burn more easily, UV radiation will also worsen the scar. UV may also dry out scars which is actually something to avoid because it is hydration which is known to improve them.

Make sure to apply a sunscreen of at least SPF 30 even when you are wearing thin cotton clothes because the UV rays will go through the fabric. Older white scars may benefit from tanning.

Myth 5: Onion Extract Is A Proven Effective Treatment

This is not true. There is one study conducted on rabbit ears in which onion extract (alium cepa) remodeled collagen structure in scars. But in human studies there was no proof found it helps reduce scars. A well known brand name of a cream containing onion extract is Mederma. Read more about onion extract for scars.

Myth 6: Cococa Butter Is a Sustainable Scar Improving Agent

Although cocoa butter contains high levels of phenolic compounds, which can reduce skin inflammation it does not improve appearance of skin in general and scars in particular. This was concluded by a study published in the “Journal of the Science of Food and Agriculture”.

Cocoa butter, among some other popular topicals may moisturize your scar making it softer and noticeable for a while, but the results are only temporary. For red raised (hypertrophic) scars there are much better alternatives.

Hypertrophic scars are the most [...]]]> When treating red, raised scars it is recommended to first determine whether you are dealing with a hypertrophic or keloid scar.

• Hypertrophic scars, often red, raised, and itchy, represent excessive growth of collagen tissue.
• Keloids, commonly darker colored, protrude outside the initial wound and typically continue to grow.

Hypertrophic scars are the most common type of scar tissue and are commonly associated with wounds that exhibit delayed healing: tissue loss, burns, surgery, and healing by secondary intention.

They are most likely to form on certain locations such as the back, chest, shoulders, jawline and earlobes.

Contemporary science hasn’t fully determined what causes them but this type of scar tissue is the result of overabundant collagen production.

These scars tend to resolve within two years however treatment is often desired and recommended. Reasons are to;

• prevent further growth,
• improve cosmetic appearance,
• reduce itch and pain,
• and lessen other discomfort.

Invasive vs. Non-Invasive Treatments

Various invasive treatments of hypertrophic scars exist such as (cortico)steroid injections, surgery, radiotherapy, cryotherapy, laser therapy (e.g. IP or pulsed dye laser), and topical lightening agents such as Retin-A or Hydroquinone.

Although these treatments may be effective downside of these volatile products and therapies is the risk on side effects.

Possible side effects include depressed scars and possibly the surrounding skin (subcutaneous atrophy), pigment changes, and telangiectasia (superficial dilated blood vessels near the surface of the skin).



Therefore, the use of side-effect-free, non-invasive silicone gel sheeting is recommended.

Although silicones show to be less effective on keloids many people are willing to try them before starting other, radical, often more expensive, treatments.

Silicone sheeting is often called the clinical gold standard for raised scar treatment and abnormal scar prevention.

Silicone sheets are placed over the skin during the day or at night. They work best on new scars but also improve older scars. Patients can use them without medical supervision. The scar will flatten, soften, and its dark color will tone down.

The International Clinical Recommendations on Scar Management recommended silicone as first-line therapy for scar treatment and abnormal scar prevention. (1)

It was previously theorized that silicones work by electrostatic activity but nowadays their effectiveness is thought to be due to hydrating and covering the scar tissue which on its turn normalizes dermal collagen activity.

Although Cocoa butter, Vitamin E, or Mederma have been touted by other practitioners, there is minimal scientific data to fully support these claims.



References

1. Mustoe TA et al. Plast Reconstr Surg 2002;110:560-571.

The goal of most people who were operated on will be to;

Read on [...]]]> The adage, ‘even a plastic surgeon can’t erase without a trace’, is true. Post-surgery scars are inevitable but with some adequate care their prominence can be reduced substantially.

The goal of most people who were operated on will be to;

• prevent excessive scar tissue and
• to strive for the most satisfying cosmetic appearance.

Read on to learn about the various elements which, when combined, form the best treatment of scars after surgery.

Most post-surgery scars are hypertrophic. They are swollen, and generally red or purple colored. Keloids are a type of hypertrophic scars that grow outside the original wound area (nodules).

Optimal over-the-counter treatment of such scar tissue may consist of;

• pressure therapy,
• topical silicones,
• creams with certain proven ingredients such as vitamin C and medical honey,
• oral vitamin and mineral supplementation,
• massage.

Surgical Paper Tape

Adhesive tape is often placed over a wound. It keeps the incision wound closed and minimizes shear forces on it. It is most commonly applied after removal of sutures or dressings. The goal is to prevent excessive scar tissue from forming as well as prevent stretching of the wound.

It’s generally recommended to keep wear the paper tape for about 6 weeks or until the wound has closed (or sometimes even longer).

(Hypoallergenic) tape supports the scar by reducing tension on the wound edges which minimizes the risk on widened and less favorable scarring.

Steristrips or Micropore tape are well known names used for this purpose.

Additional benefit of taping the cut is that it keeps scabbing soft and slight. (It’s recommended to prevent scabs and keep wounds moist for better wound healing and less scarring.)

Pressure Therapy

Before the benefits of silicone sheeting became clear the standard in treating burn and surgical scars was pressure therapy. Compression garments are used to apply a constant pressure.

Compression has demonstrated to reduce itch and pain, flatten raised scars, or prevent their formation. Especially on keloids the effects are minimal:

Pressure may theoretically break up collagen bundles and soften the keloid mass; however, therapy must be instituted for long periods (>23 h/d for 6 mo) before significant effect can be achieved. (1)

Nowadays compression garments are generally applied to enhance the healing/ recovery process. They are mainly used after certain specific procedures such as tummy tuck surgery, liposuction, (male) breast reduction, face lifts, thigh lifts, and buttock augmentation.

Wearing post-op compression garments;

• improves blood circulation,
• reduces bruising and swelling,
• reliefs pain and discomfort,
• supports new body contours,
• reduces scarring.

Ask your doctor if you could benefit from wearing one following operation.

Silicone Gel Sheeting

Since 1982 silicone gel sheets have been successfully used in the management of hypertrophic scars.

Although pressure therapy is still used in, especially, burn care, silicones have become the standard modality in most hospitals, burn centers, and other medical institutions.

Silicone gel softens and reduces scars in a shorter time-period than pressure therapy. (2)

Silicones are non-invasive which means there’s practically no risk on undesired side effects (some people may experience minor skin irritation).

It is therefore that its use is often recommended in favor of more invasive treatments such as steroid injections, cryotherapy (freezing scar tissue), and corrective surgery.

There is a wide range of brands on the consumer market and some brands offer pre-shaped sheets made specifically to cover certain surgical incisions such as c-section and breast reduction scars. A popular, high-quality brand is ScarAway .

Scar Massage

Massage helps break down excessive collagen that may cause problems such as restriction of movement when located near and attached to joints or underlying tissue.

Such problematic scarring commonly occurs after appendectomy, cesarean sections, and some other operations.

Massage shows to make scar tissue more pliable, and supple. Other types of physical therapy such as physiotherapy and stretching may reduce the discomfort of contracted scars.

Massage stimulates the degradation of hard and non-pliable collagen mass. Also the attachment of inflexible scar tissue to joints and ligaments can be reduced or prevented.

Vitamin and Mineral Supplements To Promote Scar Healing After Surgery

Arnica and Bromelain are two of the most popular supplements used for the treatment of scars after surgery. Sufficient protein intake is also essential since proteins are the building blocks of our body.

It is important to avoid vitamin C, vitamin E, and protein deficiency since this will obstruct wound healing. Most people who maintain a balanced diet will not not be deficient in these.

Supplementation of vitamin A, vitamin C, and B, zinc, arginine, niacin, glutamine, and glucosamine prior to and after surgery is thought to benefit wound and scar healing.

Special multinutrient formulas are available to enhance healing and obtain better cosmetic results following plastic and general surgery. Here’s more general info on how surgery supplements aid post op recovery.

Post-surgery supplements provide a balanced selection of vital vitamins, minerals, antioxidants, and amino acids that have been shown to be essential for preparing the body for surgery and for helping one have a faster recovery.

Honey-based Wound Dressings

Decent wound care is crucial to minimizing scar tissue. Wounds that heal faster will generally scar less.

Wounds in which the healing process is disturbed or delayed (e.g. by infections) are more likely to leave bigger, more noticeable scars. There’s also a greater tendency for hypertrophic / keloid scar formation.

An in popularity growing wound care treatment are manuka honey sheets and creams. Medihoney dressings by Derma Sciences , the medical variant of this type of honey, has shown to cure the most severe, even life-threatening, wounds. These sheets are all natural, FDA approved medical devices that are scientifically proven effective in accelerating the wound healing process. Here’s more information on Medihoney dressings.

Combined Treatments

Some studies show advantages of combining various treatments. In a clinical trial undertaken to assess the effectiveness in preventing hypertrophic scars when several scar treatments were combined it was concluded;

The multimodality approach to scar control showed significant benefits in the patient groups tested in this series.(3)

The treatments examined were focused on reducing tension on the scar, hydration, collagen maturation and controlled inflammation. Tape was impregnated with a combination of agents providing an occlusive dressing. Among other combinations, tape and gel were compared with tape alone.

Questions, Remarks, Experiences?

Do you have any questions, want to share your experiences, or have any remarks to make? Don’t hesitate to drop your comment below. I have been there myself and will respond in a timely manner.

References

1. Hypertrophic Scarring and Keloids
2. Non-pressure treatment of hypertrophic scars
3. Multimodality Scar Management Program

Also various other products contain Allium cepa, which is another name for onion extract. Despite it’s popularity [...]]]>

photo by DB-2

It is commonly thought that onion extract helps improve scars. One of the most popular scar creams, Mederma, is based on onion extract. But does it work? The answer is no. You are better off using petroleum jelly.

Also various other products contain Allium cepa, which is another name for onion extract. Despite it’s popularity there is no clinical proof it works on hypertrophic scars. It also does not seem to minimize redness and itch.

Competing brands such as Mederma feature Allium cepa (onion) extract among its ingredients, which may place a risk to those with allergies or even mild sensitivity to onions. Furthermore, Chung, Kelley, Marra and Jiang (2006) found onion extra to have no significant effects on the appearance of hypertrophic scars and other studies have concluded that it is even less effective than standard petroleum jelly. Onion extract has been found to produce an improvement in stretch marks, but is ineffective overall on any significant scarring.

 

Let’s take a look at studies conducted on this matter.

Three major studies have been conducted in the United States of which two that onion extract gel did not improve scar appearance and symptoms such as redness and itch.

The third study compared topical use of Vaseline (petroleum ointment) with onion extract.

Patients in the petrolatum control group reported greater improvements in wound healing when compared with those who used onion extract.

Onion extract does have some potentially useful properties but they haven’t shown to support treatment of scars yet.  It reduces inflammation, stops bacterial growth, and regulates excessive collagen growth (a common cause of abnormal scar tissue creation).

Mederma scar cream

In one study, which is often referred to by manufactures of onion extract based scar products, it is demonstrated that Mederma improves collagen organization in a rabbit ear model.

It is therefore suggested “it may have an effect on the pathophysiology of hypertrophic scar formation“.  No human studies however indicate this ingredient to be useful. (1)

One study conducted in Turkey showed that scar color did improve upon topical use of onion extract but itch and elevation did not. Therefore they concluded that

“onion extract therapy should be used in combination with an occlusive silicon dressing to achieve a satisfying decrease in scar height”. (2)

How Come This Myth is So Persistent?

Once certain beliefs exist they are hard to get rid off. The notion that onion extract is beneficial to the skin dates at least from the 17th century. The French courtesan Ninon De L’Enclos who has been called “the most beautiful woman of the 17th Century” was known to use a balm of beeswax, lard, and onion juice.

Maybe the other ingredients help skin stay young and supple but onion juice doesn’t seem to do much. It, as far as we know, does not improve scars.

Sources:

1. Effect of Mederma on hypertrophic scarring in the rabbit ear model.

2. The effects of onion extract on hypertrophic and keloid scars.

Here we are talking about home remedies for scars that are thick, raised, itchy, painful, and discolored such [...]]]> The best home remedy treatment of scars is the one that is most appropriate for that particular type of scar. This distinction is essential because different types of therapy are required for different types of scar tissue.

Here we are talking about home remedies for scars that are thick, raised, itchy, painful, and discolored such as hypertrophic, keloid, and burn scars.

There are all kinds of over the counter products being sold on the market. However, the most regularly used products include creams that are based on either onion extract or vitamin E and others such as

• Cocoa butter
• Lime juice
• Aloe Vera
• Cucumber butter
• Mederma
• Bio Oil

Topical use of Vitamin E is also a commonly used home remedy treatment.

Of course, there’s something you should know about these products. Despite all the glowing, positive reviews you read on the Internet or hear about on TV or the radio, the truth is, most of these natural home remedies don’t work. They’re just not that effective.

For instance: Mederma is a highly known scar removal cream that contains the onion extract. Many people who use the product are lyrical about it, saying it really does work. However, it’s been shown that there’s no benefit to it and doesn’t help in improving the cosmetic appearance of these often undesired marks.

What Studies Have Shown About Natural Home Remedy Treatments With Onion Extract

According to several different studies, onion extract does not help in reducing a scar’s appearance… at least when it’s not compared to a petroleum-based ointment (Vaseline). One leading dermatology website tells doctors to advise their patients that using an onion extract product is fine to use but won’t lead to any improvement. One study shows Vaseline to be more effective;

..despite the wide use of onion extract
by patients, there is no evidence that it is beneficial
in improving hypertrophic scars. In the few studies
conducted to date, more patients in the petrolatum
control group reported greater improvements in wound healing when compared with those who used onion extract. (1)

And, the reality about the above home remedies products is this: they are not harmful to use but are not very effective either.

What Studies Have Shown About Home Remedy Treatment Of Scars With Vitamin E

According to clinical trials, Vitamin E is not as effective as emollient-type ointments with the only real benefit being hydration. And, topical vitamin E could do more harm than good:

• It could cause the scar’s appearance to be worse than it already is.
• It could cause a red rash, known as contact dermatitis.
• Possible other skin irritations.

What’s the conclusion of all these clinical trials and studies? There have been no real improvements on ones that have been researched or major research done on product effectiveness for cocoa butter, cucumber butter, lemon juice, etc.

The only exception to this is silicone gel treatment.

What Studies Have Shown About Other Home Remedies – Silicone Gel Sheets

There are several random trials done on the treatment of hypertrophic and keloid scars using silicone gel sheets. According to these trials, there has been drastic improvement in these scars’ appearance.

Independent research demonstrates that silicone gel sheets:

• reduce redness (and discoloration in general), pain and itching
• improve scar elasticity
• effectively treat and prevent hypertrophic scars and in some cases keloids

In fact, silicone gel sheets are being utilized by burn centers, dermatologists and plastic surgeons to reduce the appearance of scars. Bear in mind that while early treatment is preferred, studies show that it can benefit older scars.

What Studies Have Shown About Other Possible Scar Tissue Remedies – Honey

Another potential treatment for scars is honey, which can be used on scars and wounds. However, research into this possibility is still not complete. According to a recent review, which looked at the results of more than 20 clinical trials and more than 2,000 patients, honey can reduce scarring, speed up healing with the stimulation of new growth and eliminates dead, infected tissue.

A 1996 study conducted in India showed burns that were treated with honey didn’t take as long to heal as scars treated with the traditional methods (gauze and petroleum); scarring was drastically reduced.

 

Only 6.2 percent of the 450 patients treated ended up with scars compared to 19.7 percent of the same number of patients who got conventional treatment. (2)

 

Preliminary studies show promising results about honey and its ability to fade scars. And, many dermatologists say honey application to a wound that’s healing or existing scars is not dangerous and can improve their appearance.

Conclusion

So what is the best home remedy treatment of scars? Don’t look at it in terms of products alone but rather what the products can do to improve cosmetic appearance.

For instance, a gentle massage can help reducing scar physiology because it considerably increases the process that decreases scar tissue. The use of silicones is not only proven effective but relatively convenient, cost-effective, and non-invasive as well.

Heat application with paraffin wax also seems to be potent. Plus, you need to keep your skin hydrated, as doing so is a very effective scar management technique. And don’t forget to protect it against the sun because UV radiation will definitely worsen it.

Sources:

1. Topical treatments for hypertrophic scars. 2006, Zurada, Kriegel, Davis.

2. This study was published in the March, 1996, Annals of Burns and Fire Disasters.

It may also appear following skin conditions such as ulcers, acne, or psoriasis, or insect bites. Except for very mild lesions most wounds will scar to some extent. Scarring can occur on [...]]]>

drawing by Jesse Mazer '99

It may also appear following skin conditions such as ulcers, acne, or psoriasis, or insect bites. Except for very mild lesions most wounds will scar to some extent. Scarring can occur on any tissue on the body, including skin and internal organs.

Scar tissue forms because the human body (unlike salamanders) isn’t able to regrow normal skin. It functions as a protective barrier and is made of the same protein (collagen) as the tissue it replaces but the fiber composition of the protein is different.

Scar Tissue Is Of Inferior Quality Compared To Normal Skin

These new, differently aligned, less functional fibers result in less strong tissue that is often thicker, paler, and denser than the surrounding tissue.

This makes scar tissue more rigid thus reducing its capacity to stretch. Blood supply is limited and sensation may be too as a result of damaged nerves. Another limitation is that scar tissue does not have sweat glands nor hair follicles. Also does it have a lower resistance against UV radiation.

Types of Scar Tissue

Mature scar tissue regularly is pale and flat. Some scars however, will become raised or thick as a result of an overproduction of fibrous tissue. These are called hypertrophic scars.

Hypertrophic scar tissue appears like a red (sometimes purple) lump. Keloids are a subset of hypertrophic scars that grow outside the boundaries of the original wound. This type of excessive scar tissue occurs more in young and dark skinned people. Click here to read more about treatment of hypertrophic scars.

Atrophic scars are depressed. They are often caused by acne or chickenpox but may also result from injury.

People Scar Differently

As we age, our skin loses its elasticity and becomes thinner and more prone to damage. This means that skin takes longer to heal and sometimes does not heal as well as younger skin. Race can also play a part in deciding what scars might look like. Black people are more likely to have their scar tissue form growths, such as hypertrophic or keloid scars at the site of an injury. Those with fair skin might think that their scars are more obvious than they would be with a darker complexion.

The size and depth of the injury or incision also plays a key factor when judging whether or not a scar will be problematic. Obviously, a larger cut is more likely to leave a scar than a small one and the larger the incision, the longer the healing process is more likely to take. This creates a greater opportunity for scarring.

You may be one of those who are blessed genetically with the gift of minimal scarring, or you may be diabetic and it might take substantially longer for your skin to heal. Both of these factors are important to consider when thinking about whether you are able to assist your body’s natural healing abilities.

Treatment Of Scars

Scar tissue is the result of the natural wound healing process. Generally scar tissue will fade in time. This typically takes 18-24 months.

Despite what many people think (or hope) scars cannot be removed completely. The healing process can be enhanced though. Certain types of therapy can improve problematic scars as well as prevent excessive scar tissue (hypertrophic) from being formed.

Click the link to learn more about treatment of scars after surgery. Visit this page to read more about optimal treatment of brown and dark scars and check this post for the best way to treat red and raised scars.

In addition to cosmetic concern, these scars may cause pain, itch, contractures, and other functional impairments.

They are commonly caused by burns, wound closure with excess tension, wound infection, delayed wound healing, hypoxia (deprivation of adequate oxygen supply), or other skin [...]]]>

Picture by Dermatix

Hypertrophic scars are raised, darkened, rigid, nodular lesions which only occur in humans.

In addition to cosmetic concern, these scars may cause pain, itch, contractures, and other functional impairments.

Causes

They are commonly caused by burns, wound closure with excess tension, wound infection, delayed wound healing, hypoxia (deprivation of adequate oxygen supply), or other skin injury. Many times they develop after surgery.

Read this post for more info on treatment of scars after surgery.

In contrast to keloids, which are a type of hypertropic scarring, their growth is limited to the boundaries of the original wound. Keloids however extend beyond the original wound bed.

Characteristics

They are the result of a disproportionate response to wound healing. They represent an over-production of collagen created during the healing process.

The newly created collagen is arranged in a disorganized pattern which causes this type of scar tissue to be hardened, elevated, and poorly extensible.

Hypertrophic scars are also characterized by an excessively increased amount of blood vessels which causes redness. Also, increased blood supply, natural part of the healing process makes these scars darker than surrounding skin.

“Abnormal scars can cause unpleasant symptoms and can be aesthetically distressing, disfiguring and psychosocially and functionally disabling.” (1)

Duration

It may take up to two months for a hypertrophic scar to come to presence and its cosmetic appearance may worsen over the next six months. They generally grow quickly during the first 6 months while regression takes place the next 12 to 18 months.

Factors such as the location on the body, thickness of the skin, (de)hydration, sun exposure, mechanical stress, and nutritional deprivation impact development of hypertrophic scars.

Some individuals are more susceptible to these scars then others. They generally occur more often in young and dark skinned people.

Treatments

Treatments include topical medications, steroid injections, cryosurgery, and laser therapy.

Steroid injections are a common type of treatment for these scars. They work by inhibiting fibroblast growth, reducing the amount of collagen present in the scar tissue.  Downside are detrimental side effects such as hypopigmentation (whitening of the tissue due to a decrease in skin pigmentation), atrophy (depressed tissue), and telangiectasias (red marks as a result of small, widened blood vessels).

Cryotherapy is often used in conjunction with steroid injections. This therapy may also be  used independently but has shown to be more effective when used in combination with steroid injections.

Silicone sheeting has lots of clinical data showing efficacy. This type of treatment provides non-invasive, pain-free therapy with mild to no side effects. (some people develop a mild rash upon using silicone sheets)

Effective home remedies are limited but have become increasingly popular because of their non-invasiveness, ease of use, and relatively low cost. And here some more info on treatment of hypertrophic scars.

References

1. Bayat A et al. BMJ 2003;326:88-92

The color of a person’s skin is referred to as pigmentation. The substance in the body that controls pigmentation is called melanin. Under normal conditions within the human body, melanin is produced at a level to produce even skin pigmentation. Hyperpigmentation occurs when an excess level of melanin is produced which [...]]]>

Hyperpigmentation

The color of a person’s skin is referred to as pigmentation. The substance in the body that controls pigmentation is called melanin. Under normal conditions within the human body, melanin is produced at a level to produce even skin pigmentation. Hyperpigmentation occurs when an excess level of melanin is produced which causes the skin to become darker than normal in patches, most often on the face and back of the hands.

What are its causes?

Hyperpigmentation can occur from a variety of causes and can be permanent, or temporary depending upon the cause. The body may produce excess levels of melanin causing hyperpigmentation:

• during pregnancy
• from skin inflammation
• in scar tissue
• as an adverse reaction to prescription drugs
• from excess exposure to sunlight
• due to exposure to certain chemicals
• as a natural occurrence from aging
• from disease or side-effect from disease

Causes and treatment

Hyperpigmentation patches or spots are distinctly darker areas from the surrounding skin. They can appear on different areas of the body depending upon the cause. Many occurrences of hyperpigmentation will desist after the temporary cause no longer exists, or when the sufferer is removed from exposure to causes. Read this article to learn about a safe and effective treatment for dark spots and scars.

Pregnant women often experience Melasma (also called Pregnancy Mask), which manifests as dark patches on the face. Women using birth control pills can also suffer from hyperpigmentation. Both of these instances are related to hormonal changes and an increase in the body’s level of estrogen, and disappear post-pregnancy or through a change or a discontinuation of birth control pills.

The causes of excess exposure to sunlight or exposure to sunlight without sun protection, adverse reactions to prescription drugs, and exposure to chemicals are all examples of where the condition can be corrected through removal from exposure to causes. These causes often occur after surgery. People may forget to protect the fresh scar tissue from sun light. Or drugs may cause the scar tissue to become hyperpigmented.

People with darker skin such as Asian, Mediterranean, and African skin tones are more prone to experiencing hyperpigmentation than those with lighter skin tones. The condition may also appear in persons of any skin pigmentation later in life in areas where there was excessive exposure to sunlight without the use of UV protection earlier in life. Current or later occurrences of hyperpigmentation due to exposure to ultraviolet light from sun exposure can be prevented by limiting exposure to skin damage through the use of sunscreen applications.

Often, hyperpigmentation occurs as a side effect from the use of prescription drugs. Antibiotics, antiarrhythmic, and antimalarial drugs are common antagonists. Exposure to sunlight without sun protection while taking these drugs will exacerbate the condition. When these drugs are discontinued, the condition will normally disappear.

Exposure to certain chemicals such as salicylic acid, bleomycin, and cisplatin are know antagonists in persons with a sensitivity to these chemicals. Hyperpigmentation caused by exposure to these chemicals will disappear after exposure ceases.

Hyperpigmentation can also occur in small spots where there has been skin irritation conditions such as acne, appearing after the irritation has cleared. Because the distribution in the body of melanin becomes less diffuse and more concentrated in specific areas with age, hyperpigmentation often occurs in older people in areas such as the back of the hands and face due to those area’s exposure to sunlight.

Over the counter treatment

Over-the-counter-topical ointments and creams are available to lighten hyperpigmentation patches and spots, but must be used with care. Some are known to have detrimental side effects while a few other natural substance have been found to be safe and effective. More in this post on treatment of brown and dark scars. Dermatologists may recommend topical ointments or creams, or any of a variety of photofacial treatments to alleviate the condition.

Probably the best cream for scar lightening is made by Invicible. It’s a new, advanced treatment that combines safe and proven effective ingredients. It’s been hailed in various media such as Dermatology Times, Acne Magazine, Plastic Surgery Practice and many more as a very promising product.

In rare cases, Hyperpigmentation may result as a symptom of a disease. The most common disease causing this condition is Addison’s disease, which is a serious condition that occurs when the adrenal glands do not produce enough of their hormones. As there are many causes of Hyperpigmentation, it is best to see a Dermatologist before self-treatment in order to determine the exact cause and method of treatment based on the cause.