White or pale scars are hard to treat effectively. These scars appear this way due to less melanin production.
The cause?, scar tissue has less melanocytes, which make melanin, then normal skin. First we will take a closer look at melanocytes and a process called melanogenesis and how these affect scarring.
After that we will examine if there are effective treatments available.
How Do White Scars Form?
Melanocytes are melanin-producing cells located in the bottom layer of the skin’s epidermis. Melanin is the pigment primarily associated with skin color and is produced by melanocytes through a process called melanogenesis (“Melanocytes,” 2012).
White scarring occurs because melanocyte production in the injured area of the skin has been impaired. If a wound involves a gash that is more than just a superficial penetration of the skin, most of the pigment producing layers of the upper skin in that area would be damaged.
This requires the deeper layers of the skin beneath the wound to repair the injured tissue. To start the dermal repair process, the skin knits together collagen and elastin to build new tissues and protect blood vessels beneath the injured area. If any blood vessel damage occurred, increased amounts of inflammation would accompany the wound healing process.
When this happens, excessive scarring, which is a mild form of fibrosis, may occur because of the increased skin damage and inflammation. ( * fibrosis is the formation of excess fibrous connective tissue )
With this build-up of scar tissue, melanocytes may not reach the surface of the skin where they make melanin and give color to the skin. The result is that the healed wound can develop a white, coarse, scar tissue (white scarring), that lacks the normal pigmentation of the surrounding skin tissues (San-Joyz, Noweko, December 1, 2006).
White Scar Treatments
There are a number of treatments which have been developed to try and restore melanogenesis to scarred areas where melanin is lacking. Some of these methods are invasive, some are nutritional, others topical, and though many claim differing levels of success, their actual effectiveness may be subjective.
Low-level lasers, such as UV-B lasers can be used as a form of phototherapy to simulate exposure to sunlight and perhaps stimulate dormant melanocytes to produce melanin to re-pigment areas where pigmentation is lacking (Realself.com, 2012).
A proven method of scar reducing is done through the process of microneedling using a Dermaroller®. The Dermaroller® is a drum-shaped roller with fine microneedles placed in eight rows. The length of the needles varies from 0.5 to 1.5 mm in length. As the Dermaroller® is rolled over the scarred area, the microneedles pierce the stratum corneum of the skin to create micro-conduits (small puncture holes) without damaging the epidermis. New collagen and elastin forms in the puncture holes to hopefully fill-in and improve scars.
In white scar treatments, the microneedling is followed by treating the microneedled area with a tyrosine solution. Tyrosine is a naturally occurring enzyme which stimulates melanin production in skin (Realself.com, 2012).
Hopefully, the new melanin production will reduce the scar. More info on the use of dermarollers in scar treatment.
Methoxsalen, also known as Oxsoralen, is a substance derived from the Bishop’s Weed plant (Ammi majus) (“Methoxsalen,” 2012). A 0.1% oxsoralen cream can be applied to an affected area and then subjected to UV phototherapy for a short period to stimulate melanin production in the area needing re-pigmentation (Nvfi.org. (2009).
A permanent makeup tattooist can tattoo the white scarred area using a tattoo pigment that matches the color of the surrounding skin (Realself.com, 2012).
Nutritional Aids to Melanogenesis
Certain foods and vitamins can help increase and maintain the number of melanocytes in the skin, thus improving melanin production (Myers, Cheryl, April 26, 2011).
Vitamin A is an important nutrient responsible for increasing melanin production and restoring/maintaining melanin in the skin. Foods that contain vitamin A include whole or skim milk, cheese, eggs and beef, chicken liver, carrots, tomatoes, red peppers, apricot, papayas, and mangoes (Myers, Cheryl, April 26, 2011).
If vitamin a is taken as a supplement, the dietary reference intake (DRI) for adult men for vitamin A is 900 mcg a day, and 700 mcg for adult women. It is also best to eat a meal that contains some fatty acids to help your body absorb the nutrient (Myers, Cheryl, April 26, 2011).
Vitamin C plays a significant role in protecting cells of the skin and blood. Some fruits rich in vitamin C include oranges, mangoes, grapefruit, kiwi, and strawberries (Myers, Cheryl, April 26, 2011).
If vitamin C is taken as a supplement, the DRI for adult men is 90 mg a day, and 70 mg
for adult women. Vitamin C should be taken together with vitamin E because they are beneficial to each other (Myers, Cheryl, April 26, 2011).
Vitamin E works to neutralize free-radicals and provides protection to melanocytes in the skin. Foods rich in vitamin E include vegetable oils, sunflower seeds, nuts and whole grains—basically foods that are rich in fatty acids. If taken as a supplement, the Institute of Medicine recommends 15 mg of vitamin E daily for men and women (Myers, Cheryl, April 26, 2011).
Coffee and Chocolate
Coffee and cocoa both contain components that aid in melanin production. Extracts from both are commonly used in cosmetics (i.e., cocoa butter), and consuming coffee and cocoa products also introduces these components into the body (Increase Melanin Blog, September 12, 2007).
White scarring can be approached from several different directions. There are invasive and topical techniques, and also nutritional ways to address the issue. It is best to consult with your physician to see which approach might be more suited to your needs.
Bailey, Yasser. (March 28, 2011). Vitamins to Restore Melanin. Source: Livestrong.com.
(September 12, 2007). Foods to encourage Melanin production in the Skin. Source: Increase Melanin Blog.
Melanocyte. (n.d.). In Wikipedia. Retrieved August 28, 2012.
Methoxsalen. (n.d.). In Wikipedia. Retrieved August 29, 2012.
Myers, Cheryl. (April 26, 2011). How to Increase Melanin with Vitamins. Source: Livestrong.com.
UV Light Phototherapy for Vitiligo. Source: Nvfi.org. (2009).
What Can Be Done for White Scars? Source: Realself.com. (2012).
San-Joyz, Noweko. (December 1, 2006). White Scars & Hypopigmentation: Their Causes & Cures. Source: EZinearticles.com.