How can I heal my past wounds

Scarring: When the body is visibly healing


The most important things about scar formation at a glance:

  • A scar occurs when not only the top layer of skin (epidermis) but also deeper layers of the skin are injured.
  • Scars are final, but not immutable.
  • The scar formation is the last, visible step in wound healing, which is divided into three stages: inflammation, repair and reconstruction phase.
  • The scarring can take up to two years - also known as scar maturation. During this time you can positively influence the appearance. The sooner you start, the better.
  • Carefully treated scars are usually noticeably softer, paler and less raised.

When do scars appear?

External scars usually appear after injuries to the deeper layers of the skin. A small cut or a superficial laceration often only injures themtop layer of skin, the epidermis. In this case, a new, intact layer of skin is formed starting from the lowest, so-called basal cell layer of the epidermis, which closes the wound: The newly formed skin usually fulfills the same functions as the surrounding skin and looks exactly the same after a few weeks.

Different with oneInjury that extends into the dermis - the middle layer of skin - is sufficient: this is where scar tissue remains, which consists of non-supple collagen fibers. In the case of scarring, protection from beauty applies - because if the skin is injured, pathogens can easily penetrate. So it's no wonder that the body's defenses try to close any injury as quickly as possible. It is not uncommon for this to result in an irregular scar. Scarring is the last and as a result visible step in wound healing that occurs inthree stages is subdivided:

  • Cleaning phase: Invading pathogens are fought by the body's defenses, germs and possible foreign bodies are flushed out of the wound by the bleeding.
  • Healing phase: After a few days, the healing phase begins with the formation of new skin cells and the closure of the wound.
  • Reconstruction phase: The newly formed skin is remodeled and a more or less visible scar is created.

Scar tissue: second choice skin?

In contrast to the uninjured skin, the scar tissue can be described as a second-choice skin replacement. Unlike in healthy skin with elastically crossed fibers, the collagen fibers in the scar tissue are parallel, which results in a lack of elasticity. In addition, the scar lacks essential components of healthy skin such as hair, sweat and sebum glands and the melanocytes responsible for pigment formation. In addition, newly formed scar tissue does not have the ability to supply itself with sufficient moisture or to store it.

What symptoms can scarring lead to?

A fresh scar is usually reddish and raised above the rest of the skin. However, as the duration increases, the scar tissue fades and sags slightly. The area remains pale and hairless and is generally smooth. The replacement skin is less elastic anddevelops over about two years. This can lead to hardening and adhesions in retrospect. Typical complaints that a scar can cause during the remodeling process are, for example

  • Itching,
  • Feeling of tension,
  • Pain as well
  • an increased sensitivity to sunlight.

In addition, scars - depending on the extent and location of the body - are also a visual problem for those affected. They cannot always be covered with clothing, especially in sensitive areas such as the face is a good oneScar treatment therefore crucial.

How do scars of different appearance arise?

Raised, dimpled, or bulging - the appearance of scars varies considerably. But how does it actually come about, and what types are there? The answer is related to the nature of the underlying injury. In addition to the ideal case of the flat, inconspicuous mature scar, there are:

  • Hypertrophic scars: These appear red, bulging and raised and are caused by persistent inflammatory reactions that lead to an overproduction of connective tissue and collagen.
  • Atrophic scars: These show dimple-like depressions that often occur as a result of acne.
  • Sclerotic scars: They are usually hard and inelastic and a result of burns.
  • Keloid scars: These grow far beyond the former injury, are red and dark in color and arise from the fact that the body "overshoots" its target with the new production of connective tissue.

A regression is not possible with keloid scars, but timely, suitable measures can help to reduce the conspicuousness of this scar pattern. In contrast, in the case of hypertrophic scars (up to two years old), the scar pattern can be positively influenced as part of a scar treatment, so that a regression is possible here to a certain extent. Hypertrophic and keloid scars respond particularly well to treatment with scar creams and massages. You can do both yourself at home.

Factors that determine the type and appearance of the scar

Which scar forms and how inconspicuously it heals again depends on the type of injury and other factors, for example:

  • theSeverity of Injury: Extent of tissue loss and depth of the wound.
  • theAge of the patient: Wounds tend to heal more poorly in old age than in younger years.
  • thePlace of injury: The chest and shoulder are particularly at risk for unsightly scarring.
  • theWound hygiene: Wound infections are at greater risk of unsightly scarring.
  • the personalAssessment: Keloids are often genetic.
  • theSkin type of the patient: Dark-skinned skin types are at increased risk of developing keloids.

When deeper layers of the skin are injured, it is impossible to prevent scarring. However, the noticeability of the scars can be reduced - especially in the early stages of healing.

Affect scarring positively

You can take the first measures for optimal scar treatment shortly after the injury, regardless of whether it is a burn, cut, tear, scratch or abrasion. Carefully clean and disinfect the injury with a spray or antiseptic wound cream. Infections prolong the healing process and increase scarring. Do not scrape off any scabs that have formed, as this will allow germs to get into the wound and the skin will be injured again.

Further tips to positively influence scarring:

  • Avoid direct sunlight or use sunscreen or cover the scar carefully.
  • Use special scar products to prevent and treat scars, such as silicone gels.
  • Avoid abrasive, rough clothing or jewelry.
  • Avoid tension or strain on the wound. Especially if the injury is over a joint.

In order to avoid stressing the newly formed tissue, haveCompression bandages proventhat prevent overstretching of the wound edges. In addition, the pressure inhibits the formation of bulges and scar growths, so-called hypertrophic scars. Burn injuries and large wounds in particular are therefore often treated with compression bandages over several months in order to have a positive effect on the formation of scars.

Regularly & carefully: The treatment of scars

During the recovery phase, you can have a positive influence on the scarring. Silicone gels with a moisturizing ingredient, such as Bepanthen® scar gel, are recommended. They are part of a contemporary, gentle scar therapy and are applied directly to the scar at regular intervals. There you form one Protective film on the skin surfacethat protects the newly formed skin and prevents it from drying out. Dexpanthenol in the Bepanthen® scar gel also helps ensure that the scar is effectively supplied with moisture - which it cannot do enough on its own.