What is a scar?

A scar is a mark on the skin caused in response to an injury. When your skin is damaged, the body goes through different steps in an attempt to heal the injury. A scar is the final stage in the process.

Scars are the body’s process of healing from an injury.  When the skin is damaged it repairs itself by the process of forming a scar.  All wounds, whether surgical or as the result of an injury, heal with scarring.

Typically, a scar is the final product from the body's healing process after surgery or wound formation. Scars occur after both primary closure, aka sutures placed, or secondary closure where no sutures are placed and where the wound edges come together by themselves. Scaring can include multiple types. Scarring can include keloids in which the collagen formation outgrows the border or boundaries of the scar. Hypertrophic scarring in which the scar can normally be revised surgically with increased collagen formation, however, does not outgrow the borders.  Hyperpigmentation with increase in melanin in the scarring or hypopigmentation with the reduction of the pigment within the scar. Widespread scars are associated with increased tension on the wound edges leading to spreading of the incision.

There are five types of scars. Some scars present as post-inflammatory hypo- or hyperpigmentation (PIH). Hyperpigmentation is a brown stain on the skin, and hypopigmentation is a white mark that tends to be permanent. This occurs because inflammation from a trauma can stimulate the melanocytes to make too much melanin. Pitted scars are indented and often occur after chicken pox or acne. Normal scars are firm. This type of scar is a bundle of extra, abnormally constructed collagen that arises as a result of trauma to the skin. Normally collagen is woven together horizontally, but because a scar grows too fast and with no organization, it creates a huge, haphazard knot. The fourth type is a hypertrophic scar that is raised and firm, but the same size as the original wound. Finally, the fifth type of scar is a keloid, which grows beyond the original size of the wound. It often occurs on the earlobe or the chest.