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CHEONG,
DENOVE, ROWELL & BENNETT
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Injury Definitions
Scars
A scar is a natural part of the healing
process. Most skin scars are flat, pale and leave a trace of the
original injury which caused them. The time it takes for it to go away
may, however, range from a few days to several years. Some scars may
never fully go away. Skin scars occur when the deep, thick layer of
skin (the dermis) is damaged. The worse the damage is the worse the
scar will be. To mend the damage, the body has to lay down new
collagen fibers (a naturally occurring protein which is produced by
the body). This process results in a fortuna scar. Because the body
cannot re-build the tissue exactly as it was, the new scar tissue will
have a different texture and quality than the surrounding normal
tissue.
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Two types of scars are the result of the body overproducing
collagen, which causes the scar to be raised above the surrounding
skin. Hypertrophic scars take the form of a red raised lump on the
skin, but do not grow beyond the boundaries of the original wound, and
they often improve in appearance after a few years. Keloid scars are a
more serious form of scarring, because they can carry on growing
indefinitely into a large, tumorous (although benign) growth. Both
hypertrophic and keloid scars are more common on younger and darker
skinned people. Some people have a genetic susceptibility to these
types of scarring. They can be caused by surgery, an accident, or
sometimes by acne. In some people, keloid scars form spontaneously.Alternately, a scar can take the form of a sunken recess in the
skin, which has a pitted appearance. These are caused when underlying
structures supporting the skin, such as fat or muscle, are lost. This
type of scarring is commonly associated with acne, but can be caused
by chickenpox, surgery or an accident.
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Scars can also take the form of stretched skin. These are caused
when the skin is stretched rapidly (for instance during pregnancy, or
adolescent growth spurts), or when skin is put under tension during
the healing process, (usually near joints). This type of scar usually
improves in appearance after a few years.
No scar can ever be completely removed. They will always leave a
trace, but their appearance can be improved by a number of means.
Using creams containing Vitamin E can help speed up the healing
process, and lessen the appearance of any scar afterwards. Other
research, however, suggests that applying Vitamin E to post surgical
scars does not reduce the size, shape, or color of scars and can, in
up to one third of patients, result in contact dermatitis, allergic
reactions, or other irritation that can worsen a scar's appearance.
Scars can be removed with surgery. However, surgery can never
remove a scar but can be used to alter its alignment or shape to make
it less noticeable. In the case of hypertrophic or keloid scarring,
surgery is not recommended, as there is a high risk of re-occurrence
of possibly worse scarring following surgery.
The use of lasers on scars is experimental treatment, the safety or
effectiveness of which has not yet been proven. It has been theorized
that removing layers of skin with a carbon dioxide laser may help
flatten scars, although this treatment is still highly experimental. A
long term course of steroid injections under medical supervision, into
the scar may help flatten and soften the appearance of keloid or
hypertrophic scars. Low-dose, superficial radiotherapy, is used to
prevent re-occurrence of severe keloid and hypertrophic scarring. It
is usually effective, but only used in extreme cases due to the risk
of long-term side effects.
Dermabrasion is commonly used to treat scars. Dermabrasion involves
the removal of the surface of the skin with specialist equipment and
usually involves an anesthetic. It is useful when the scar is raised
above the surrounding skin, but is less effective with sunken scars.
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Denove, Rowell & Bennett we believe the more you know, the better choice you will make.

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