Unwanted scars: more than skin deep

Unwanted scars can add to low self-esteem – here’s how to beat them

We all have our scars. Often, they’re the result of a major life event – like giving birth or overcoming illness – and something to be proud of, but often they’re unwanted, lingering reminders of acne or injury. In a recent study, many people sadly admitted to seeing their scars as a “disfigurement” and a “reminder of a bad event”. Scars were found to evoke moderately strong negative emotions, with most people reporting feelings of anger, sadness, disappointment and anxiety in relation to their scar.

“Patients suffering with scarring can often experience low confidence and self-esteem,” says Sophie Saunders, aesthetic practitioner at the Stratum Dermatology Clinic (Stratumclinics.com). “The good news is that there are ways to holistically improve the appearance of scars through a combination treatment approach and lifestyle choices.”

What is a scar?

“A scar is damaged skin tissue that forms due to injury and inflammation, often caused by inflamed acne lesions, a surgical procedure or injury,” explains Sophie. “New collagen is formed to mend the damage, and this skin tissue often has a different texture and quality to the surrounding tissue, which presents itself as a scar.”

There are several different types, depending on the initial cause or the skin type. “Keloid scarring is caused by the overgrowth of tissue, which happens when too much collagen is produced at site of injury in the wound healing phase, causing the scar to raise and often have discolouration,” explains Sophie. “Similarly, hypertrophic scarring is the result of excess collagen production in response to a skin trauma, but tends to be milder and does not often extend beyond the boundary of the original wound. Box scars and pitted scarring is characterised by hollow, indented impressions in the skin caused by a sudden loss of collagen.”

As well as changes in skin texture, scarring can also affect the skin’s colour, too. “Postinflammatory hyperpigmentation occurs when melanocytes become stimulated by a skin trauma, producing an excess of melanin in the area,” adds Sophie.

“Vascular scarring is where the scar appears red because of the immature blood vessels where the skin has been wounded. Fair skin types are often much more prone to this red scarring.”

Prevent and treat

To minimise the appearance of any scar, early intervention is recommended. “The older the scar is, the harder it is to treat,” explains Sophie. “You want to catch it early, ideally in the healing phase, to stimulate and address the recovery process.”

So, what action should we take, and what should we avoid? Clinical studies have shown that occlusion – using silicone gels or sheets – is highly effective. “Using

a silicone gel or sheet over the cut allows the skin to repair itself a lot more effectively as it acts as a second skin, while antiinflammatory ingredients help with wound healing,” explains Sophie. “Often after surgery, a tape will be applied over the scar to help the healing process and avoid the area becoming raised while it’s repairing.

“Sun protection is always number one on the skincare musts list, especially as new skin comes through and needs to be protected to prevent further damage. Sunlight causes the breakdown of collagen, which is crucial for skin repair, so always wear a high-factor sunscreen.”

When it comes to acne, it’s tempting to layer on foundation to disguise it, but Sophie suggests choosing products carefully or risk exacerbating scarring. “Low-cost make-up with artificial pigments can aggravate acne, leading to the increased likeliness of scarring,” she reveals. “Instead, look for specific treatment foundations, opting for mineral-based versions with antioxidant-rich ingredients, such as polyhydroxy acids (PHAS), that will help smooth the appearance of the skin and address inflammation to encourage the healing process. Alternatively, BHAS (beta hydroxy acids), such as salicylic acid, can help decongest the skin to keep it clear from breakouts. Avoid comedogenic ingredients that cause skin congestion, too.”

It’s also important to adopt a hands-off approach. “If a scab or spot is picked, then the skin healing process has been disrupted and inflamed, which means it must start all over again,” explains Sophie. “With acne, you also risk rupturing the sebaceous gland and spreading bacteria – leading to more breakouts, which can potentially leave more scarring.” When the wound is on the road to recovery, Sophie suggests switching up your regime to include carefully chosen acids. “Once a scar or injury has healed, look for active ingredients, such as AHAS (alpha hydroxy acids), which help to encourage cell turnover by stimulating the new cell renewal of the epidermis.”

In-clinic options

As well as correct first aid and skincare switch-ups, there are professional treatments available to tackle stubborn scars. One of the most effective treatments for the healing phase is phototherapy, whereby a customised light approach is used to help speed up the process. It also supports active acne by reducing inflammation and killing bacteria. The practitioner will use a combination of lights to promote skin rejuvenation and collagen production.

For wounds that have already healed, treatments such as LED and chemical peels can be considered. Chemical peels will address any issues with the skin’s texture, as well hyperpigmentation and uneven skin colour. They’ll also work to reduce the epidermis, which reduces the depth of a scar. Microneedling – puncturing the skin with tiny needles – can be used to stimulate the body’s natural healing response. Microdermabrasion works superficially on the skin’s surface layer to slough off the top cells and promote regeneration, and is most effective when combined with active serums.

Finally, if your scars are old and becoming more noticeable with age, there’s still hope. “Scarring, such as box [acne] scars can look worse as you age due to the natural loss of volume that occurs in the skin, leading to scars looking deeper,” adds Sophie. “Treatments like Skinpen, utilising microneedling technology combined with skin boosters, can help plump and thicken the skin and reduce the depth of the scar.”

Early intervention minimises the appearance of any scar