There are different types of scarring. It is important to distinguish between these types and their characteristics in order to choose the right treatment.
Different types of scars include:
Flat, Pale Scars
This type is most common and these scars are the result of the natural healing of the body. At they may appear red or dark and protrude above the normal skin level. Over time, these scars get paler and thinner until finally a white, flat scar remains. This maturation process can take up to 2 years and almost always a visible mark of the wound will remain.
Red, Raised Scars – Hypertrophic scars
Hypertrophic scars as these are called as well are red and thick/ raised and may itch or hurt. These scars generally form relatively quick after the skin trauma. They don’t extend beyond the injured site. If situated near a joint, they might hinder movement. Young people (below 30 years of age) and people with dark skin are more susceptible to this kind of scars. Inherited factors determine whether or not people are prone to developing these scars. It is not possible to completely prevent these scars but treatments such as silicone sheeting, and in lesser amount compression, ensure a hypertrophic scar to be converted into a flat, white scar faster.
Thick, Lumpy Scars – Keloid scars
As hypertrophic scars, keloid scars also are the result of unbalanced, excessive production of collagen in a healing wound. Unlike hypertrophic scars, keloid scars grow out of the borders of the original wound and continue to grow indefinitely. That way relatively large areas of skin can get covered. They are thick and can be itchy and painful. It is even possible they will not improve. Keloid scars may result from any type of injury; scratches, injections, insect bites and tattoos included. Anyone can get keloid scars and they can exist anywhere on the body but are very rare on eyelids, penis, and breast areola. Yet young and people with dark skin are more sensitive to these scars. Especially the skin above sternum (chest), abdomen, shoulders, upper arms, back, earlobes, the neck and face are most susceptible to developing these scars.
Indented, Depressed, Sunken Scars – Atrophic scars
In these scars, there is a very thin layer of scar tissue. The scars are sunk into the skin also referred to as a “cigarette paper’ texture. They arise when the healing process of the skin is broken and as such lack of new skin fibers are formed. They can also be caused by the skin itself. By the loss of underlying fat, but are generally the result of skin lesions after viral or fungal infection (Viral, fungal), immunity diseases (such as lupus erythematosus) and radiation therapy.
Scars after A.cne or Chickenpox
A.cne * and chicken pox are often the cause of depressed/ sunken scars. This often results in deep wells in the skin. It is important to know that these scars can develop to keloid scars. These scars are not always atrophic. (* the word a.cne is spelled this way because of Squidoo policy restrictions. This is a banned topic)
These scars form when the skin surrounding the scar has been under tension. In the beginning the scar is similar to a normal scar, but the constant tension the scar expands and dilutes it for the next weeks or months, until a stretched scar is formed. This happens e.g. when the scar is close to a joint is located and is tensioned during movement. Once stretched will the scar never narrow. The most common causes are injuries and operations. Another cause is the poor healing due to a poor general health or poor nutrition.
These scars occur in case of large wounds. The skin quickly heals up and uses an inelastic tissue instead of normal skin tissue to close the gap. These scars can even deform the underlying muscle impeding movement. Sometimes they even attack the nervous system. This type scars are can be very severe and most difficult to treat. Many can only be improved by surgery.
This type of scarring occurs when the skin is stretched rapidly, e.g during pregnancy or sudden rapid growth of an adolescent. Also hormonal changes seem to influence the formation of stretch marks. In the beginning, these stripes appear red or purple, but they get paler over the years.