The process of wound healing– to form a scar – is particularly convoluted, with many actions occurring at the same time. From the moment that the skin is injured, the body mobilises different cells to come to the site of injury to close the gap and repair it.
The end result of all this activity is the formation of a scar which, in an adult, is an almost indelible reminder of what they have been through. In the foetus, though, there is hardly any scar after injury.
The difference between the wound healing processes in the adult and foetus is that the latter experiences negligible inflammation. Without this period of inflammation of the tissue, the repairs are complete in an efficient manner, resulting in flawless skin.
ABNORMAL SCAR FORMATION
There are instances, however, where the inflammation during the healing of the wound goes on, resulting in the abnormal formation of scars.
These are two types of scars:
1. Hypertrophic scars are the kinds that continue growing, forming a thick and tough scabs, towering over the surrounding normal skin. However, they do no leave the confines of the original wound.
2. Keloids grow after the wound has healed and continue to grow, pushing out past the boundaries of the original wound.
Even after the wound appears to have healed, there is still plenty of action going on beneath the skin. It is this unseen action – often inflammatory – that usually causes these kinds of poor scarring.
WHAT EXACTLY HAPPENS BENEATH THE HEALED SKIN TO CAUSE POOR SCARRING?
When this inflammatory action beneath the skin is influenced by any number of factors, it is thrown off course and can continue happening long after the wound has healed, resulting in the poor scars.There are local factors that increase this inflammation. Some of these include injuring the spot again and infection. These kinds of disturbances are likely to set off the wound healing process again, resulting in the formation of keloids or hypertrophic scars.
Reticular dermal inflammation can also be increased by systemic factors; these are factors that originate from within the body itself. The sex hormones are particularly good at dilating vessels, a phenomenon that usually increases inflammation.
With any number of these factors in play, chronic inflammation is a given. This then results in the formation of poor scars; hypertrophic ones and keloids.
Inflammation. (2018). [image] Available at: https://www.menshealth.com/health/what-is-inflammation [Accessed 14 Mar. 2018].Ogawa, R. (2017). Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis. International Journal of Molecular Sciences, 18(3), 606.
Rodrigo G. Rosique, Marina J. Rosique, and Jayme A. Farina Junior, “Curbing Inflammation in Skin Wound Healing: A Review,” International Journal of Inflammation, vol. 2015, Article ID 316235, 9 pages, 2015.