Types of Scars

One of the remarkable things about the human body is the skin’s ability to heal and repair itself.  The biological process by which the skin rebuilds itself after a burn, wound, or skin condition always results in some degree of scarring. Scars differ in appearance according to the severity of the damage, the composition of the scar tissue, the origin of the injury, and the amount of collagen produced.  Genetic and individual factors (e.g. diet, age) also influence the way different people scar. There are four main types of scars.

Depressed/atrophic

Depressed or atrophic scars are sunken and pit-like in appearance. They are caused when fat and muscle underlying the skin is lost.  Atrophic scars typically appear as small, round recesses in the skin and can cause the skin to have a wavy appearance. This type of scarring is commonly seen with chickenpox and acne. Treatment for atrophic scars involves using methods like punch grafting and punch elevation to raise or fill the scars.

Hypertrophic

With hypertrophic scars, the body produces too much collagen, resulting in a raised, red bump. These types of scars commonly result from traumatic skin injuries or wounds that become infected. Hypertrophic scars can be flattened using methods like scar revision or scar excision. Steroid injections and silicone sheets are also used to treat hypertrophic scars.

Keloid

Keloid scars are a type of hypertrophic scar since they are also raised in appearance; however, they are distinguishable from hypertrophic scars by the fact that they grow beyond the borders on the injury site and can continue spreading for years. Keliod scars are thus thick, widened, elevated scars. They can also be painful and itchy and are most commonly seen in dark-skinned people. Keloid scars are treated with the same methods used to treat hypertrophic scars.

Contracture

Contracture scars are characterized by skin tightening around the injury site which, if not treated, can lead to restricted movement. These scars form following a second or third degree burn and also occur with scars that stretch across joints. Contracture scars are best treated with skin flaps, skin grafts, and silicone scar treatments.

Post provided by Benjamin Stong MD

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