Dog Bite Injuries – 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.
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.
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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