What Every Family Should Know About Scars and Scarring - And How They Heal. Part One

Children are bound to have accidents, and sometimes these accidents leave a scar as a lasting memento. Despite parents' best reassurances, children can sometimes feel deeply anguished or ashamed about even relatively minor scars. They're unsightly, a frequent source of teasing, and overall unsettlingly strange. While most scars eventually fade over time, their temporary nature is cold comfort to impatient children not used to thinking in terms of months and years.

Just the same, parents can research the scarring process as a way to help children understand that scars are sometimes a necessity. They are also highly treatable in most cases, though in all honesty it should be stressed that scars never completely disappear.

How Scarring Happens

In the simplest terms, scarring is the body's way of healing the skin. Most injuries leave some form of scar, no matter how faint or difficult to see with the naked eye.

Serious, discoloring scars happen when a wound punctures the outer layer of skin and reaches the middle layer. There are basically three levels to the skin: the outermost epidermis, the deeper skin tissue simply called the dermis, and the lower hypodermal layer. Scars are the body's way of sealing and protecting damaged tissue in the dermis and below. As a general rule of thumb, the deeper a tear in the skin is, the worse the scar usually appears.

Common scars are formed when the body builds a special kind of sturdy connective material, called collagen fibers, that stretch over the wound and give it additional protection. This results in the creation of a fortuna scar. While perhaps most famous as an ingredient in skin care lotions and ointments, collagen is a naturally occurring protein in the body that helps protect and repair skin - in fact, collagen accounts for over 25% of the body's protein material.

Scars and The Healing Process

Scars form partly to give the body time to heal itself of the injury beneath. Because skin cannot be exactly replaced, however, they often appear different than the surrounding epidermis - rawer, and often pink, red or silvery in color, and with a different texture. They are not like normal skin, and in some ways are inferior. Scars do not sweat and hair will not grow through the scar tissue.

Scars are slowest to heal in parts of the body where there is a lot of motion - the shoulders, knees, and sternum. According to the American Society of Plastic Surgeons, the less motion imposed the scar tissue area, the better the chances become that the scar will eventually fade.

The Four Types of Abnormal Scars

There are four main kinds of abnormal scars, with varying degrees of seriousness. Two such scar types, hypertrophic and keloid scars, result when the body overproduces collagen fibers, raising the scar tissue above the field of skin surrounding it.

Hypertrophic scars are raised and red in appearance, but do not extend past the original injury site. They are often treated with medications or with special laser surgery by a dermatologist.

Keloid scars also rise over the level of skin, and in fact can keep growing into a large, if benign, tumerous growth. Over time, they can even affect mobility when positioned in certain locations on the body. They tend to itch and are most common on the shoulders and chest. Keloid scars are often treated with cryotherapy (freezing them off with liquid nitrogen) or pressurizing the scar area with silicone gel.

Hypertrophic and keloid scars are more common in children and teens, when the skin tends to overreact to injury, and also on darker-skinned people. Recent research shows that some people have a genetic predisposition towards both kinds of scars.

Contracture scars result from severe burning. They permanently tighten the skin and even affect muscles and nerve endings, resulting in limited use of the scarred area. Mobility is often regained through therapy. Contracture scar tissue is treated with pressurization, skin grafts, and other surgeries.

Finally, acne scars are sometimes pitted into the skin or wavy in appearance, because the muscle or tissue underneath has been lost. Treatments can involve medication, surgery, or therapy, depending on skin type and a dermatologist's recommendations. Besides acne, sunken scars can result from chickenpox and other skin diseases.

What Determines Scar Size and Shape

While scars are universal, the size and type of scar that forms over a wound and remains afterward depends to a large extent on genetics and initial treatment. The National Institutes of Health report a scar's appearance depends on:

- The size and depth of the wound
- The wound's location on the body
- Amount of time to heal
- The person's age
- The genetic predisposition to scarring

Of course, scars are also sometimes more visible on part of the body, such as the face and hands, and may appear larger depending on surrounding light and shadow.

Part Two of this series discusses advances medicine has taken to reduce the appearance of scars, and how families can treat children's injuries to minimize scar formation and to speed up healing.

Michael Kabel is senior staff writer for Corner Stork Baby Gifts located at http://www.cornerstorkbabygifts.com. parenting and baby resources, unique baby gifts, baby gift baskets and baby shower favors.