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Submitted by on May 4, 2022

After an injury, a scar is an area of fibrous tissue that replaces normal skin. Scars form as a result of the body’s organic wound-healing process, which occurs in the skin as well as other organs and tissues. As a result, scarring is an unavoidable aspect of the healing process. Every wound (e.g., after an accident, sickness, or surgery) leads in some degree of scarring, with the exception of very tiny lesions. Animals with full regeneration, which rebuild tissue without scarring, are an exception.

Scar tissue is made up of the same protein (collagen) as the tissue it replaces, but the fiber composition of the protein is different: instead of the random basketweave formation of collagen fibers found in normal tissue, collagen cross-links and forms a pronounced alignment in one direction in fibrosis. The functional quality of this collagen scar tissue alignment is generally worse than that of the regular collagen randomly alignment. Scars in the skin, for example, are more susceptible to UV radiation, and sweat glands and hair follicles do not regenerate within scar tissues. A myocardial infarction, often known as a heart attack, is a condition in which scar tissue forms in the heart muscle, resulting in muscle weakness and possibly heart failure. However, certain tissues (such as bone) can recover without causing structural or functional damage.

Scarring is made up of the same collagen as the tissue it replaces, but the scar tissue’s composition differs from that of normal tissue. Scar tissue also lacks elasticity, whereas normal tissue has fiber elasticity distributed throughout it. Scars vary in the quantity of collagen that has been overexpressed. The discrepancies in overexpression have been given labels. Hypertrophic and keloid scarring are two of the most prevalent kinds, both of which include excessive stiff collagen coiled development overextending the tissue and limiting tissue regeneration. Atrophic scarring (sunken scarring) is another kind that contains an overabundance of collagen that prevents regeneration. Because the collagen bundles do not overextend the tissue, this scar appears sunken. Some people consider stretch marks (striae) to be scars.

High melanin levels, as well as African or Asian heritage, might amplify the appearance of scarring.

When the body overproduces collagen, the scar rises above the surrounding skin, resulting in hypertrophic scars. For lighter coloured skin, hypertrophic scars appear as a red elevated lump on the skin, whereas darker pigmented skin appears as a dark brown. They commonly appear 4 to 8 weeks after a wound infection or wound closure involving excessive tension and/or other traumatic skin damage.

Keloid scars are a more hazardous type of excessive scarring because they can develop into enormous, tumorous (but benign) neoplasms that grow endlessly.

The absence of development outside the initial incision region distinguishes hypertrophic scars from keloid scars, yet this often taught difference can cause misunderstanding.

Keloid scars can affect anybody, however they are more frequent in persons with dark skin. Surgery, an accident, acne, and, in certain cases, body piercings can all cause them. Keloid scars develop spontaneously in certain persons. Keloid scars are inert masses of collagen that are absolutely innocuous and non-cancerous, despite the fact that they can be an aesthetic issue. They can, however, be irritating or uncomfortable in certain people. They are most commonly found on the shoulders and chest. In wounds closed by secondary intention, hypertrophic scars and keloids are more prevalent. Surgical excision of a keloid is dangerous, as it may aggravate the disease and cause the keloid to worsen.

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