Scars

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Medical Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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• Scars always occur when tissues have been significantly damaged and repaired.
• Cutaneous scars produce changes that disturb the physical architecture of normal skin.
• Scars can occur after physical trauma or as part of a disease process.
• Poorly controlled wound healing can result in thick, unsightly scars that cause symptoms.
• There is a genetic predisposition in some people to produce thicker, itchy, enlarging scars called keloids.
• Scarring in areas of increased skin tension or movement tend to be unsightly.
• When wounds are produced surgically, physicians utilize techniques to minimize scarring.

Scarring is the process by which wounds are repaired. Damage to the deeper layer of the skin, the dermis, is required to produce a scar. Damage to only the epidermis, the most superficial layer of skin, will not produce a scar. Scars produce a structural change in the deeper layers of the skin which is perceived as an alteration in the architecture of the normal surface features. It is not just a change in skin color.

There is only one type of scar. The appearance of a scar depends on the nature of the wound that produced the damage, the anatomical location of the wound, and a variety of genetic factors that are different for each individual.

A defective healing process can result in a keloid, an unsightly, itchy, thick, red, knobby bump that often continues to enlarge over time. Keloids often are larger than the margins of the original wound.