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Find a Scar
Removal Specialist
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Patient Education
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 | | The Patient’s Guide is the most respected online publication providing information about scar removal. Our mission is to provide you, our reader, with unbiased, scientifically accurate information about scars, as well as potential treatments. | | >>More About the Patient's Guide | |
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| It’s rare to reach adulthood without some kind of scar. That’s because almost any injury to the skin—other than your run-of-the-mill superficial scratch or cut—is likely to damage the dermis, the tissue located right below the epidermis, or top layer of skin. When the dermis becomes injured, the body reacts by producing fibroblast cells, the most common cells in human connective tissue. Fibroblasts in turn make protein-based collagen fibers, which quickly get to work filling in the gap in the skin left by the injury.
Medically speaking, a scar doesn’t form until the wound has completely healed. | | What Causes Scars to Look Either Raised or Pitted? The collagen fibers produced by the fibroblasts never fill in the gap in the skin to the exact level as the surrounding tissue. Sometimes there is an overproduction of fibers, causing a raised hypertrophic scar to form. And sometimes the underlying structures that support the skin, such as fat or muscle, are destroyed during the injury. The resulting scar then appears as an indentation in the skin. Why Does a Scar Differ from Surrounding Tissue? Mature surface scars are often paler than the surrounding skin due to a lack of a blood supply. They also lack sweat glands and hair follicles. (That’s why hair doesn’t grow back on scar tissue.) In addition, scars do not have the same sensitivity as normal skin tissue—and are more vulnerable to ultraviolet light from the sun. What Causes Stretch Marks Stretch marks, which are sometimes classified as a type of scarring, are also caused by damage to the dermis. In this case, however, the injury occurs without breaking the skin’s upper layer (epidermis)—and the damage is to the elastin fibers in the dermis. It has nothing to do with collagen. Elastin is the netlike protein that gives skin its flexibility and ability to stretch. It makes up only 4 percent of the skin’s total weight, but it’s very difficult to repair. Contrary to popular belief, stretch marks (striae) are not caused by the skin becoming stretched. Instead, their formation is triggered by hormonal changes, such as the kind that occurs during pregnancy and puberty or as the result of taking steroid drugs for a prolonged period of time. |
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Ask The Doctor
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