How does the healing process work?
The healing process consists of three stages, each of which plays a vital role in the road to recovery:
1. Vascular and inflammatory phase
Following the injury, a cleansing process begins; the wound rids itself of devitalised or damaged tissue, which is no longer needed to fulfil its primary function: to protect the body. The processes of haemostasis and inflammation help to protect the body.
2. Proliferation phase
The wound takes on a more granular appearance. A multitude of small, ‘raspberry-like’ growths are gradually filling the wound. Its bright red colour is due to the intensive production of collagen and the body’s formation of new blood vessels (proliferative phase). These will replace those that have been destroyed.
3. Remodelling phase and completion of healing
Starting from the edges, the wound finally closes (scar remodelling). The formation of fibrous tissue will replace the granulation tissue and the breakdown of collagen. The area looks drier. New skin, initially pink and delicate, will gradually form until it covers the entire wound, which has now become a scar. This latter will remain lighter in colour than the skin surrounding it.
The appearance of a scar can affect a patient’s life in various ways. First aesthetically as this can be debilitating if the scar is large and/or on a part of the body that is visible. But also psychologically, as the scar is not always accepted and can therefore lead to self-confidence problems. Finally, this can lead to functional problems, limiting the range of motion of a joint and the flexibility of the area affected by the scar.
Various factors will influence healing such as the aetiology of the injury, its condition, its location, its depth, the condition of the skin, whether or not an infection has occurred, the quality of diagnosis and treatment, the age of the patient, malnutrition, oxygenation, vascularisation, disease, taking medication, being obese, or smoking. External factors will also play a part in whether the wound heals well or poorly: pollution, dust and sunlight are factors that should not be overlooked.
Scar development.
Scars can develop in different ways:
- Immature: If the scar has not reached maturity and may still fade. It is red, sometimes itchy or painful, slightly raised.
- Mature: If the scar continues to develop, it will eventually take on its final appearance and will not disappear without surgery. It is flat and light in colour.
- Atrophic: This occurs when the healing process has been interrupted and the amount of new connective tissue formed following a flare-up of acne or chickenpox is insufficient. This appears as small rounded depressions, located below the surface of the surrounding skin.
- Hypertrophic: This scar develops a few weeks after the wound has healed and can quickly spread, though it may eventually fade. Usually red, thick and raised, may be painful or itchy but remains confined to the boundaries of the original wound.
- Keloid: A keloid can develop several months after healing and usually does not fade. It consists of an irregular, thick mass of scar tissue that extends across the skin beyond the original wound, often red in colour or darker than the surrounding skin.
How to reduce scars
It is possible to intervene at every stage of the healing process in order to promote recovery and minimise the risk of complications. Scar management is essential, particularly during the inflammatory phase, which is crucial to the scar’s development. Even the slightest external irritation can have adverse effects, so it is important to protect the scar properly by keeping it in a moist environment and also by using SPF 50 sun cream to prevent the scar from being damaged by UVA and UVB rays.
The best-known treatments involve the application of creams, which can be effective if applied during the healing phase; these include zinc-based creams, corticosteroids and sun creams. Pressure therapy is also an effective method for reducing the appearance of scars; it involves flattening a scar by applying pressure to it. Thanks to silicone gels or silicone sheets, which apply pressure to the scar and help to flatten it.
Other, more specific treatments may also be effective. Dermorestauration is recommended for acne or age-related scars and dermabrasion for protruding scars. A peel promotes skin regeneration and helps to reduce the appearance of scars. Collagen or steroid injections will affect collagen synthesis. Surgery is performed to remove a scar, even if this means a new one will form, which will be monitored. Laser treatment can correct colour and texture imperfections.
There are many treatments for scar reduction. It is important to correctly identify the type of scar and to find the appropriate treatment to promote optimal healing.
URGO, a triple-action gel.
URGO presents URGO Scarform, a triple-action gel indicated for the treatment of hypertrophic scars and keloids, which improves their appearance, filters out 95% of UVB rays thanks to its sun filter, and conceals imperfections with its skin-coloured tint.