What is Scarring
A scar is a spot on the skin that remains after an injury or wound has healed.
Scars are a normal byproduct of healing, and although they never entirely vanish, the majority of the scar will fade. A scar can be an unnatural proliferation of tissue, a fine line, a pitted hole, or both on the skin.
There are several types of scars. The following are the different types of scars:
- Normal fine-line scars
A cut or other small wound will typically heal with a raised line that will eventually diminish and flatten. This procedure could take two years. There will still be a visible mark or line where the scar was, so it won't go away. Following surgery or an injury, fine-line scars are typical. Although they are typically not painful, they could be itchy.
- Scarring after keloid surgery
An excessive amount of collagen is formed at the site of a lesion, which results in an overgrowth of tissue known as a keloid scar. Even after the wound has healed, the scar continues to spread. Raised above the skin, keloid scars might be pink and red, the same colour as the surrounding skin, or even darker. They frequently itch or hurt, and if they're tight and close to a joint, they may limit motion.
- Scars with hypertrophy
Hypertrophic scars, like keloid scars, are caused by an overproduction of collagen at the site of a wound. Hypertrophic scars, unlike keloid scars, stop at the edge of the original wound. They might continue to get thicker for as long as six months before progressively getting better over a few years.
- Sunken or pitted scars
Some scars from skin diseases, like chickenpox and acne, may appear sunken or pitted. Pitted scars, often called atrophic or "ice-pick" scars, can also emerge from an injury that causes the underlying fat to lose volume.
- Scar contractures
Burns are a common cause of scar contractures. They develop when the skin "shrines," causing tightness and movement restrictions.
How do scars develop
Scars can develop as a result of a chronic condition like acne as well as an acute event like a burn or surgical incision. The size and location of the wound on the body, whether the initial injury was excisional or incisional, as well as the patient's age, ethnicity, and skin type, which can predispose some people to more severe scars, all have an impact on the healing process of the skin and subsequent scar formation. Scars can appear as red, elevated, uneven regions of tissue or as flat, hypopigmented areas of tissue and can also feel uncomfortable, itchy, or hypersensitive.
Silicon's function in reducing scars
The top layer of skin (the epidermis) takes around two weeks to completely heal after a deep cut that penetrates multiple layers of skin. During this time, your body needs a lot of collagen (a protein) to aid in early healing. Thus trying to prevent scars from forming is ineffective.
The new skin that has surfaced after those two weeks is not quite like your usual skin. It loses water more readily, which tells your skin cells to produce cytokines, which are a class of chemical messengers. These signals instruct the fibroblasts, which are other skin cells, to produce more collagen. The scar may appear and feel different from your usual skin due to the additional collagen that rushes to the scar's location.
Silicon in products is a substance that can be placed on the scar. Similar to how your healthy skin maintains moisture, it functions as a layer of your skin and keeps the scar wet. As a result, some of the unfavourable characteristics of scars may be avoided. This may halt the signals instructing fibroblasts to produce an excessive amount of collagen.
Since its effectiveness in the management of hypertrophic and keloid scars became more generally acknowledged throughout the 1980s, silicon-based products have continued to be the preferred clinical scar therapy. Since these studies,1 2 scar treatment has developed significantly with clinical proof.
Benefits of silicone-based products
Biocompatibility, atraumatic removal, prolonged wear time, reposition ability, resistance to microbial development, and hydrophobicity are just a few of the skin-friendly qualities that silicones have.3
The quick adoption of silicone gel adhesive into the medical field has led to its dominance in several healthcare fields, especially those requiring direct skin adhesion, like advanced wound care and scar therapy.
Summary
Scars are traces of an injury or wound on the skin that do not disappear after healing. They normally lessen over time as a normal part of the healing process, but they never totally vanish. Scars can appear in a variety of ways, including as fine lines, raised bumps, pitted or sunken areas, or contracture-like, constricted scars.
Among the various scars are:
- Commonly occurring fine scars: These are caused by cuts or minor wounds, and as time passes, they progressively lose their elevated appearance.
- Keloid scarring: This happens when the body produces an excessive amount of collagen, causing the scar to extend over the site of the lesion. They may be elevated and uncomfortable or itchy.
- Hypertrophic scars: Similar to keloid scars in that they involve excessive collagen creation but remain contained to the original wound's borders, hypertrophic scars get better with time.
- Sunken or pitted scars: Scars that are sunken or pitted can be the consequence of injuries that cause the underlying fat to shrink or skin problems like acne.
Burn injuries frequently result in scar contractures, which, when the skin shrinks, cause tightness and limit movement.
Scars may appear for many reasons, such as persistent problems like acne or sudden occurrences like burns or surgery. The size, location, age, ethnicity, and skin type of the person, as well as the wound, can all have an impact on how scars develop. Scars may be itchy or uncomfortable and have a red, raised uneven, or flat appearance.
Products made of silicone can help lessen the visibility of scars. The skin needs two weeks to completely heal from a severe cut, and during this time, collagen is crucial for quick recovery. However, the newly formed skin is prone to water loss, which stimulates the formation of collagen. The scar may change in appearance and texture as a result. Products made of silicone serve as a barrier, retaining moisture like healthy skin and possibly avoiding the overproduction of collagen, which helps scars look less noticeable.
Due to their biocompatibility, simplicity of removal, extended wear period, resistance to microbiological development, and skin-friendly qualities, silicone-based solutions are preferred in scar therapy.
Since their efficiency in treating hypertrophic and keloid scars was recognised in the 1980s, they have been widely used in medical sectors like wound care and scar treatment.
References
- Perkins K, Davey RB, Wallis KA. Silicone gel: a new treatment for burn scars and contractures. Burns Incl Therm Inj. 1983 Jan;9(3):201–4.
- Puri N, Talwar A. The efficacy of silicone gel for the treatment of hypertrophic scars and keloids. J Cutan Aesthet Surg. 2009 Jul;2(2):104–6.
- Sandhofer M, Schauer P. The safety, efficacy, and tolerability of a novel silicone gel dressing following dermatological surgery. Skinmed. 2012;10(6):S1-7.
