In its simplest medical sense, scar tissue is connective tissue that has formed over a wound through tissue such as skin, muscle or internal organs. The human body is incapable of reforming damaged areas back to their original composition so a fibrous tissue is rebuilt in its place. This replacement tissue has limited capabilities compared to the original – for example, in its ability to produce sweat.
The process of wound healing is a complicated one, and the resulting scar can vary in appearance greatly from person to person, and also greatly even on one individual, depending on the location and type of injury
Different types of scar tissue
- Atrophic scars are sunken, depressed areas of scar tissue. The scar tissue is generally very thin and weak, and blood vessels can be seen very close to the surface. They are caused when insufficient collagen is laid down in the wound. This sort of scar tends to be formed as the result of acne, though some scarification work (especially when no aftercare regime is followed) will result in this sort of scar.
- A wound healed under optimum conditions will form scar tissue that is almost the same colour and thickness as the skin around the wound, and be substantially smaller than the original wound. The body tries to form scars which mimic the tissue around them. A large number of scarification pieces heal like this, most of the people who get scarification work are young and healthy, and consequently their bodies heal wounds very well, even if aftercare techniques are followed. For the first couple of months the scars may be red/purple, but over time they will fade through pink to white, leaving a very subtle effect on pale skinned individuals.
- Hypertrophic scars are raised scars which do not extend beyond the border of the wound. They are formed when the rate of collagen production in a wound exceeds the rate of collagen breakdown. Unlike keloid scars, the collagen fibers are still aligned evenly within the scar, so the scar will be more even, and less likely to be painful when you move. Hypertrophic scar formation can be encouraged by giving the wound a difficult healing environment, although the predisposition to forming hypertrophic scar tissue is a genetic trait. Hypertrophic scars sometimes form next to piercings, especially on the ear. They often fade in colour and become less raised over time, especially when any irritant (i.e. piece of jewelery) is removed. Wearing high quality, well-fitting jewelery and massaging regularly with Vitamin E oil can help reduce hypertrophic scar tissue around piercings.
- Keloid scars are large, raised, generally uneven scars that extend beyond the border of the original injury. The word ‘keloid’ is very commonly misused by individuals who are actually referring to hypertrophic scarring. People with dark skin are much more likely to form keloid scar tissue, especially on the back, shoulders, upper arms, and earlobes. Keloid scars are formed when the rate of collagen production in a wound exceeds the rate of collagen breakdown, and the collagen fibers align themselves in a random pattern (as opposed to in parallel lines as in normal scars). It is not known exactly what triggers the formation of keloid scars, but it is thought that the wound healing factors mentioned above can influence keloid formation. Keloid scars tend to increase in size over time. Keloids also occasionally form next to piercings, and while removing the jewelery and rubbing with Vitamin E oil may help, it is likely that a medical professional will have to assist with their removal.