My scar SOS
Scars basically fall into 4 categories, which determine their size, shape and hardness
Hypertrophic and keloid scars are more common in people of African descent, although anyone can get them, especially on the chest and ears. If your scar falls into one of these last two categories, scar treatments are available, so see your doctor for advice.
My scar is bleeding
It is normal for a healing wound to ooze a small amount of blood. Simply apply pressure with a clean piece of gauze until the bleeding stops – if it won’t, you will need to see your doctor or go to A&E as you may need stitches. If your wound already had stitches and has reopened (dehiscence), you will need to see your doctor to avoid a wide scar. If old scars re-open and start to bleed, this could be due to a nutritional deficiency, so see your doctor for advice.
My scar is oozing
It is normal for healing wounds to ooze clear liquid called serous fluid for several days, or even weeks, depending on the area. But if your wound starts to ooze white/yellow pus, this is a sign of infection and you will need to see your doctor for advice on whether you need antibiotics.
My scar is itchy
Healing wounds can itch for several years. In the early stages of scar formation, the wound is inflamed, releasing inflammatory mediators including the itch molecule histamine. These stimulate nerves in the surrounding skin. As the scar “knits” together, the mechanical pull also stimulates itch receptors. Over time, this sensation will slowly wane away.
My scar is painful
When a wound is deep enough to leave a scar, nerve fibers can also be damaged. This can lead to burning sensations or pain, in a phenomenon known as “neuropathic pain”. This will usually fade away on its own as the nerve fibers heal and regrow, but can be treated with certain drugs such as amitryptiline. See your doctor if you are uncomfortable.
My scar is pink or red
It’s normal for new scars to be pink or red, that’s part of the body’s natural healing process. As the tissue regenerates, increased blood vessels are formed around it to feed the healing tissue and the influx of cells. The redness should fade away on its own, but if your scar is still red after several months, you may want to see a doctor to ask about the best scar treatments such as silicone patches, steroid shots, intense pulsed light (IPL) and laser treatment for acne scars. Surgical scar revision is also possible and certain scar creams also promote healing.
My scar is black
The body’s natural response to a wound is to generate intense inflammation, with the release of multiple inflammatory mediators. These substances can stimulate the activity of pigment producing cells called melanocytes, resulting in brown or black pigmentation in or around the scar (Post Inflammatory Hyperpigmentation, PIH). This phenomenon is more common in darker skin types, but it can be avoided or reduced by using a high SPF on the healing scar.