Will you definitely get stretch marks? Why do some scars disappear and others don’t? We break it down for you…

In an ideal world we would embrace our bodies, without having any superficial concerns. Back in the real world, we strive for perfection or our own near-versions of it – we primp, tuck, colour, conceal, hide the signs of years ticking by…   

What is a scar, and why is it there?

Scars form as part of the healing process when the skin and underlying tissues are damaged. New, healthy skin cells are created in the dermis, and work their way up to the skin surface to protect the vulnerable areas directly after a wound is healed. Scars can present in many forms – smooth, lumpy, rough, smooth, pink, white, red, brown – so there isn’t really a blanket classification for all. 

budabar – @123rf.com

What determines the severity of a scar?

The appearance of a scar is determined by many things – your cell turnover, immune system response, general health, age, race, genetic predisposition – the list of contributing factors are long. If the scar results from an injury or surgery, treatment, wound care and hygiene also play a role. 

Different types of scars

  • The average scar for small wounds, trauma and sun damage and injuries is flat and within a couple of shades of your skin tone – it can either be lighter or darker, depending on the type of damage it results from. 
  • Raised or hypertrophic scars (commonly known as keloids) present when your body created more collagen than is required. This can occur in any skin type, but is more commonly seen in darker and younger skin. It seems that genetic predisposition plays a role in keloid scarring as well, although a clear reason for why some individuals develop keloid scars for even the smallest wounds remain unclear. We do know if you’ve had one keloid scar, you’re likely to be prone to them in future. – it’s something to be mindful of when opting for piercings, tattoos and surgery. 
  • Scars can also appear as stretched skin – which we know as good old stretch marks. This most likely occurs when the skin rapidly needs to stretch to accommodate weight gain or pregnancy, but can also occur if the opposite happens – i.e. you loose weight fast. Stretch scars can also occur surrounding wounds that are under great tension. 
  • Another type of scar is sunken scars, where the skin is not necessarily discoloured, but the appearance is dented. This is classified as deep scarring, as it’s a result of underlying tissue damage in the fatty or muscular layers of the skin. It’s most often seen as acne pitting, or around surgical incisions. 
  • Burn scars can vary greatly in degree. They can vary from a flat discoloured mark if it’s a superficial burn, to smooth, raised, keloid-like lesions for deep burns. 
Paisan Changhirun – @123rf.com

How do I improve or remove scars and stretch marks?

If there was a blanket answer we would all walk around with flawless skin! There are multiple options available to improve the appearance of scarring. Most work on a combination of chemical resurfacing to smooth the skin surface (if the scar/stretch marks are raised) combined with therapies to encourage healthy collagen and elastin formation to encourage healthy skin cell growth. 

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It’s a broad scope so we’re not going to try give specific solutions, but here’s a general guide: 

  • If it’s stretch marks or a scar is flat and within a couple of shades of your skin tone, go to a reputable aesthetic clinic for a consultation. These have the best success rate for improvement. There are lasers and needling treatments that show good success rates. 
  • For larger scars that are slightly raised as well as keloid scars, you can start at an aesthetic clinic, but be open to seeing a plastic surgeon as well.
  • For sunken scars and raised burn wounds, it would be best to work with a dermatologist or plastic surgeon.