Scarring typically occurs around a wound or lesion that is extensive enough to permanently damage the skin. The primary factor that determines scar formation is naturally the size, type, and location of the wound or lesion and thereafter, how the affected area is treated.

Scars occur as a result of the natural healing process. Rather than concerning itself with vanity, the body quickly shifts into survival mode making quick, sloppy, repairs with basic materials to close off any potential entry-point for infection into the body. Fresh scars tend to be irregular, prominent, and sometimes reddish as blood vessels reform.

Once the scar is formed, the body will go about fixing it up by replacing the hastily assembled type III collagen with type I, which is stronger. The capillaries in time recede and what is left is usually a flat, pale spot that more or less represents the original wound or lesion. Scars will normally be lighter than the surrounding skin due to the lack of pigment cells though in dark skinned people, the area may be darker, or hyper-pigmented.

Of course, a person’s own physiological makeup - genetics, age, etc. - also plays a role as to how well someone heals. Sometimes scarring can be minimized or modified by using certain scar-inhibiting agents such silicone gel sheets.

Irregular scarring

Hypertrophic scars form when the body does not follow up on its early wound-closing phase. The resulting scar permanently resembles a fresh scar. They are raised, firm, and red in color due to the body not replacing collagen or suppressing capillary growth. As a result, the scar never properly fades or diminishes.

Similar to hypertrophic scars, keloid scars also form as a result of the body’s inability to properly update the scar tissue; however, whereas hypertrophic scars stay the same shape and area as the original wound, keloid scars extend beyond and do not regress. Keloid scars tend to be a genetic trait and occur more frequently in dark-skinned people.

Atrophic scars are pits or saucer-like depressions that occur from excessive degradation of collagen in the dermal layer. Atrophic scars typically occur as a result of acne or chicken pox.

Scars don’t ever completely go away but their appearance can be diminished with scar revision treatment. The type of treatment depends on the scar.