Scars are marks left behind when an injured tissue is healed. Scars are fibrous tissues formed when normal tissues are injured or destroyed by some kind of disease, injury, or medical surgery. Most people are troubled by the scarring left behind after surgery or injury because the scar tissue becomes itchy and irritating most of the time. Scar tissue formation is a normal and healthy process that is a healing response of the body. Scars usually become reddish and inflammation also occurs in the scar tissue. There are different types of scars that are of distinct sizes and shapes. The different kinds of scars are usually;
- Stretch Marks: Stretch marks are also called “Striae distensae”. They are a form of dermal scarring that usually occurs after the sudden loss of heavy fat or during periods of growth like puberty or pregnancy. They occur due to the tearing of the dermis (The layer beneath the outermost layer of the skin) in places accumulating heavy fat ratios like the belly, breasts, thighs, and buttocks. They usually start to become less visible but do not completely disappear.
- Atrophic Scars: These types of scars usually occur when the healing process after the normal tissue is destroyed does not properly occur. The scar tissue is formed beneath the expected layer of the skin which makes the scar malformed. This type of scar is usually associated with acne and chickenpox. So, the normal place of their occurrence is the cheeks and chickenpox sites.
- Contractures: These are the types of scars that occur due to the damage and loss of a large area of the skin due to an accident. When contractures form, they tighten the skin around them because they take the help of the surrounding skin tissues to form scar tissue. The tightening causes a decrease in the size of skin in a particular area of the body which can affect the surrounding muscle, joints, and tendons. This causes a decrease in body movement. But don’t worry different surgical treatments are available nowadays for contractures.
- Keloids: Keloids are the protective scars of the skin that protect the skin after a burn or other kinds of tissue damage. It is usually a thick raised scar that is quite visible. Keloids are much bigger than the actual size of the wound. The common places of keloids are earlobes, cheeks, chest, or shoulders but they can be anywhere on the body. They are not of any concern because they don’t affect our well-being but people have them surgically removed because they can be of great cosmetical concern.
- Hypertrophic scars: Hypertrophic scars are quite similar to keloid scars but unlike the keloid scar, a hypertrophic scar remains in the boundary of the actual wound. These scars are usually thick, and elevated and may appear reddish. The formation of the hypertrophic scar normally starts after a week or within some weeks. In most cases, hypertrophic scar starts to become better and improve by itself within a year or after a year. If a person wants to treat hypertrophic scar there is no simple cure available. Steroids are given through injections for their treatment, direct application may also be applied. Surgery is also an option. Usually, after steroid injections, surgery is followed to remove the scar and this process continues for a year or two to completely remove the scar.
CAUSES OF ITCHY SCAR:
Scarring is a form of homeostasis which means that our body’s natural healing response forms scar tissue. There are many factors that may contribute to making a scar itchy. Some of these reasons and causes are given as follows:
- Histamine: It is one of the major reasons for scar itching. Histamine is a chemical that is present inside some parts of the human body. It works with the nerves to produce itching. They are produced by our immune system to remove allergens that have infiltrated our body, in response histamine causes reactions like sneezing and itching to remove those foreign allergic particles. So, if a foreign particle lands on our scar histamine can mistake it for an allergen and cause itchiness in the scar.
- Proliferation: Proliferation is the third phase of the wound-healing process. During proliferation, the cells around the wound start to rapidly increase in number and multiply. Following this rapid increase in the number of cells, the margins of the wound start to migrate toward the center of the cell where the base is present. Simply speaking this migration of the cells toward the center closes the wound and during this process, the mechanical stress due to the wound closing activates different nerves around the wound which results in the scar becoming itchy and tight.
- Due to an Old Scar: The scar can also become itchy if it becomes old. A scar that is at least 2 years old can be considered an old scar. There are various reasons that an old scar becomes itchy. It can be due to the reason that the scar has become very dry because of your dry skin. Sometimes the old scar may itch because the scar is making the skin very tight, this phenomenon usually occurs in those scars which are formed after a skin burn. As we know tight skin becomes itchy so it may be one of the reasons. Another major reason for old scar itchiness can be sudden weight loss or gain because it may make the scar tighter which eventually leads the scar to become itchier. Skin changes may also contribute to making the scar tighter and itchy.
Formation of New Scars.
Scars may also itch when they have newly formed due to an injury or any kind of burn because at that time the nerves surrounding the wound which is recently formed are very sensitive and may cause itchiness at the site as the wound is healing. This healing eventually leads to scar formation which is an itchy process. These types of scars are usually those which are formed due to some kind of cut or scrape, or excessive stretching during exercise leading to stretch marks and scars due to acne blemishes.
Scars formed after surgery:
Itchiness can also occur in those scars which are formed after surgery because surgery cuts are often deep and the scars formed are also in-depth as compared to the normal injury of the skin. So, when the skin after surgery starts to heal it becomes very itchy and can be greatly felt by the person due to the itchiness.
TREATMENT FOR ITCHY SCAR:
The treatment of itchy scars depends upon the type of scar. Your doctor will only advise you on treatment after knowing the nature of the scar. No doctor will ask you to remove any small scar surgically but in the case of a keloid or hypertrophic scar, surgery may be necessary.
Depending on the type of scar a doctor may recommend an invasive or non-invasive treatment.
Non-invasive treatment means that medications are used to diminish the itchiness and improve the overall form of the scar, Doctors mostly suggest non-invasive treatment to a patient. Non-invasive treatments include:
- Using Moisturizing Oils and Creams: Applying moisturizing creams and oils like coconut oil or vitamin E oil can also help relieve the itchiness in the scar, but in new scars, it can also affect the healing process so it should be kept in mind. Overall moisturizing your skin greatly relieves you of itchiness most of the time.
- Applying Silicon Sheeting Bandages: Silicon sheeting bandages can also be used to relieve yourself from itching. They can easily be found at any pharmacy or drug store. These bandages are placed over the scar or can be used as an adhesive.
- Massaging The Scar: Another way to prevent itchiness in the scar tissue is to massage it in a circular motion daily for 10 minutes or at least three times, but the pressure should be applied within tolerable ranges. This method is only helpful for new scars within a period of 2 years, after 2 years scars become old and this method will not be effective.
- Using Special Compression bandages: These bandages keep the scar from getting hard and maintain constant pressure on them. These bandages can easily be found at a pharmacy or your doctor can also have them.
- EXTRA TIP: Always use sunscreen on your scar this will let your scar be the same color as your original skin tone and the scar will not get darkened.
In case the non-invasive methods don’t work and the scar becomes itchier, disturbing, and ugly in appearance, then your doctor will move to the invasive options which include the following:
- Surgical Excision of the Scar: In a surgical excision, the doctor removes the scar by doing surgery only if he is sure that the surgery will improve the scar condition without any abnormality or making it worse.
- Laser Therapy: Laser therapy is also an option that burns the skin beneath the layer of the scar which helps in improving the healing process.
- Cryosurgery: Cryosurgery is a method in which chemicals are used to freeze the scar tissue and then destroy it which also improves the appearance of the scar, Cryosurgery is usually followed by steroid injections, and other medications are also used by doctors.
- Radiation Therapy: In rare cases, radiation therapy is also opted for by the doctors if the scar is not reacting to any other available treatment. Radiation therapy is usually used for keloids or scars which become elevated. It is the last resort used by doctors because it has significant side effects which can’t be ignored.
PREVENTIONS FOR ITCHY SCAR:
If we start to take prevention when our skin gets injured due to some reason then we can minimize the damage and after-effects like itching. Preventions for itchy scars include.
- Keeping your Skin moisturized.
- Keeping the site of the injured tissues clean.
- Don’t scratch the wound.
- Don’t apply any product to your wound which can be allergic.
If you try any of the prevention and the scar still itches or becomes painful immediately consult with your doctor.
WHEN TO GET MEDICAL ATTENTION?
Itchy scars are not too much to concern about because they heal themselves, but if they start to itch frequently and excessively it can be a symptom of a bacterial infection that has been introduced to your scar because of your hands or something else. In the case of a bacterial infection, the scar becomes reddish, painful, and swollen, so you have to see your doctor as soon as possible.
There are also some other reasons to see your doctor such as:
- If it is becoming a nuisance to your daily life.
- If the scar is making the skin painful.
- If you don’t like its appearance, you can also consult with your doctor to remove it.
But in any case, the doctor will not right away start your treatment, he will first diagnose the problem and will start the treatment only then.
An itchy scar can be a nuisance sometimes but it is also a symptom of your wound-healing process, so if the itching is very minor it is not to worry about. You can prevent your scar from being itchy by moisturizing your skin and doing other basic preventions to minimize the discomfort, but if basic treatments don’t work and the scar itching is frequent or excessive consult a doctor.