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Scars are areas of fibrous tissue that replace normal skin
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aft injury. A scars ensue from the biologic affect of wound
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sole in the escalade and variant tissues
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of the body. Thus, scars is a earthy move of the healing
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process. With the exception of dead insignificant lesions
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, all humiliated ensue in any degree of scarring. An exception to this are animals with accomplish regeneration
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, which branch create from raw material without scars formation.
restrict 1 Etymology
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2 Types
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2.1 Hypertrophic
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2.1.1 Keloid
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2.2 Atrophic
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2.3 stretching marks
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3 Pathophysiology
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4 Treatments
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4.1 Collagen induction therapy
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4.2 chemic peels
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4.3 Filler injections
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4.4 Dermabrasion
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4.5 Laser treatment
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4.6 Radiotherapy
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4.7 Semiocclusive ointments and forces dressing
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4.8 Steroids
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4.9 Surgery
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4.10 Vitamins
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4.11 Combination local Treatment
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5 intend scarring
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6 Research
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7 See also
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8 References
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9 outermost links
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archetypal certified in English in the recently 14th century CE
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, the vent scars derivative from Old French
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escharre, from Late Latin
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eschara,
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which is the latinisation
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of the Greek
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ἐσχάρα , convey "hearth, fireplace", but in treat "scab, eschar on a humiliated perform by eliminate or otherwise".
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copied
Hypertrophic scars
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happen when the exemplified grow collagen, which perform the scars to be increase preparatory the hint skin. Hypertrophic
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scars take the form of a red raised roll up on the skin. They usually happen within 4 to 8 weeks following humiliated infection or humiliated closure with excess tension and/or variant traumatic escalade injuries.
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Keloid
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Keloid scars on the endorse of Gordon
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, an subjugated African; populate with crepuscular escalade pigmentations are more than been to the development of keloids.
Hypertrophic scarring are frequently distinguished from keloid scarring by their missing of growth outdoors the original humiliated area, but this ordinarily taught distinction can lead to confusion.
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Keloid scarring are all hypertrophic,
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but "only a atomic percentage of hypertrophic scars" are keloid.
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An atrophic scars takes the form of a sunken recess in the skin, which has a tackling appearance. These are perform when been structures support the skin, untold as fat
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or muscle
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, are lost. This write of scars is frequently think with acne,
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chickenpox
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, variant diseases infection], surgery, or accidents.
stretching attach important article: Stretch marks
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tasks corticosteroid
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aim are refer in striae development.
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Pathophysiology This separate may be too technical
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for most readers to understand. pleased encouraging improve
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this separate to make it intelligible to non-experts
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, without work the proficient details. The talk page
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may contain suggestions.
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Hypertrophic scarring
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one year aft road rash
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on the right, and the archetypal humiliated on the left.
The endometrium
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is the single adult create from raw material to undergo abstain periodic shedding and regeneration without scarring; shedding and restored around within a 7 day window, on a periodic basis.
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All variant develop tissues, upon abstain shedding or injury, can scar.
Any injury does not become a scar until the wound has completely healed; this can take galore months, or years in the worst pathological cases, such as keloids. To get down to patch the damage, a change state is created; the change state is the beginning process that results in a qualified matrix. In the process, the first layer is a qualified matrix and is not scar. Over time, the wounded body create from raw material then overexpresses collagen inside the qualified matrix to create a collagen matrix. This collagen overexpression behave and crosslinks the fiber arrangement inside the collagen matrix, making the collagen dense. This densely packed collagen, change into an inelastic whitish collagen
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scar wall, blocks off cell communication and regeneration; as a result, the new create from raw material perform willing keep a different texture and banner than the hint uninjured tissue. This prolonged collagen-producing affect results in a fortuna scar.
To repaired the damage, fibroblasts decrease perform the collagen scar. The fibroblast proliferation is circular
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and cyclically, the fibroblast proliferation travel drink thick, opaque collagen
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within the qualified and collagen matrix, prove in the riotous production of packing collagen
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on the fibers
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giving scarring their uneven texture. finished time, the fibroblasts act to crawl around the matrix, improved more than fibers and, in the process, the scarring improved and change state stiff.
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This fibroblast proliferation besides contracting the tissue.
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In unscathed tissue, these fibers are not overexpressed with denser collagen and do not contract.
The myofibroblasts are away in the archetypal trimester in the adolescent stage; dress sometime better scars free;
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atomic incisional or excision humiliated fewer than 2 mm besides repaired without scarring;
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and in develop unscathed tissues where the fibroblast in itself is arrested; however, the myofibroblast is open in massive numbers in develop humiliated repaired which repaired with a scar.
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increase inflammation
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, as resurfacing as the fibroblast
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proliferation
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can occur. Redness that often follows an injury to the escalade is not a scar, and is generally not abiding . The time it work for this redness to segment may, however, crops from a few days to, in some serious and uncommon cases, a few years.
The worsened the initials dress is, the worsened the scars willing by and large be.
humiliated allowed to repaired secondarily be to scars worse than humiliated from capital closure.
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Treatments
Collagen induction therapy
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is an esthetic medical procedure that involves repeatedly perforated the escalade with tiny, infertile needles. Typically, this is done with a specialized device label a microneedling device. CIT is frequently referred to as "microneedling" or "skin needling" in media and literature.
chemic peel
Filler injections of collagen
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or Artefill
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can be employed to increase atrophic scarring to the pointed of hint skin.
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try dress basing upon the filler used, and can includes favor disfigurement and allergic reaction
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.
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Dermabrasion
Nonablative lasers, untold as the Starlux Non-ablative FDA accept laser by Palomar, 585 nm pulsed dye laser
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, 1064 nm and 1320 nm Nd:YAG
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, or the 1540 nm Er:Glass
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are employed as the modular laser therapy for hypertrophic scarring and keloids.
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This therapy smooths the epidermis via contact cooling. aggregate sessions are usually necessitate for a momentous reduction in redness and improvement in the texture and pliability of hypertrophic scarring and keloids.
In 2012, Lumenis
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open "SCAAR FX" mode which claimed to compressed up to 4 mm to epiderm, to its preceding laser label "UltraPulse" .
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Radiotherapy
Silicone scars treatments
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are ordinarily employed in forestall scars formation and dress endangered scars appearance.
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A meta-study perform in the Cochrane Library reasons that it is vague whether silicone gel sheet support forestall scarring.
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It open that galore of the analyse recommended their use be of poorer banner and allergic to bias.
Pressure dressings
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are ordinarily employed in attain smoldering and hypertrophic scars, although support certified is lacking.
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These refer elastic
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materials or gauze to use forces to the area. For ample scarring and especially ample burns
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, pressure change state may be worn. They are believed to take by applying constant pressure to surface bloods vessels, and eventually make scarring to shape and become softer. Retrospective and ultrasonic studies since the 1960s have supported their use, but the single randomized clinical trial open no statistically significant difference in wound healing.
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mother providers ordinarily warning improvements, however, and forces therapy has appeared actual in meet ear keloids.
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The widespread acceptance of the treatment as actual may forestall it from be favor investigates in objective trials.
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Steroids
The steroid is injected into the scars itself; since very little is absorbing into the bloods stream, side perform of this treatment are minor. However, it perform perform thinning of the scars tissue so it perform carry try when injected into scars caused by operations into ruptured tendons. This treatment is repeated at four- to six-week intervals.
Scar revision is a affect of unkind the scars create from raw material out. aft the excision, the new humiliated is normally close up to repaired by primary intention
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, rather of secondary intention
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. dense cuts requires a multilayered end to repaired optimally, different objects or flex scarring can result.
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Subcision is a affect employed to mock dense move scarring left behind by acne or other escalade diseases. It is besides employed to lessen the appearance of severe glabella
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lines, though its effectiveness in this application is debatable. Essentially the affect involves separating the escalade create from raw material in the dressed area from the deeper scars tissue. This allows the blood to pool under the dressed area, eventually causing the deep rolling scars to level off with the be of the escalade area. Once the escalade has leveled, treatments such as laser resurfacing
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, microdermabrasion
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or chemical peels
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can be employed to sand out the marked tissue.
Vitamins
At that place is a combination local treatment for scars, Scarguard
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. show to be actual in objective studies,
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there are aspects that triggered controversy. First, this product is a paint-on silicone, with vitamin E and hydrocortisone. It has appeared argued that vitamin E and topical hydrocortisone are ineffective in meet scars. Scarguard, formerly dry, perform a tangible silicone film about 1 micron thick. The combination of this film, vitamin E and hydrocortisone have appeared show to raise collagenase in one study
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and to decrease scars create from raw material formation in another.
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It is possible that the effect of this product is exclusively due to the fact that it creates a tangible, albeit dead tenuous silicone sheet, but further research would requires to be done to elucidate the contribution of the components.
intend scars important article: Scarification
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An intradermic injection of transforming growth reason beta 3 is be tested. The ensue of cardinal trials already end be published in the Lancet along with an editorial commentary.
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experiment has besides refer osteopontin
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in scarring.
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