Any process that can disrupt the epidermis, the outer layer of the skin, has the potential to cause scarring, from inflammatory disorders such as acne and chicken pox to other forms of trauma such as cuts, falls or burns. Consultant dermatologist Dr Ratna Rajaratnam explains that there are a variety of different scar formation patterns - they can be flat, raised or proliferative (ie, overgrown) in nature.
Scars that are flat are the ones that look most like normal skin, however they can be either lighter (hypopigmented) or darker (hyperpigmented) in appearance.
Scars that are raised in nature but confined to the actual area of the scar are called hypertrophic.
Keloid scars are raised but have overgrown outside of the original area of the scar. Afro-Caribbean and people of darker skin types are at increased risks of developing keloid scars. Also scars in some sites of the body such as the chest and upper arms have an increased tendency to become keloid scars too.
Unfortunately, due to the change of cell structure in the skin, scars are normally permanent. However there are various things we can do to reduce their appearance, and help them to fade over time. Remember when your mum would tell you not to pick your scabs and spots? Well, she was right. Dermatologist Richard Barlow (www.baaps.org.uk) says that his top tip for preventing scarring in the first place is to resist the urge, no matter how tempting it may be. The lesions may become deeper as a result. He also strongly advises against intervening too hastily to remedy scarring.
Don't underestimate your body's ability to heal itself naturally, and only consider more dramatic solutions after about 12-18 months following, for example, a bout of chicken pox.
For surgical scars, which are commonly raised, Richard Barlow suggests applying a silicone dressing or silicone gel such as Dermatix Silicone Gel, £29.99 (www.boots.com) on the wound after the stitches have been removed to reduce the severity of the scarring. According to Richard, there are no good scientific studies or journal articles to back up anything other than the use of silicone to treat these types of scars.
Approximately a month after the initial trauma or inflammation to the skin, try massaging scars with oils or other suitable creams in order to soften and flatten them. However, Richard warns against using products that are too oily as this could result in breakouts occurring around the scar and potentially amplifying the problem. Try Heal Gel, £33.50 (www.victoriahealth.com), a specialist anti-scarring product created by leading surgeons that is crammed with skin-healing and anti-inflammatory properties.
For light acne scarring, aesthetician and Cosmetologist Caroline Hitchcock (www.carolinehitchcock.co.uk) recommends using NUBO Diamond Peel & Reveal, £65 (www.nubobeauty.com) once a week in conjunction with a cleanser containing glycolic fruit acid such as NUBO Exfoliating Foaming Cleanser, £35 (www.nubobeauty.com). They stimulate the skin’s rejuvenation and repair process, breaking down dead skin cells and increasing cell turnover. Caroline also recommends products with vitamin C in them as its brightening and healing properties will help scars to fade.
We’d also recommend massaging a few drops of Trilogy Certified Organic Rosehip Oil, £28.50 (www.trilogyproducts.com) onto scars every morning and night to help improve their appearance over time. Crème de la Mer’s The Concentrate, from £225 (www.cremedelamer.co.uk) is also great at aiding skin cell renewal following scar-inducing bouts of acne and chicken pox.
If your scarring is still very obvious after 12-18 months, Caroline Hitchcock suggests the following treatments. She adds that whilst they are all highly effective, it's important to have realistic expectations. Patience is required and none will provide overnight results.
The Derma Roller
Although it may look like a torture device (a hand-held roller with tiny needle pricks all over it), this treatment has seen a recent gain in popularity recently and can treat a range of different types of scarring, ranging from acne to surgery, chicken pox scars and pitted skin. For best results, Caroline recommends at least three Derma Roller treatments, one every 6-8 weeks. Bear in mind that it can be painful, especially if used to treat scars on a particularly sensitive body parts. Using anaesthetic cream to numb the skin beforehand will help though and there is the added bonus of around a 24-hour recovery time (albeit you may look a little sunburnt for a bit longer).
The Derma Roller works by puncturing the dermis (the second layer of skin), which sends a message to the skin's growth factors to repair the cells. This also supplies new blood to the site to increase the healing process as well as promoting collagen production. To treat particularly severe scarring, this could be combined with light therapy too (see below).
Glycolic Skin Peels
Not to be confused with deep acid peels, a glycolic skin peel is an non-invasive option for lessening the appearance of scarring and thankfully they aren't quite as traumatic as acid peels. Affecting the epidermis (top layer) of the skin only, the results won't be as long-lasting as you'll get with the Derma Roller, but will certainly improve their appearance. Particularly effective against acne scarring, the glycolic peel works by removing dead skin cells and stimulating the development of new healthy cells in their place. Caroline Hitchcock recommends three treatments in order to achieve optimum results. The same goes for the following three treatments too.
Another non-invasive option, this treatment deeply exfoliates the skin and stimulates collagen production and the generation of new skin cells.
High Frequency Light
This treatment involves applying a high frequency sterile light current through a glass electrode onto the skin. It encourages the skin to regenerate and therefore lessen the effects of scarring.
Colour Light Therapy
A combination of coloured lights penetrate the skin layers and affect the regeneration of skin cells. The blue light is particularly effective at tackling acne and the green light is great at reducing pigmentation, plus there is the added bonus of virtually no downtime.
The Multi-tasking Treatment
Caroline also offers a treatment for acne scarring which involves a dual diamond, glycolic and lactic acid exfoliation, followed by micro-needling, light therapy and a stage incorporating an oxygen plasma step. It is a complete skin rejuvenation treatment which can be performed on all skin types. It is also indicated for numerous skin conditions such as loss of tone, fine lines and sun damage.
To book an appointment with Caroline, email email@example.com or call 020 8546 7566/07572 416954 for the Derma Roller (£250) and glycolic peel treatments (£60). She also offers microdermabrasion, high frequency and colour light therapy, which are incorporated into a tailor-made facial. These usually last 90 minutes and cost approximately £150. Court House Clinics also offer Derma Roller (from £299), glycolic skin peels (from £55) and microdermabrasion (from £65) (0845 555 5050). The last multi-tasker treatment detailed above by Caroline costs £250 a session or £600 for three treatments.
We wish the beauty industry had more of a selection of scar-concealing makeup. Although few and far between, one of our favourites is dermatologist-approved Cover FX Cream Foundation, £37 (www.houseoffraser.co.uk) which is water-resistant, has an SPF of 30 and comes in a wide range of shades. Cover FX Corrective Specialist Suzi Dos Santos recommends using a powder such as Cover FX's Setting FX Loose Mineral Powder, £29 (www.houseoffraser.co.uk) on top to help seal it in and ensure that it doesn't budge.
Speciality coverage brands such as Keromask London and Veil are also particularly good. Both have sample packs available, Keromask Camouflage Cream and Finishing Powder Sample Kit, £4.99 (www.keromask.com) and Veil Cover Cream Sample Pack, £6.50 (www.veilcovercream.com) which will allow you to find out what your correct shade is, before investing in the full-size products.
We would also recommend a visit to the Mac Cosmetics counter who have a broad range of cover-up shades and textures. Go to www.maccosmetics.co.uk to find your nearest one.