The Skin's Three Layers and Scar Formation
We are all familiar with scars and their unsightly appearance, but how much do you know about the three layers of the skin and their role in scar formation? The skin is a complex organ, and the way it forms scars is part of an intricate healing process. You can view this article as an informational guide for understanding the what, why and how of scars. Read until the end to find out what you can do to treat them and prevent irregular scarring.
The skin is composed of three layers, each of which is vitally important for giving the skin its tone, texture, and ability to heal and produce scars. In order to understand why scars form as part of the wound-healing process, or in response to a burn or infected cut, it’s helpful to first learn about the skin’s three distinct layers.
The epidermis is the top, outermost layer of the skin that acts as a waterproof barrier, protecting the body from environmental pathogens. This layer is also responsible for regulating the amount of water released from the body via sweat glands and other forms of transepidermal water loss. Under a microscope, the cells of the Epidermis appear flat and scaly.
The dermis comprises the thick, vascular layer of the skin lying beneath the epidermis. Tough connective tissues, fibroblasts, and collagen constitute the substance of the dermis. Hair follicles, sweat glands, and mechanoreceptors (touch sensors) are also present in this lively middle layer of the skin. Sweat and other secretions emitted by the dermis reach the skin's surface through small openings called pores.
The hypodermis, also known as subcutaneous tissue, is the innermost layer of the skin composed mainly of fatty and connective tissue. The hypodermis acts as a padding layer against shock and force trauma. It also works to reserve energy and maintain the body's core internal temperature. Special connective tissue in the hypodermis connects the dermis to muscles and bones in the body.
Scar production and formation
The dermis and epidermis layers of the skin play pertinent roles in scar formation and work to facilitate a natural, biologic process of wound repair. When a person sustains a wound that penetrates the middle layer of the skin—the dermis—the skin repair response begins. Damage to the dermis layer signals fibroblasts to synthesize massive amounts of collagen
. The collagen is then sent to the wound site, promoting the growth factor.
Collagen is the predominant structural protein not only in the skin of human beings but in the bodies of most mammals. The buildup of collagen at the surface of the skin replaces the previous skin tissue with new tissue, resulting in a scar. In some cases, collagen buildup can lead to irregular scar formation that can be unsightly, painful and burdensome.
Types of scars and their appearance
When the skin repairs itself after, say, a tummy tuck
, or breast reduction procedure
, we notice its imperfect craftsmanship by the presence of a scar. Scars often appear as irregular skin tissue that differs in complexion and texture from the surrounding skin. More often than not, the cosmetic appearance of scars is the only worry people have after a surgery or accident.
Keloid and hypertrophic scars are cutaneous conditions that sometimes occur as a result of excessive collagen production; these are the scars most people wish to avoid. Keloid scars, also known as keloidal scars, are characterized by lumpy, ropey growths on the skin, often purple or red in color. Keloid scar tissue tends to branch out, covering a larger skin area than the wound itself.
are raised and rigged in appearance, with a red or purple complexion. Though not as severe as keloid scars
, hypertrophic scars can still be unappealing and painful. Both of these scar types can occur as a result of a surgical procedure or injury, in addition to any form of piercing or acne scarring
What can you do to prevent abnormal scarring?
As a first line of defense, one should always seek a topical solution
for scar management
before resorting to costly surgical procedures or corticosteroid injections.
There are many products on the market that claim to reduce scarring, but how do you know which ones are effective? Ingredients like onion extract found in Mederma, and Vitamin E found in other popular scar gels, are pure marketing hype. There are no clinical studies that prove the efficacy of these ingredients in scar therapy, and supporting literature is anecdotal and unreliable.
Topical silicone for scar management has been on the market for over thirty years, and numerous clinical trials support its effectiveness as a prominent scar care solution. Biodermis emerged 30 years ago as the number one provider of medical-grade silicone and offers a variety of unique products. Epi-derm Silicone Gel Sheets
by Biodermis come in a multitude of colors, shapes and sizes. And Xeragel
is the purest, 100% silicone scar gel currently available.