Last reviewed 08/2022
A scar is used to describe the appearance and formation of a disordered or incomplete connective tissue repair to a wound.
A scar is the final common outcome of tissue repair in mammals. It describes a fibrous growth in response to injury in tissues, but it is most commonly described in relation to the skin. Skin scarring has both normal and abnormal variants. Normal, mature skin scars appear as a pale, fine line. Abnormal scarring can take many forms including contractures and hypertrophic, keloid, atrophic and stretched scars.
The word "scar" derives from the Greek word "eschara" meaning fireplace. In ancient Greece, the fireplace was the focal point for activity within the house and a common agent for producing burn scars.
Scarring may have serious functional consequences such as outflow blockage of a hollow viscus, reduced contractility after myocardial infarction, cirrhosis, blindness with retinal scarring and reduced range of motion for scars spanning joints. Abnormal cutaneous scars can be disfiguring with consequent psychosocial morbidity. Additionally, cutaneous scars may be itchy and painful. Rarely, malignancy can develop at the site of a scar, typically squamous cell carcinoma.
Recent research into the background to scarless or minimally scarring repair in lower vertebrates and in the embryonic environment has led to the several putative protein targets to prevent scarring. Indeed, the fibroproliferative scarring response in higher vertebrates may be an evolutionary adaptation to a dirty environment to ensure rapid healing before overwhelming sepsis supervenes.
Treatment of cutaneous scarring is dependent on the type of scar, its site, stage of development and the effect it has on the patient. Common options include camouflage, massage, corticosteroids, excision, pressure and resurfacing with lasers.