Why Scars Happen, Plus the 7 Best Scar Treatments
By: Dave Asprey
- You might think scars are cosmetic, but they can be painful, itchy, sore, and cause long-term problems like insomnia, anxiety, and depression.
- Scar tissue is made of collagen, the same fibers that hold together normal skin cells, and fibrin, fibers that link together like mesh.
- In scar tissue, the collagen fibers align in the same direction, which makes a much less flexible adhesion when cross-linked with fibrin protein fibers.
- The result: the color is different, the texture isn’t as flexible and is sometimes itchy or painful, pores and hair follicles do not return. Scar tissue is inferior to skin in more ways than you can count.
- Read on to find out why scars form and the best scar treatment for them.
You might think of scars as harmless, cosmetic flaws, but there are plenty of reasons people seek scar treatment. In addition to aesthetics, scars can be painful, itchy, sore, and even cause long-term problems like insomnia, anxiety, and depression. People with noticeable scars lose self-esteem and may find themselves on the receiving end of social stigma.
Scars can be small enough to forget about, or they can seriously impact your life. You’re not vain if a scar bothers you enough to seek out scar treatments.
Chances are, you’ve been told that your scars will be there forever, and that’s not always true. My friend, former sunglass model Andy Hnilo, essentially regrew the skin on his face after he was severely injured in a life-changing car accident. You can hear about that in this episode of the Bulletproof Radio podcast (iTunes). To see him today, you’d never know he had any type of facial injury.
Point is, for certain types of scars, there are things you can do to regenerate your skin. Read on to find out why scars form and what you can do to get rid of your scars.
Why do you get scars?
There’s a pretty good chance you have a few scars somewhere on your body. (Pierced ears? That’s two, right there.) Scars happen almost every time a scratch or cut gets deep down to the dermal layer of the skin or beyond. They form as a normal part of your body’s tissue repair.
Scar tissue is made of collagen, the same fibers that hold together normal skin cells, and fibrin, fibers that link together like mesh. In scar tissue, the collagen fibers align in the same direction, which makes a much less flexible adhesion when cross-linked with fibrin protein fibers.
The result is skin that doesn’t look or behave like non-injured skin. The color is different, the texture isn’t as flexible, the scar is sometimes itchy or painful, and pores and hair follicles do not return. Scar tissue is inferior to healthy, undamaged skin in more ways than you can count.
Some camps hold that scars are permanent and there’s not much you can do to treat scars. Others believe you can fade them, and some believe you can completely get rid of scars and restore your old skin. Here are some things you can do to treat scar tissue.
How to treat scars naturally
There’s a distinct difference between skin that’s held together by collagen and skin that’s fused together with fibrin. Collagen gives your skin its soft, flexible, bouncy quality. It makes your skin thick and also helps your skin cells hold water, which makes it appear smooth. Fibrin in scar tissue makes it stiff and less flexible.
So, when you have an injury, you want to boost your skin’s natural collagen production as much as possible while minimizing the amount of fibrin your skin produces. Here are a few ways to nudge collagen production in the right direction to minimize your scars.
1. Microneedling for scars, acne scars and stretch marks
One to four treatments of microneedling followed by four weeks of topical creams containing vitamins A and C resulted in 40% thicker epidermis in patients with scars and other skin concerns. Microneedling followed by platelet-rich plasma (PRP: platelets separated out from your own blood) is especially effective for acne scars. You have to do this at the doctor’s office. At-home microneedling devices (aka dermarollers) offer similar, but less effective, results.
2. Silicone patches reduce scars
Silicone patches demonstrated more effective collagen production for burn scars. Four months of wearing a silicone patch at night significantly reduced scores on the Vancouver Scar Scale, which tells you how severe a scar is. The effects were even better when silicone patches also contained vitamin E or when used in combination with topical onion extract.
3. Take collagen peptides
Unless you’re super into organ meats, you’re probably not getting much collagen in your diet. Your body can only make collagen if it has the right building blocks to produce it.
While you’re healing from anything, it’s a good idea to take collagen peptides, and combine them with a little extra vitamin C. Vitamin C is crucial for your body to be able to assemble peptides into collagen fibers in your skin.
4. Laser treatment for new and old scars
Laser treatment is well-established as an effective treatment for certain types of scarring in only a few treatments. How few? One study showed that raised, red scars less than a year old were completely resolved in less than 3 treatments. Scars over a year old were resolved in less than 5 treatments.
5. Enzyme therapy for scars
Systemic enzymes are enzymes that you take in pill form, and they act on your whole body.
People have used enzymes successfully to fade and resolve scars. Here’s some of the preliminary science behind enzymes as a potential scar treatment:
- Cleaning scars with a papain (papaya enzyme) cleanser resulted in better collagen formation and more complete cell formation in rats.
- A case study found similar results. Using a bromelain (pineapple enzyme) based cleanser resulted in better skin healing and quality.
- Serrapeptase is a proteolytic enzyme, which means that it digests protein. Silkworms produce it and use it to dissolve their cocoons. It is powerful enough to dissolve fibrin, the protein that gives scars their stiff, tough quality.
- Wobenzym seemed to decrease severe c-section scarring, but the study was too small to reach statistically significant results.
Any combination of enzymes can be marketed as a systemic enzyme, so check labels carefully and choose the combination based on what you want to address. Serrapeptase is the heavy hitter when it comes to scars.
A few notes on systemic enzymes
Don’t take systemic enzymes while wounds are fresh. They will break up fibrinogen, which your body needs to form blood clots and scabs to sew itself up. You need fibrinogen at first to keep wounds from reopening.
Don’t take systemic enzymes while menstruating. It will interfere with stopping your flow when it’s time.
Systemic enzymes work only when taken on an empty stomach. If there’s food in your system, systemic enzymes will digest your food and there won’t be any dissolving action left for your scars. Take them at least two hours after you’ve eaten and one hour before you’ll eat again. Ideal times would be first thing in the morning if you intermittent fast, or before bed if you didn’t snack after dinner. Your functional medicine doctor will tell you how much you should take and how often.
Certain populations have special cautions around systemic enzymes. People with blood disorders, the elderly, children, and other circumstances call for specific instruction. Consult your functional medicine doctor.
If you have piercings, keep them in during enzyme therapy. Your healed piercings are scars too, and might heal over when you didn’t necessarily want them to.
6. Surgical scar removal
A skilled plastic surgeon can work miracles on severely scarred skin. Set up a consultation to discuss what’s possible for your scar treatment. It’s ultimately up to you if you decide to leave it or go through with surgery.
7. Hyperbaric oxygen for treating severe burn scars
Hyperbaric oxygen therapy (HBOT) shows promise as part of scar prevention and healing, specifically for severe burns. Not only did HBOT reduce the length of hospital stay for burn victims with significant skin surface area burns, it also reduced the need for surgery in up to 80% of burns.
Further research is needed to find out why, but preliminary studies show that hyperbaric oxygen improves collagen synthesis after burns.
It’s tempting to want to attack your scars from all possible angles, but it’s crucial to work with a plastic surgeon and a functional medicine doctor to fully evaluate the type and severity of scarring you have, then take that information and design the best scar treatment program for you.