Linda Crampton is a writer and teacher with a first-class honors degree in biology. She often writes about the scientific basis of disease.
Scar Tissue and Its Function
Scar tissue forms in injured areas of our bodies and replaces cells that have been destroyed. It appears either inside the body or on its surface and is a normal part of the body's healing process whenever we have a significant injury. Scar tissue acts as a barrier and protects the place that was injured, but it unfortunately lacks the functionality of the original tissue and has low elasticity. On the surface of the body, it may be a cosmetic problem or may even be disfiguring. Medical treatments may be helpful for both external and internal scars.
Scar tissue on our skin looks different from the surrounding area and is usually referred to as a “scar". Some people develop hypertrophic scars on their skin. These are larger than normal and have a lumpy appearance. Keloid scars are raised and spread beyond the wound. Atrophic ones are sunken and form depressions in the skin. Inside the body, scar tissue in the form of adhesions or fibrosis may cause problems.
Scars on the skin form when the dermis is damaged and collagen fibres fill the injured area.
Fibrous Connective Tissue
Scar tissue is made of fibrous connective tissue. This tissue supports and connects body structures and holds them in place. It contains fibres made of a protein called collagen. It also contains cells called fibroblasts, which make the collagen, as well as water and carbohydrates.
Fibrous connective tissue is sometimes known as dense connective tissue because the collagen fibres are densely packed and there are comparatively few cells present. It's a normal component of the body and is present in uninjured areas. Researchers have discovered that the connective tissue in scars has a slightly different structure from the normal form, however. The collagen fibers have a different arrangement and give the area different properties from normal skin.
Scars on the Skin
Scars may be caused by wounds such as burns, surgical incisions, physical injury, chemical injury, infections, diseases, inflammation, and acne. Not all wounds cause scars. There must be significant damage to the body before they form. Some people tend to form scar tissue more easily than others, however.
Scars on the skin are red when they are first made due to an increased blood flow as the wound heals. Over time, the blood supply decreases and the area becomes paler. It may take many months or even years to reach its final form. Scarred areas are generally thicker than their surroundings and lack hair, sweat glands, and melanin (the pigment that helps to protect the skin from ultraviolet radiation).
Stretch marks are a type of skin scar. They often develop due to stretching of the skin during rapid weight gain. In some cases, as in pregnancy, their formation is influenced by hormones.
Reducing Scar Formation
The first structure that forms in a wound is the blood clot, which prevents blood loss. The clot may be replaced by scar tissue. Scarring can be reduced by making sure that the edges of a wound are brought close together during the healing process. When the edges of a wound gape, scar tissue may be formed to fill in the gap.
Good wound dressings, good nutrition, and appropriate medications (such as prescribed antibiotics) can help to protect and defend an injured area. The amount of scarring and the final appearance of a scar depend mainly on genetics and age, however. Older people tend to scar more easily than younger people. Their bodies may not make enough of the normal skin cells needed to replace the ones that have died.
Although we can discourage our body from producing scars, it's hard to completely avoid the process. Surgeons are well aware of the body's tendency to scar. They often try to make their incisions in a direction or a place that will minimize scarring or that will minimize its visibility.
Though the video below is presented in cartoon form, it contains some useful information about the structure of a scar.
Raised and Sunken Scars
In a hypertrophic scar, too much collagen is made. The scar forms a raised area or lump above the wounded area of the skin. The lump is often pink in its early stages and may be itchy.
Keloid scars grow beyond the wound, forming a reddish tumour. This tumour is benign (not cancerous) and consists mainly of collagen. Raised scars should always be assessed by a doctor to make sure that they are harmless, however. Keloid scars may form as a response to injury, but in some people they form spontaneously with no known cause. They may be itchy and create a burning sensation.
Atrophic scars look like pits in the skin and may be formed during problems such as acne and chicken pox. In this type of scar, the body doesn't make enough connective tissue to fill in the wound.
It may not be possible to completely remove some scars on the skin, but they can probably be treated to make them less noticeable. The improvement in appearance may be very significant. Treatments may require weeks or months to be effective, however. Many scars fade to some extent on their own as time passes. I have a small scar on my thumb that after many years is barely visible.
Some treatments that may be recommended by a physician include the following.
- Pressure applied to a scar or silicone sheets placed over the area may improve its appearance. These treatments may flatten raised scars and make the altered area paler.
- Doctors may inject corticosteroids into a raised scar to inhibit collagen synthesis and reduce inflammation.
- Surgical techniques can remove some scars, but the body may make a fresh scar as it heals itself from the surgical wound. The new scar may look better than the old one, however.
- In dermabrasion, the surface layer of scarred skin is removed in an abrasive process. Laser surgery can be used to remove the raised surface of a hypertophic or keloid scar.
- A different type of laser treatment can improve the appearance of acne scars. The treatment stimulates the formation of new collagen, which partially fills in the pitted areas.
- Skin grafts may be used to cover some scars, such as those created by burns.
The liver is a large and important organ that appears to consist of two lobes when viewed from the front of a person's body, as shown in the illustration above. Two additional and smaller lobes are located on the underside of the liver and are hidden from view. They are shown in the illustration below.
Scar Tissue Inside the Body
As a result of trauma, fibrous bands or sheets may form inside the body. These bands are known as adhesions because they join structures or different parts of the same structure together. Adhesions arise due to the inflammation caused by conditions such as surgery and infections.
Another type of internal scar tissue is fibrosis, or the buildup up of excess fibrous connective tissue in a particular location in the body. Fibrosis may occur inside organs. Sometimes the cause of the fibre buildup isn't known, but in other cases it appears after an injury and acts as scar tissue.
Scar tissue in the lungs is known as pulmonary fibrosis. The production of the tissue in the heart may be caused by a heart attack and the accompanying death of heart muscle. Cirrhosis of the liver, a condition in which normal liver tissue is gradually replaced by scar tissue, may result from excessive alcohol consumption, a hepatitis B or C viral infection, accumulation of fat in the liver (nonalcoholic steatohepatitis or NASH), and other causes.
Adhesions often cause no symptoms, but they sometimes produce pain and other problems. They may cause organs to change their shape or move out of their correct positions. They may also prevent the movement of a structure that should be moving.
Scar tissue in an organic may be more problematic, but doctors can help the situation. The formation of the tissue in the lungs may reduce the amount of oxygen that can be absorbed. In the heart, scar tissue may increase the chance of an irregular heartbeat (arrhythmia) because the damaged tissue interferes with the electrical signal that triggers the heartbeat. The liver has many vital functions. Cirrhosis of the liver can sometimes be a serious condition, since the scarred area is unable to perform the organ’s normal jobs.
In the illustration above, 1 = right lobe of the liver (from the owner's point of view), 2 = the left lobe, 3 = quadrate lobe, 6 = caudate lobe, 7 = the inferior vena cava (a large and major blood vessel), and 13 = the gall bladder (which stores bile produced by the liver).
Possible Treatments for Internal Scar Tissue
Adhesions may improve on their own. They can also be removed surgically. There is a risk that new adhesions will develop after the surgery, however. Doctors sometimes place a thin barrier material around an organ during surgery. The barrier prevents the attachment of adhesions and eventually dissolves.
Doctors do have some techniques for dealing with scar tissue in hearts, livers, and other organs, but extensive scar tissue can sometimes be hard to manage. Once cirrhosis of the liver starts, the replacement of liver tissue with fibrous tissue may be progressive. Treatments that may help the condition exist, however.
Dealing With Scarring
Scar tissue formation in our bodies is often unavoidable, but the good news is that there are steps that we can take to prevent or reduce the process. Proper wound treatment and a healthy lifestyle can decrease the probability of scar tissue formation or decrease the amount that's made.
If scars do form, medical treatments can often improve their appearance and even remove some of the scar tissue. Makeup can hide many skin scars that can't be completely removed. In addition, clinical trials are being performed to test new treatments that may be more effective than the current ones.
References and Resources
- The National Institutes of Health or the NIH has created a web page containing information about different types of scars. The page contains a link to a list of clinical trials of new treatments.
- The Columbia University Medical Center also has a page with information about types of scars and their treatment.
- In addition, the website of the NHS (National Health Service) has a page describing scars and their treatment.
- WebMD has an overview of cirrhosis of the liver.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2011 Linda Crampton
Linda Crampton (author) from British Columbia, Canada on September 06, 2017:
I'm sorry that you are in such discomfort, Lucy. I'm afraid that I can't give you advice, though. A doctor needs to do this.
lucy ashley on September 05, 2017:
I have adhesions that are attached to my intestines and they cause me a lot of pain and distress I am 80 years old and the doctors say that until I have a complete blockage they will not operate do you have any advice for me
Linda Crampton (author) from British Columbia, Canada on August 04, 2017:
Hi, Faraz. You would have to ask your doctor this question. He or she will be able to give you better advice then I can. I hope you get help for the scar.
Faraz Ahm on August 01, 2017:
Hi, I have discoid lupus scar (atrophic) scar on my scalp and it is disfiguring. Does platelet rich plasma (PRP) therapy help to improve the condition of the scar ?
Linda Crampton (author) from British Columbia, Canada on July 13, 2017:
Hi, Shirley. Your scars sound interesting! Your doctor should be able to explain what is going on.
Shirley on July 12, 2017:
I have scars that are 50 years old and you could not really see them. Then they all decided to puff up and turn red very noticeable . Then it goes away then a few years later it comes back .any idea.
Linda Crampton (author) from British Columbia, Canada on June 14, 2017:
Hi, Lexychan101. An adequate amount of the required vitamins in the diet can often improve general health and the ability to heal. Your doctor may be able to give you more specific advice in relation to vitamins and scarring.
Lexychan101 on June 12, 2017:
Hello, I was wondering if vitamin deficiency could be the cause for easy scarring?
Linda Crampton (author) from British Columbia, Canada on February 22, 2017:
Hi, Joan. According to what I've read, it is possible to get scars after laser treatment, but the incident is very low, especially if the doctor is skilled and experienced and infection is avoided. You should ask a doctor familiar with your problem (if you have a problem) for specific information that applies to your case.
joan on February 22, 2017:
can you get scare tissue from lazar surgery?
Jane on November 16, 2016:
Can a twenty year old scar form additional tissue?
Linda Crampton (author) from British Columbia, Canada on August 27, 2016:
Hi, Jo1963. You need to seek your doctor's advice as soon as you can. He or she will know what is happening in your situation and will be able to help you. I can't do this, since I'm not a physician. I hope your lip problem is solved soon.
Jo1963 on August 27, 2016:
I had a operation 17 days ago to remove built up filler on both lips. Healing was going great, but on the 15th day I noticed my skin was getting very tight around my mouth area. This happened very rapid, I now have no motion in my lips, I can't smile and am finding it hard to clean my teeth. My opening of my mouth has become much smaller. Please tell me this isn't scar tissue :(((( I am in bits......
Linda Crampton (author) from British Columbia, Canada on August 19, 2016:
Hi, Maribel. I'm sorry that you had to have two surgeries so close together. Since a doctor has told you that scars are causing your pain, they may well be the cause of your problem. Since I'm not a physician, however, I can't diagnose medical problems that an individual is experiencing. If the pain doesn't go away, I suggest that you see your doctor again or that you visit a different doctor if you'd like a second opinion. I hope your problem is resolved soon.
Maribel on August 19, 2016:
Hi I just had surgery I got my gallbladder removed but dr punctured my bile duct so I had another surgery within a week of having my first surgery I've been having strong pains whereby had my surgery I had ultrasound but everything came out negative doctor told me my scars are thick from inside that is what is cause my pain but my pain travels to my back and suffocates me could it be the scars?? Thank you
Linda Crampton (author) from British Columbia, Canada on August 16, 2016:
I hope a quick fix is found too, Nickel Quarter. I'm sorry that you've experienced such bad pain. Hopefully the treatment that you eventually get will be helpful. Best wishes.
Nickel Quarter on August 16, 2016:
After a visit to an Urgent Care for what I thought was bone spurs in my toe, I come to find, it is scar tissue from a previous fracture, oddly enough I never knew it happened. I was told I may have to have the tissue removed. Working 2 jobs where I'm on my feet all day is not helping and I've literally broke down crying before because it hurts so bad. I hope one day they actually find a quick fix for this other than surgery, or just waiting.
Linda Crampton (author) from British Columbia, Canada on April 29, 2016:
I hope a solution is found for your situation one day, Ernesta. Thank you for the comment.
ERNESTA MBOGO on April 29, 2016:
I had a TL 6 years ago and those adhesions have formed its uncomfortable and as the doctor says if you insist on surgery it might cause other adhesions i have learned to live with it
Linda Crampton (author) from British Columbia, Canada on December 20, 2013:
As I said to the previous commenter, I'm sorry about your scars. I can't help a specific problem, however, because I'm not a doctor. Please visit your physician for help.
Fifi on December 20, 2013:
I've got lots of scars on my legs ,these remind's me of my teenage period. I was careless when I was a child, these scars makes me feel ashamed to expose legs. What do I do about it.
Linda Crampton (author) from British Columbia, Canada on December 02, 2013:
Hi, dalima@2. I'm sorry about your annoying scars. There are treatments that may improve the appearance of scars, as I describe in my article, but you need to visit a doctor to try these treatments. Good luck.
dalima@2 on December 02, 2013:
I've lots of scars on my legs ,these scars remind's me of my teanage life. I was very rough when i was a child, these scars piss me up when ever i look at. What can I do to make the scars lessnoticable
Linda Crampton (author) from British Columbia, Canada on October 21, 2013:
Hi, MIMI. I'm sorry about the car accident. I'm afraid you'll have to consult a doctor about your son's rash. I'm not a doctor myself, so I can't give medical advice to individuals. I'm sure your physician will be able to help you, though,
MIMI on October 21, 2013:
Hi, my son en i were in a road accident about two months ago, recently he has developed rashes on the scar, what cn i do about it,what could be the cause?
Linda Crampton (author) from British Columbia, Canada on August 20, 2013:
Thank you for your visit, dr sitaram kanuja. I am neither a doctor nor a lawyer, so I cannot describe exactly how long a scar will take to heal or give any medicolegal information. These are questions that you should ask your doctor. The doctor may be able to make an estimate of scar duration if he or she sees a specific scar and knows your medical history. The doctor will also be able to suggest the best treatment.
dr sitaram kanujia on August 20, 2013:
iwant to know duration of healinng process of scar &its medicolegal importance
Linda Crampton (author) from British Columbia, Canada on May 13, 2012:
Thank you for the comment and for forwarding this hub to your friend, STEVEW13! I hope that your friend is able to get some help for her scar.
Steve Wright from Norwich, England on May 13, 2012:
This is a very interesting hub, I have a friend who has some scarring that they are very conscious of and who I know was recently looking up information in them. I will certainly be forwarding this on to her. Thanks for sharing
Linda Crampton (author) from British Columbia, Canada on January 26, 2012:
Hi, pam g. There are several possible reasons for internal scar tissue, as I mention in my hub. I'm a biology teacher, not a doctor, so you should ask your surgeon or doctor what could have caused the scar tissue in your particular case.
pam g. on January 26, 2012:
Recently had gallbladder removed: surgeon said extensive scar tissue over liver, small intestines and omentum. What would cause this: only previous operation a tubal ligation through navel?
Linda Crampton (author) from British Columbia, Canada on July 13, 2011:
Thank you very much for the visit and the comment, b. Malin. It is good that improved methods of scar tissue treatment are being created. Some stores and companies do sell over the counter scar treatments. I've read that these treatments may work, but some researchers think that it's the pressure on the scar and the moist healing environment created by the dressings that's improving the appearance of the scar. It will be interesting to see if scientists can discover for certain why scars improve with these treatments!
b. Malin on July 13, 2011:
Wow, another Interesting Hub on Scars and Scar tissues, and Internal Scars Alicia. I too have some Scars. Its so good to read the improved methods for getting rid of some scaring. I've seen they even make an "over the counter" treatment, I'm not sure how good it is.
Linda Crampton (author) from British Columbia, Canada on July 12, 2011:
Hi Tina. You're right - my scar reminds me of the incident I experienced as a teenager that created the scar, and also reminds me of how lucky I was to suffer from nothing more serious than a scar as result of the incident! Thanks for the comment.
Christina Lornemark from Sweden on July 12, 2011:
Great article about scars! Every scar is a reminder of the event that created the scar, some memories a good, others are bad. Interesting to read why some people get bad scares that are very visible while some people don't. Sadly I belong to the group that gets ugly and very visible scars. But I have learned to live with them, they are a part of me.
Linda Crampton (author) from British Columbia, Canada on July 11, 2011:
Hi, GetSmart. I've been lucky with scars so far - I have one small scar that isn't very noticeable, so I'm not worried about it. Thanks for the visit and the comment!
GetSmart on July 11, 2011:
I have a few scars that I would love not to see so much of! Very interesting article. Thanks!