Scars can happen anywhere in the body regardless of age or gender. Other than complications, the cosmetic issue it is causing can be intimidating especially in youngsters. In reality, scars are a natural part of the body’s healing process. A scar results from the biologic process of wound repair in the skin and other tissues. Most wounds, except for very minor ones, result in some degree of scarring. Scars can result from accidents, diseases, skin conditions such as acne, or surgeries. Some scars can be managed by therapies to an extend but most of them are incurable. Covering or hiding them can help in the presentation.
Signs and symptoms
Scars come in many shapes and sizes.
Cicatrix-when this scar first appears it tends to be pink to reddish in colour and slightly raised. It may also be itchy or painful. As skin continues to heal, the scar will flatten and change colour. In time, many flat scars are nearly the same colour as skin. A flat scar may also be paler or slightly darker than surrounding skin.
Hypertrophic scar-This scar rises above the surface of skin.
Atrophic scar- below the surface of skin or depressed.
Keloid- This scar rises above the surface of the skin. Unlike other raised scars, keloids grow much larger than the wound that caused the scar.
Causes
A scar forms when body heals an injury like burns, cuts, etc.
Some skin conditions like Epidermolysis bullosa and hidradenitis suppurativa, can also cause scars.
Pathophysiology
Scarring is a natural part of the healing process after an injury. Its appearance and its treatment depend on multiple factors. When the deeper layers of skin are injured, cells make collagen to repair the wound. Because body makes this collagen quickly, it’s thicker and less flexible than the rest of skin. The thicker, less flexible tissue is a scar.
Diagnosis
Visually diagnosed by a physical examination
Treatments
Silicone gel (sheet or ointment)
Polyurethane dressing
Laser treatment
Corticosteroid injections
Cryosurgery
Radiation
Prognosis
The scar will never completely go away. But there are some methods that can help reduce its size and change its appearance.
Complications
Infections
Emotional Stress
Disease & Ayurveda
Removing scars comes under the name Vaikrutaapaham described in Ayurveda while explaining the post-operative management. It explains the possibilities to manage a scar after a surgical procedure.
Nidana
Kshata – injury (can be accidental or due to any disease like kushtha or induced as part of surgery etc.)
Purvaaroopa
Not mentioned separately
Samprapti
When the Vaata & Pitta gets vitiated on the site of injury, the skin wounded gets abnormal discoloration & inflammation. Kapha causes swelling and hardness. After the injury, a scar is formed due to all three doshas get stucked & vitiated at the site causing discolouration & thickened skin.
Lakshana
Discolouration of skin
Raised skin/thickened skin areas with well-defined or poor defined margins
Divisions
Not mentioned
Prognosis
Kricchrasadhya or Yaapya
Chikithsa
The tissue repair and wound healing are a very important section in Shallyatantra in Ayurveda. Details are in Sushruta Samhita where Varana and vranaropana(wound and its management) are elaborated with sixty treatment modalities of wound care & wound healing. This is called shashtirupakrama(60 fold treatments) for stepwise instructions on therapies for wound healing.
Vaikrutapaham(getting rid of ugliness/abnormality) is the last stage explained it, regarding the management of scars with or without discolouration. It can be done by various methods namely,
Krishnakarma – blackening of a white cicatrix by mdicines like bhallataka, gomootra etc.
Pandukarma – bringing back the normal skin colour to a dark/black scar by using specially prepared medicines with rohiniphala, goat’s milk, kapittha fruit, goat’s urine, kasisa, rasanjana, arjuna etc
Pratisarana -rubbing the area with powder made from shell of hen’s egg, kataka, madhuka, pearl oyster etc mixed with cow’s urine.
Romasanjanana – producing hair by using medicines with burnt ash of ivory, rasanjana etc.
Lomaapaharana/Lomapaatana – removal of hair using medicines like conch shell, haritaala etc.
Samana
Swedanam
Lepanam with Rookshana dravyas
Varnyalepas
Parisheka with varnyakashayas
Abhyanga with varnya oils
Sodhana
Virechana
Commonly used medicines
Drakshadi kashayam
Eladi choornam
Manjishthadi choornam/kashayam
Kumkumadi tailam
Guluchyadi Kashayam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Apple cider vinegar
Aloe vera
Tea tree oil
Turmeric
Milk
Honey
Extra virgin coconut oil
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, fresh fruits and vegetables
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from extreme changes in climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active
Yoga
Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
- PMID: 30793408
The study was done to evaluate long‐term patient‐reported quality of burn scars. Adults with a burn center admission of ≥1 day between August 2011 and September 2012 were invited to complete a questionnaire on long‐term consequences of burns. The vast majority reported at least minor differences with normal skin (POSAS item score ≥2) on one or more scar characteristics and 78.9% of the patients’ overall opinion was that their scar deviated from normal skin. Patients with severe burns had higher POSAS scores, representing worse scar quality, than patients with mild/intermediate burns, except for color, which was high in both groups. A longer hospital stay predicted reduced scar quality in multivariate analyses. In addition, female gender was also associated with a poorer overall opinion of the scar. In conclusion, this study provides new insights in long‐term scar quality. Scars differed from normal skin in a large part of the burn population more than 5 years after burns, especially in those with severe burns.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
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