What is a Scar?
A scar is a fibroblastic replacement of normal healthy skin tissue. The tissue forms by force of resolution rather than natural ages and regeneration.
The type of scarring and degree of the scar is determined by many factors, including the size of the initial wound, and the amount of time between the trauma and complete healing of the site.
Other common factors include location and tension on the wound and infection.
Normal skin tissue has a matrix of collagen sheets, compared to scars which have organized unidirectional collagen bundles. This leads to prominent or raised tissue, unlike normal undamaged skin tissue. In some cases, scars require treatment in an attempt to control the stages and growth it is forming.
Typically significant scar formation is separated into two categories; Hypertrophic and Keloid.
Hypertrophic scars are defined as a scar that form an excessive amount of tissue production at the site of the injury, which remain within the boundaries of the initial wound. These can also be subdivided into linear or widespread hypertrophic scars. In most people, these scars soften over time without the need for treatment to control the scar. If control is required, products like medical silicone dressings are a first stage intervention for these scars. This type of scar is the most desired scar formation in relation to scarification. In many cases, we try to keep the scar slightly stimulated in this stage for size and noticeability once healed. Inevitably for most locations, these scars will lose their colour and soften after 5 years, and will not remain as firm and pronounced, becoming less visible.
Scars once healed and during healing, can undergo further treatments to both decrease scar size and increase scar size. We have multiple treatments that we offer in the Studio for scar revision and scar enhancement. The over stimulation of a hypertrophic scar can give the impression of a keloid, however in most cases, this over stimulation is never actually the formation of a true keloid and in most cases will still soften with time; unlike Keloids, which have a tendency of not softening much at all and not reducing much in size.
Keloid scars involve excessive scarring that extends beyond the boundaries of the initial wound and impregnation of surrounding healthy tissue. There are some differences to the formation of the scar and the timeline in which they form, including the types of collagen fibres that form in the scar itself.
Scars can be graded and categorized by their appearance and by individual factors including the size, the scars height or depression, thickness, pigment, vascularity, flexibility, individuals’ pain, itching and discomfort.
Personally, I will not work on those with a medical history of keloid scar formation in healthy wounds or minor wounds. Keloids are not so simply treated and controlled, and in many cases, keloids require treatments such as cortisone injections combined with silicone dressings, cryotherapy and often surgical intervention with reapplication of early stage intervention in the hope of prevention; as prevention is easier than treating the formation of scar tissue once to a sizeable formation. Keloids are renowned for their unpredictable nature, and as growth is not limited to a time frame, they can stay active for years, seem stable and then enlarge further and present a range of discomfort for individuals including pain, itching, disturbance in function and emotional stress regarding appearance.
It is of my opinion that as a modern-day practitioner of scarification with an understanding and education in scar formation and wound healing, that it is negligent to carry out a procedure on an individual with a greater risk of keloid formation. It is myth and uneducated practitioners that spread the ideals of keloid formation as the be all and end all of goals for scar results, when this is not a safe practice.
Traditional scarification and ritual practice are of another discussion and is not what is carried out in a clinical setting, which we offer. Individual spiritual motives may be at hand, or pure love for the art, but I do not offer a compromised service that may result in disfigurement or mutilation, preventing limb function and daily living quality.
My aim is to educate and decorate.