When you look in the mirror and notice that some days your scars look better than others, you may be asking the question, “What makes scars worse?”
The answer depends on timing. There are certain factors that affect a wound during early healing and thus affect the formation of a scar. Other factors may influence the scar once the wound has already healed and during the time the scar is maturing.
What Affects Scars During Early Wound Healing
There are five factors that influence how scars look, which are related to the early stages of healing.
1. How did you get the wound?
Was the wound a traumatic injury that resulted in jagged edges? Was the wound the result of surgery where the surgeon was very precise and carefully planned the incision to hasten healing? A physician’s training includes how to make an incision to make it less likely that a scar will be visible. (This is why it’s difficult to find plastic surgery scars.) Precise incisions have a greater chance of wounds closing than those with jagged edges – and thus jagged scars will often look worse than surgical incisions.
The bottom line is that wounds that are tidy heal much better than untidy ones.
2. Your initial wound care
How you take care of a wound in the beginning stages is critical to how it will look later. Was the wound cleaned right away? Or were you in a situation such as hiking outdoors where cleaning the open area had to be postponed for several hours?
The cleaner a wound is, the less likely it will get infected. On the other hand, the dirtier a wound is, the greater the bacterial count is in the wound and the greater the chance it will get infected.
3. Did you get an infection?
There is a connection of infections to ugly scars. Some bacteria and fungi create toxins or metabolic byproducts that destroy tissue. If additional tissue is destroyed during this early stage, the scar that forms later could be uglier.
4. Are you a smoker?
There are many reasons why health experts recommend giving up smoking. Although the biggest reasons are decreased lung capacity and the ability to cause lung or other cancers, smoking also has effects on blood flow. The nicotine in cigarette smoke decreases the circulation to any new injuries. Thus, you end up actually diverting the blood, which is carrying the oxygen and nutrients to the wound to heal it – and decrease the healing of the wound.
When you have a new wound, you may want to consider that it’s a good time to kick the habit of smoking.
5. Was the wound exposed to the sun?
Another factor in what makes a scar worse is sun exposure. The skin cells should be protected during the critical and initial time of healing a wound. Common sense would tell you not to expose a wound to skin irritants or chemicals during this time; the same is true of exposure to the sun. The sun’s ultraviolet rays can harm the newly developing skin and lead to a scar that looks worse.
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