Scarred by many falls

Q: I am a 12-year-old girl. I am very clumsy and fall a lot, leaving me with many scars.

An extra layer of skin has grown on some of the scars. I am currently using vitamin E oil but it does not seem to help remove the scars.

Are there other ways to remove them?

A: Scars are produced as a result of the skin trying to repair itself.

They are areas of fibrous tissue that replace normal skin - a biological process of wound repair in the skin. There are three types of scars - hypertrophic, keloidal and atrophic.

Hypertrophic scars occur when the body overproduces a protein called collagen, which causes the scar to be raised above the surrounding skin.

A keloidal scar is formed due to an overgrowth of the granulation tissue that heals the wound, which causes a firm nodule at the site of the injury.

Atrophic scars are flat, thin or depressed scars.

From what you have described, you have developed a hypertrophic scar.

There are numerous types of treatment for scars that can reduce their visibility.

Research has shown that the use of vitamin E is not significantly effective in scar reduction.

Injecting triamcinalone (a form of steroid) into the scar at four-weekly intervals prevents the build-up of collagen that grows beneath the skin's surface, leading to the thinning of the scar tissue.

Non-ablative lasers can also be used to reduce the amount of tissue growth in hypertrophic scars and keloids.

Silicone-based gel, when applied and massaged onto a scar, is able to soften the tissue and improve the appearance of the scar.

Lastly, scar revision surgery may be done. This involves removing the scar partially, or even completely, and closing the new wound very carefully.

Dr Harneet Ranu Eriksson, consultant dermatologist at Raffles Skin Centre and Raffles Aesthetics at Raffles Hospital

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