Scar tissue is the body’s natural response to injury, forming as part of the healing process to repair damaged skin and other tissues. When skin or other structures are injured, the body initiates a wound-healing response that involves the production of new cells, particularly collagen, to fortify the damaged area. Concerns about its behavior, such as whether it can grow or “spread,” are common. This article clarifies the behavior of scar tissue and explains various forms of abnormal scar growth.
The Direct Answer: Does Scar Tissue Spread?
Scar tissue generally does not “spread” in the way a disease or infection might, meaning it does not typically invade or grow into previously healthy, uninjured tissue elsewhere in the body. It forms as a localized response directly at the site of trauma or injury. The perception of scar tissue “spreading” often refers to abnormal growth that occurs at or beyond the original boundaries of the wound.
During the healing process, collagen multiplies quickly at the injury site to form new tissue. While this is a normal part of recovery, the collagen fibers in scar tissue are often laid down in a disorganized, crisscross pattern, unlike the parallel arrangement of fibers in healthy tissue. This structural difference can make scar tissue less flexible and elastic than normal tissue. Scar tissue typically begins to form within the first day after an injury or surgery.
Forms of Abnormal Scar Growth
Certain types of scars exhibit abnormal growth patterns at or near the injury site. These can be mistaken for spreading due to their expansive nature. Understanding these distinct forms of abnormal scarring helps clarify their behavior.
Keloids
Keloids are a type of excessive scar growth that extends beyond the original wound boundaries. These scars are characterized by an overproduction of collagen. Keloids can continue to grow long after the initial injury, appearing as firm, smooth, and sometimes rubbery growths that can be itchy or painful.
Hypertrophic scars
Hypertrophic scars, in contrast, are raised and red, but they remain strictly within the confines of the original wound boundaries. While they also result from excess collagen during healing, the collagen fibers in hypertrophic scars tend to have a more regular pattern compared to the random arrangement seen in keloids. Unlike keloids, hypertrophic scars may regress and flatten over time, even without treatment.
Scar contractures
Scar contractures form when scar tissue tightens over a joint or a large area of skin, significantly restricting movement. This type of scarring results from an intense healing response where myofibroblasts persistently activate and contract the wound. While not “spreading” to new tissue, the tightening effect can create significant functional limitations and physical deformities, especially around joints or areas of extensive burns.
Internal scarring (Adhesions)
Internal scarring, known as adhesions, consists of bands of scar tissue that can form inside the body, often between organs or tissues after surgery or inflammation. These internal “scars” can cause organs to stick together, which normally have slippery surfaces to allow for movement. Adhesions can lead to symptoms like chronic abdominal pain or, in severe cases, cause complications such as intestinal obstruction.
Addressing and Preventing Abnormal Scarring
Managing and preventing abnormal scar formation involves a combination of proactive wound care and specific treatments. Early intervention can significantly reduce the likelihood and severity of these conditions.
Prevention strategies
Prevention strategies include meticulous wound hygiene, including keeping the surgical site clean and moist. The application of silicone sheets or gels after wound closure is often recommended, as these can help regulate collagen production and reduce scar thickening. Pressure therapy, involving the use of pressure dressings or garments, can also reduce the chance of abnormal scar formation, particularly if applied early.
Treatment options
For existing abnormal scars, various treatment options aim to reduce their size, improve appearance, and alleviate symptoms. Common approaches include intralesional corticosteroid injections, which can reduce inflammation and promote scar flattening. Laser therapy targets blood vessels within the scar to reduce redness and prevent growth, while also improving scar texture and flexibility. Surgical revision can be considered, often combined with other therapies, though surgery alone for keloids often has a high recurrence risk. Cryotherapy, which uses extreme cold to freeze and destroy scar tissue, can also be effective, particularly when combined with other treatments.