When Hota Kotb spoke out publicly about how seeing her own mastectomy scars for the first time was shocking, millions of viewers could relate to her pain and embarrassment. Some may relate on a deeper level and feel the emotional impact of scars. Feeling depressed, anxious, and withdrawing socially. This all begs the question: can scars make you sick?
The short answer is yes.
Sure, a scar is only skin deep. However, these marks can alter your quality of life. Experts believe that the psychological impact of having physical scars can be very serious, even if the scar itself is relatively minor.
For many people, scars are reminders — and those reminders can be painful and stir up underlying trauma. The trauma of a disease, an accident, or an injury.
For some, the psychological effects are limited to embarrassment or lowered confidence, and for others, they run much deeper. The psychological impact of scars can diminish your mental health — especially when a traumatic event causes the scar.
Why do scars form
A scar signifies the body’s healing process. When the skin is wounded, the tissue breaks, which causes a protein called collagen to be released. Collagen builds up where the tissue is damaged, helping to “seal” off the wound to keep bacteria and dirt out and prevent infection. New collagen continues forming for several months and the blood supply increases, causing the scar to become raised and lumpy.
Physical Limitations
One area of consideration is scar tissue pain. After scar tissue develops, it can cause the skin to tighten. The limited movement of this area can be uncomfortable or painful. Other causes include nerve damage and the development of fibroblasts — cells that form during scar tissue growth and cause prolonged inflammation.
Although scars symbolize the physical effects of healing, their psychological implications are far more complex.
The Emotional Impact of Scars
The change in appearance that results from a scar can negatively affect body image and self-confidence. Scarring is often stigmatized in society because of the emphasis placed on beauty. Scars and disfigurement are still used to portray evil in horror films, comic strips, and fairy tales.
The presence of scars can result in clear markers of mental disturbance in patients with associated symptoms of depression, anger, anxiety, and post-traumatic stress. A scar can interfere with relationships and cause emotional withdrawal. Scars from lower pelvic surgeries can produce pain making intercourse painful or not even possible. Scars from mastectomies may affect self-image and feelings of femininity.
The emotional impact of scars is just as real as the physical appearance and can be much more painful.
PTSD
According to the Mayo Clinic, PTSD or Post-traumatic stress disorder is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event.
If your scar is the result of a traumatic event or episode, seeing this mark can be a constant reminder and trigger the feelings of the initial incident.
Depression and Anxiety
This Mini-review from PubMed reveals that those with scars undergo remodeling of their emotional state and are more prone to developing depression and anxiety. Often accompanied by feelings of shame and aggression, this creates strain in social interactions and relationships. The results are often stunted communication, reduced intimacy, and avoidant behaviors.
Does size matter?
One of the biggest contributing factors to the negative emotional impact of scars is where they are on the body and not the overall size.
A 2008 PubMed study interviewed 34 patients on the impact scars had on their lives. The researchers collected hundreds of statements from participants and identified five main areas of concern:
- Physical comfort and functioning
- Acceptability to self and others
- Social functioning
- Confidence in the nature and management of the condition
- Emotional well-being
Most of the participants were unhappy about the appearance of their scars because of perceived stigma and unpleasant feelings associated with them. Some adopted coping mechanisms to hide or compensate for scars. Often this made them unsociable and interfered with their communication skills, personal relationships, work, life, and leisure activities.
Scar Treatments and Costs
While in some instances, there is no magic wand we can wave to make scars disappear completely, there are many different scar treatments available today.
PDL Lasers
Background Low-fluence (low irradiation energy density) pulsed-dye lasers (PDLs) have been used for atrophic acne scarring, and anecdotal experience suggests that long-term improvements in inflammatory acne can be seen after one PDL treatment.
Most patients will usually need between 1-3 treatments.
Laser treatment for acne scars isn’t typically covered by insurance. According to the American Society of Plastic Surgeons, the average out-of-pocket cost for laser skin resurfacing is around $2,000 for ablative and $1,100 for non-ablative laser treatments.
Resurfacing Treatments
Removes the outer layer of skin and eliminates skin cells that have been damaged at the surface level. Your doctor may use a carbon dioxide (CO2) laser for deeper scars, or an erbium laser for surface scars.
Scars may require up to 6 treatments depending on the severity of the scar.
According to the American Society of Plastic Surgeons In 2019, the average cost of this procedure was just under $2,000 for ablatives and $1,200 for non-ablatives.
Light therapy
A non-ablative treatment option uses an intense but gentle beam of light to treat scars without damaging surrounding tissue.
You’ll need to be seen one to three times a week for weeks or even months.
In general, expect $25 to $200 per treatment.
Microneedling
Works by penetrating the top layer of skin with tiny needles which induce an increase in collagen production where the micro-wounds are created. The excess collagen acts as a ‘filler’, smoothing out the skin around the scars and improving overall appearance.
You will need at least 3 to 4 sessions if you have moderate scars and as many as eight sessions if the scars are severe. Microneedling done by a dermatologist is considered a cosmetic procedure, so it is not covered by insurance.
Microneedling may cost anywhere from $200 to $700 per session.
Cortisone injections
Typically used for keloid scars. A steroid is injected directly into the scar. This can help soften and then shrink hard scars. Keloids and hypertrophic scars often soften after this treatment.
After several injections with cortisone, the keloid usually becomes less noticeable and flattens in three to six months’ time. Hypertrophic scars often respond completely, but keloids are notoriously difficult to treat, with recurrences commonly seen.
Typically costs around $200 per treatment.
An inexpensive, At-Home Option
The problem with most options mentioned is that they are painful, require multiple treatments, and are very expensive. But there is a great deal you can do to accelerate your healing process and minimize the appearance of scars at home, on your own with an inexpensive and effective self-treatment! This is where scar creams come in.
Dr. Dendy Engelman is a board-certified, award-winning, New York City dermatologist. Dr. Jaliman, known as one of the top dermatologists in the nation, is an expert in the field of cosmetic dermatology as well as medical dermatology.
Here are some expert tips to help minimize your scars
1. Act Early After an Injury
It isn’t always possible to tell if and when an injury or surgery will lead to scarring after it has healed. That said, the earlier you act, the less likely you’ll be to experience severe scarring.
Dr. Engelman’s biggest piece of advice when using scar creams is to start using them as soon as a scar forms, because “it’s easier to treat scars when they are fresh.” Dr. Jaliman agreed, adding, “It all depends on the severity and depth of the scar. But taking proper care of your trauma initially is crucial because it will ultimately dictate how it heals.”
Dermatologists recommend that you keep the recent wound clean (with mild soap and water) and hydrated, cover it with an adhesive bandage to maintain cleanliness and moisture, change the bandage and clean the wound at least once a day, and protect it from direct sunlight. Following these steps won’t just protect the wound from infection — it will also aid in the body’s natural healing process, thereby minimizing scar tissue.
2. Stay Cautious in the Sun
Some people think that getting some color from the sun will help their scars blend in, but on the contrary, any sun exposure can actually cause further discoloration in scars. Scar tissue is more susceptible to sun damage than the rest of your skin, so it is very important to protect your scar from the sun’s ultraviolet (UV) radiation.
The best way to do this is by covering the scar completely for at least the first year! Use a flesh-colored bandage to blend in and don’t worry about having a funny tan line. It’s much more temporary than a darker scar.
If you do venture out into the sun, use sunblock. After the initial year, apply an SPF of at least 30 and wear protective clothing when you will be in the sun for prolonged periods.
3. Apply Topical Treatments
While existing scars cannot always be erased without a trace, you can speed up the fading process by regularly applying certain topical creams, lotions, and gels to them.
Some effective ingredients in these scar treatments include coconut oil, rosehips, Gotu Kola, Vitamin E, and other hydrating materials. If your scar is painful or itches, consider a scar cream with CBD. Keeping your scar hydrated is very important to the healing process.
To Sum it all up
Though our physical scars can be treated, the emotional impact of the scars can sometimes linger on.
As your scars heal, the psychological implications of having them will also begin to fade. For some, this can take months, and for others, longer. If you are having trouble dealing with the mental effects of your scars, try to focus on confidence-building exercises, affirmations, and practice self-acceptance.
There are also promising therapies that are being employed to treat the psychological effects of scarring. Cognitive Behavioral Therapy (CBT) is one that focuses on identifying and changing destructive thought patterns that negatively impact our emotions.
If you feel you are struggling with the emotional impact of scars, you should seek professional help.
Are your scars hampering your self-esteem? Learn more about our scar-reducing solution for your skin.
