Q: What are scars?

A. Scars are a natural part of the body’s healing process. A scar results from the biologic process of wound repair in the skin and other tissues. Most wounds, except for very minor ones, result in some degree of scarring.

In most cases, scar tissue is of inferior functional quality to the tissue it replaces. Scars in the skin are less resistant to ultraviolet radiation. Hair follicles and sweat glands do not grow back in the scar tissue.

Q: What causes scars?

A. Scars can result from accidents, diseases, skin conditions such as acne, or surgeries.

Q: How do scars form?

A. Scars form when the dermis (the deep, thick layer of skin) is damaged. The body forms new collagen (a naturally occurring protein in the body) fibers to mend the damage, resulting in a scar. The new scar tissue will have a different texture and quality than the surrounding tissue. Scars form after a wound is completely healed.

Q: What are the different kinds of scars?

A. Most scars are flat and pale. However, in cases when the body produces too much collagen, scars can be raised (i.e., higher than the surrounding skin). Raised scars are called hypertrophic scars or keloid scars. Both of these kinds of scars are more common in younger and dark-skinned people.

Some scars can have a sunken or pitted appearance. This kind of scarring occurs when underlying structures supporting the skin (i.e., fat or muscle) are lost. Some surgical scars have this appearance, as do some scars from acne.

Scars also can appear as stretched skin. Such scars result when the skin stretches rapidly (i.e., as in growth spurts or during pregnancy). In addition, this type of scar can occur when the skin is under tension (near a joint, for example) during the healing process.

Q: Will insurance cover scar removal treatments?

A. If your scar is impairing you physically, your health insurance plan may cover the cost. You can ask your doctor to write a letter detailing your particular case. He or she can also take photos to help prove your case. If you are undergoing scar removal treatment for cosmetic purposes, you will probably have to pay for it yourself. If your scars resulted from cosmetic surgery, your insurance company may or may not pay for treatment. Some plans will not cover treatments that arise from elective surgery that is not medically necessary. Check with your insurance plan.