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Scars & Stretch Marks
Understanding scars from the collagen up
Scars and stretch marks share one root: collagen, the skin's structural framework, healed unevenly. A scar is not a flaw but an emergency repair, laid down fast when an injury reaches the dermis. Depending on whether the skin rebuilds too little, too much or disorganized collagen, the result sinks, rises or streaks, which is what sorts this whole family of concerns.
Too little, too much, or disorganized
When a wound reaches the dermis, the body patches it quickly with replacement collagen rather than rebuilding the skin exactly. Over months of remodelling, this goes three ways. Too little collagen leaves a depressed, atrophic scar, the most common acne scar. Too much raises the skin into a hypertrophic scar or, if it spreads beyond the wound, a keloid. Stretch marks are an internal tear from skin stretched too fast.
Understanding scars and stretch marks
Across this family, the common thread is how the skin heals. Deep injury or inflammation damages collagen, and the repair that follows decides the outcome, sunken, raised or streaked. Genetics, skin tone, tension on the wound and hormones all shape that repair. Understanding which way a scar has gone is what points to the right, and the safe, approach.
Too little collagen
When healing rebuilds less collagen than was lost, the scar floor lacks support and the surface sinks. This is the atrophic family, which includes most acne scars. Because the core issue is a deficit, these scars are treated by stimulating new collagen to lift and smooth the depression, gradually, over several sessions.
Too much collagen
When repair cells overproduce collagen and the remodelling phase does not trim the excess, the skin rises into a raised scar. If it stays within the wound, it is hypertrophic; if it spreads into healthy skin, it is a keloid. Here treatment flattens and softens the excess rather than building more, the opposite direction from a sunken scar.
Stretching past the limit
Stretch marks form when skin expands faster than the dermis can adapt, so collagen and elastin tear internally without an open wound. Cortisol weakens these fibres, which is why hormones matter as much as mechanics. Fresh marks are red and more treatable; mature marks turn white and respond more slowly.
The keloid tendency
Some skin is prone to healing that does not stop, producing keloids that spread and return. This tendency is largely genetic and more common in deeper skin tones. It matters across the whole family, because energy-based treatments are themselves a controlled injury, so a keloid tendency is assessed before any such care.
How to Prevent
Scars and stretch marks we address
Acne Scars
Textural marks left after inflammatory acne, where deep inflammation damaged collagen. They are a relief problem, distinct from the brown or red colour marks acne can also leave behind.
Atrophic Scars
Depressed scars that sit below the skin because healing rebuilt too little collagen. The family that includes most acne and chickenpox scars, sometimes deepened by tethering bands beneath.
Hypertrophic Scars
Raised, firm, often red scars from too much collagen during healing. They stay within the borders of the original wound and often soften and fade partly over time, unlike keloids.
Keloid Scars
Raised scars that grow beyond the original wound into healthy skin, from healing that never switches off. Largely genetic, they tend to return and call for cautious, individualized care.
Stretch Marks
Parallel streaks from skin stretched faster than the dermis can adapt, tearing collagen and elastin internally. Red and more treatable when fresh, pearly white and slower to improve once mature.
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