Types of healing

There are different types of skin healing because not all wounds are the same. Different mechanisms of lesion production result in more or less deep injuries.

It is also important to consider which skin layer has been affected, since it consists of three layers: epidermis, dermis and hypodermis or subcutis. The epidermis is the most superficial layer and in contact with the outside, while the hypodermis is the deepest, in contact with the inside of the organism.

The middle layer of the skin is the dermis and is capable of producing pathological scars when it is affected by a wound deep enough to penetrate it. The dermis is a highly specialized tissue, and hence the difficulty of the body to achieve repair.

Let's first see how the skin reacts to a wound to produce the scar, and then we'll see what types of scarring are possible.

Healing phases

When the skin receives a wound it unleashes a series of successive phenomena to repair it. The way in which these phases are carried out is what determines the types of healing. The phases are five and we explain them to you:

1. Coagulation and vascular response

The injury just happens, the blood causes a wound wash. Foreign bodies are dragged out of place to avoid infections. Subsequently the vessels close to clot and stop bleeding, with the help of platelets.

2. Inflammation

The second phase is the inflammatory. While the skin is reddened, this has nothing to do with the onset of an infection. The redness of the inflammation is due to intense cell movement and increased blood flow. A clear inflammatory fluid may even form in the wound that is also not a sign of infection.

3. Granulation

Now the essence of the repair begins. The cells that are most involved are fibroblasts, who travel to the site of the injury to produce collagen. Collagen is the main component of the dermis, therefore, it is the one who replaces the lost tissue.

To continue discovering: How to increase the natural production of collagen

4. Epithelization

A final function of wound repair is to restore the layer that separates the external from the internal. The skin has its barrier function thanks to the epidermis. Epithelialization, then, consists in re-forming epidermis that disappeared through the cells called keratinocytes.

5. Remodeled

Once the wound is closed, the body must define what the final appearance of the scar will look like. If the wound only affected the epidermis, possibly there is only cell regeneration and the scar tends to be normal. Instead, if the wound was deep there is more chance of getting a pathological scar.

Wounds that affect the dermis are more likely to form a pathological scar.

Types of healing

The phases of skin healing are always the same in all wounds, but not all wounds are equal. That is why three types of healing have been identified in the world of dermatology and surgery:

First intention

This is the name of the process that happens when the wound is small, It is not deep and there is approach between the edges of it. It is very rare to leave a long-term scar.

Ulterior motive

This is the healing process of a deeper wound, which affected the dermis. The result is usually a larger than usual scar and a striking appearance. The main cause is the loss of substance or the existence of a very large distance between the edges of the wound. When that happens, the dermis must form a lot of new tissue in the granulation stage, and that is the reason for the final deformity.

Third intention

This type of scarring is associated with medical intervention. It happens when a second suture is surgically performed on an existing first, or when dermal grafts are added to repair. It is a final scar guided by health intervention.

You may be interested: Treatment to erase or reduce scars

Types of scars

The scars can be normal or pathological. The latter can be excessively large or deep.

While there are normal and expected scars, there are also those considered pathological scars. Let's see how they classify for medicine:

  • Normal: It is what happens after a usual process. The end result is a thin line.
  • Atrophic: It is the loss of substance in the skin, when there is a small depression in the area where the wound was. It is a very common presentation of acne, for example.
  • Hypertrophic: they are scars caused by types of scarring with excessive collagen production. The resulting skin is thick and protrudes above the level of the normal epidermis. It usually happens in areas of the skin with constant movement, such as the knee.
  • Keloid: It is the excessively larger hypertrophic scar. It can itch and even cause some burning. It usually extends beyond the initial limits of the wound that caused it.
  • Contracture: It is the name that burn scars receive. The scar tissue contracts by deforming the area of ​​involvement.

Each of these types of healing that result in different forms of scar has a medical approach. You can consult a surgeon or a dermatologist if you have a scar that worries you. The professional will know to tell you which is the best approach for your case.