[Health Byte] Your Scars and Your Life: A Quick Guide to Both

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Scars. Everybody has a few. That raised line from a childhood tumble, the surgical mark you've learned to ignore, the spot where something got infected and your skin decided to remember it forever. Scarring is just your body doing its job, patching over damaged skin the only way it knows how. Infections, surgeries, injuries, inflammation. the causes are mundane and universal.

What's less universal is how your skin handles the job. Scars can come out flat or lumpy, sunken or raised, darker than the surrounding skin or lighter. Some itch. Some ache. The final result depends on a cocktail of variables: your genetics, your skin type, where on your body the injury happened, how deep it went, how old you are, and whether you got proper treatment in the aftermath.

Dr Li Xin, director of the dermatology department at Shanghai Yueyang Hospital, cuts right to it. "Scar formation is primarily linked to genetics," he says. "Some people are simply more prone to significant scarring than others." Meaning: you can do everything right and still end up with a more prominent scar than someone who did everything wrong, just because of the hand your DNA dealt you.

The skin science here matters. If an injury only damages the epidermis (the outermost layer, the part you can touch), it typically heals clean. No scar. But once damage reaches the dermis (the deeper structural layer beneath), scarring becomes likely. As a rule of thumb, the more it bleeds, the deeper it went. People with a keloid-prone constitution (a genetic tendency to produce thick, raised, overgrown scar tissue) are especially at risk. And when the layers of skin heal slightly out of alignment after surgery or injury, the result is rarely pretty.

The good news, says Dr Li: "With minimally invasive surgery or cosmetic suturing, scarring can often be avoided or minimized." But the real key, especially if you already know you scar badly, is getting ahead of it. Prevention first, always.

Practical Tips for Minimizing Scarring

When an injury reaches the dermis (that deeper structural layer), your body floods the area with collagen fibers to patch things up. It works, mostly. But "mostly" is doing a lot of work in that sentence. The repair is rarely a perfect restoration. What you do in the days and weeks after an injury, though, can meaningfully shift the outcome. Keep inflammation down, protect the area, and you give your skin its best shot at healing quietly.

A few things worth knowing:

• Clean it. Gently, regularly. Infection drives inflammation, and inflammation is the enemy of clean healing.
• Keep it moist and covered. Dry wounds form scabs. Scabs are not your friend. A moist, bandaged wound heals faster and with less drama.
• Get stitches if you need them, and ask about cosmetic suturing. Don't tough it out. The sooner a wound is properly closed, the better the odds. Cosmetic suturing (a technique focused on minimizing scarring rather than just closing the wound) is worth asking about.
• Use silicone. Silicone gel, sheets, or tape are among the few over-the-counter options with real clinical evidence behind them. They help flatten and soften scars over time.
• Don't stretch it. Movement that pulls at healing skin creates tension, and tension creates worse scars. Dial back whatever activity is tugging at the area.
• Stay out of the sun. UV exposure causes healing scars to darken and become more visible. Cover up or use sunscreen religiously on any scar that's still pink.
• Apply pressure where you can. For facial wounds, a pressure mask. For body wounds, use tape or a compression wrap. Consistent pressure helps prevent scars from raising up.

When the scar is already there, go see someone. Lasers, dermabrasion (a controlled sanding down of the skin surface), chemical peels, injections, surgical revision, cryosurgery (freezing the scar tissue), skin grafts. There are options, more than most people realize.

On timing, Dr Li is emphatic: start early. "Treatment can begin one to two weeks after a scar forms," he says. "The earlier, the better." His go to in the clinic is carbon dioxide laser, typically scheduled every two to three weeks initially before spacing out the sessions as the scar responds.

For scars that have gone beyond cosmetic concern and are actually limiting movement or function, surgery followed by rehabilitation is the path. "Scar treatment is a long-term management process," says Dr Li. "Early prevention, timely treatment, and long term management are all important."

And then, the hardest part: patience. Wounds take time. Scars take longer. Set realistic expectations, follow your doctor's instructions, and resist the urge to declare defeat at the three month mark. The skin is still working.

Health Byte Tips: When Back Pain Is Not Just Back Pain

Back pain is one of those complaints that sits in an uncomfortable middle ground. Most of the time, it's nothing: a bad night's sleep, too many hours hunched over a laptop, the accumulated insults of a body that's been used. But occasionally, back pain is the only warning you get before something catastrophic happens.

During Spring Festival this year, a patient walked into Shanghai Yueyang Hospital complaining of back pain that had been building for about a week. He had a reasonable explanation ready: fatigue, plus a history of kidney stones. Classic self-diagnosis. The doctors listened, asked more questions than he probably expected, and then, instead of sending him home with the usual advice, ordered a CT scan.

What the scan showed was not a kidney stone.

It was a massive abdominal aortic aneurysm (a dangerous ballooning of the aorta, the body's main artery, which runs from the heart down through the chest and abdomen) that was already showing signs it was about to rupture. When an abdominal aortic aneurysm ruptures, the internal bleeding is catastrophic. The death rate is 90 percent.

Dr Chen Tongyu took the patient straight to surgery. He survived.

The unsettling thing about abdominal aortic aneurysms is how quietly they develop. The aorta balloons slowly, over the years, and most people feel nothing. "Many patients are discovered during routine health checkups," says Dr Chen, director of the hospital's cardiothoracic surgery department. By the time symptoms appear, including that deep, persistent pain in the abdomen or back, or a strange pulsing sensation near the belly button, the situation is already urgent.

The people most at risk: those with hypertension (high blood pressure), high blood lipids (elevated fats in the bloodstream, also known as high cholesterol or triglycerides), smokers, older adults, and people with atherosclerosis (a hardening and narrowing of the arteries caused by plaque buildup).

Dr. Chen's advice is simple and worth remembering: "If people, especially those in middle or old age, have strong pain in the waist and back without an obvious reason, it is important to visit a doctor for screening." Don't assume it's the kidney stones. Don't assume it's fatigue. Let someone with a CT scanner make that call.

If you go

For scar consultation or aneurysm screening, you can contact Shanghai Yueyang Hospital's international medicine department at 65161782-3223 or shyyyygjyl@163.com.

Address: 110 Ganhe Rd | 甘河路110号

The hospital is covered by commercial medical insurance.

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About the Author

Cai Wenjun is a seasoned health reporter with Shanghai Daily. With extensive experience covering the local medical system, hospitals, health officials and leading medical experts, Cai has reported on major pandemics including SARS, swine flu and COVID-19, as well as developments in the local health industry.