[Fat Bear Science] Some scars on the face are fine, but some can turn into cancer. You should pay attention to these types of scars

Nowadays, more and more people are getting their ears pierced.

Some for beauty, some for handsomeness, and some...

Today Fat Bear wants to tell you

Whatever the reason, be careful.

(Especially those with scar tissue)

Recently, Ms. Zhang, 27, from Shapingba, had a 2-cm keloid grow behind her right ear because she had her ears pierced two years ago. She will have to undergo radiotherapy after surgery in our hospital.

Wang Shengqiang, director of the Comprehensive Department of our hospital, said that many people do not care about scars and think that it is normal to have scars after an injury. However, some scars, such as atrophic scars and keloids, are precancerous lesions and manifestations of tumors. Therefore, people with scar-prone constitutions should be especially careful.

Experts of this issue

Wang Shengqiang

Wang Shengqiang: Director of the General Department of Chongqing Cancer Hospital/Chongqing University Affiliated Cancer Hospital, deputy chief physician, member of the Chongqing Emergency Committee of the Chinese Medical Association, member of the Chongqing Emergency Committee of the Committee of Integrated Traditional Chinese and Western Medicine, has been engaged in emergency trauma, various critical and severe diseases, and poisoning treatment for a long time, and is good at diagnosing and treating superficial tumors. Clinic hours: all day on Monday

25-year-old woman developed keloid scar after getting her ears pierced

"Doctor, why do I get keloids after piercing my ears?" On December 21, Ms. Zhang, who was undergoing radiotherapy at Chongqing Cancer Hospital, asked Director Wang Shengqiang of the General Department.

Two years ago, 25-year-old Ms. Zhang had her ears pierced in a jewelry store. Not long after, she found a small lump behind the ear hole on her right ear. The lump gradually grew larger and itchy and painful. So Ms. Zhang had surgery to remove it at a hospital in Shapingba. But a year and a half later, Ms. Zhang found that the lump had grown again, with a diameter of about 2 cm. Worried that it would grow larger in the future, she came to Chongqing Cancer Hospital for help 10 days ago.

After examination, Director Wang confirmed that the lump was a keloid, a fibrous tissue tumor that occurs on the skin, and recommended early surgical removal. At the same time, because this type of tumor has a high recurrence rate, chemotherapy is also required immediately after surgery to reduce the chance of recurrence.

"Because this is a recurrence, although I have undergone two courses of radiotherapy, I cannot guarantee that there will be no recurrence in the future. I can only say that the chance of recurrence will be much smaller." Director Wang pointed out that keloids should also be treated scientifically in the early stages.

The repair of wounds heals in the form of scars

"Scars are commonly known as wounds. In daily life, people will inevitably suffer from various injuries, such as burns, cuts, skin trauma, etc., which cause trauma of varying degrees." Director Wang said that the healing process of trauma is completed in the form of scar formation, that is, the repair process of various traumas heals in the form of scars.

Before understanding the formation of scars, we should first understand the structure of the skin. The skin is composed of the epidermis and the dermis. The epidermis is composed of five layers stacked from the outside to the inside. The bottom layer of the epidermis is the basal layer. The basal layer cells have the function of re-division. Therefore, after the human skin is injured by burns, cuts, skin trauma, etc., scars will only occur if the wounds are deep into the dermis and subcutaneous tissue. When the trauma damages the dermis, the most intuitive feeling is bleeding and pain. "Therefore, when a wound accompanied by pain and bleeding appears after an injury, scars are inevitable." Director Wang said.

Superficial scars, which do not require treatment

"Due to individual constitution, wound area, depth, improper care and other factors, the final scars are not the same." Director Wang said that scar tissue is an imperfect replacement, mainly manifested as weak tension resistance, nutritional exchange barriers, and excessive contraction causing limb dysfunction. After the formation of general scars, there will be no scar hyperplasia or only slight scar hyperplasia, which will immediately subside, mature, and become static. A few scars will gradually become soft and smooth after several months or longer, close to normal skin.

However, some scars proliferate for a long time, not only are they significantly higher than the skin surface, but they are also reddish-brown in color, very hard, and accompanied by itching, pain, or tightness. Some scars even erode normal skin, contract and deform, not only affecting the appearance, but repeated ruptures can also affect the normal function of the local area.

"Scars can be divided into superficial scars, hypertrophic scars, atrophic scars, keloids, etc." Director Wang said that superficial scars are the most common scars in life. They are mostly caused by mild skin abrasions, shallow II° burns, or superficial skin infections. They are mild scars limited to the superficial surface of the skin. This type of scar has no functional impairment, but the appearance is slightly different from normal skin, with a rough surface or pigment deposition or loss. Generally, no treatment is required, and the scar gradually becomes less obvious over time.

Hypertrophic scars, which are common in children and around puberty

Director Wang said that hypertrophic scars are mostly caused by relatively serious skin trauma, such as wounds caused by surgery and trauma, deep second-degree or third-degree burns. Due to the massive destruction of blood vessels and nerve tissues, coupled with the pulling of skin tension, a raised scar that is significantly higher than the normal skin surface will be formed.

This type of scar is caused by the wound involving the deep dermis, and then it comes into contact with external foreign bodies, such as dust, chemicals, cotton fibers, talcum powder on medical gloves, and internal foreign bodies such as keratin produced by the destruction of hair follicles and sebaceous glands in the skin, resulting in proliferative lesions. Therefore, preventing wound infection and foreign body stimulation is the main measure to prevent the formation of this type of scar.

Clinically, hypertrophic scars are common in children and around puberty, which may be related to the active secretion of growth hormone and high skin tension. Moreover, they are more common on the chest, which may be related to the stimulation of respiratory movement. Generally, hypertrophic scars in non-functional parts will not cause serious functional disorders, but hypertrophic scars occurring in active joints will affect joint movement. "Therefore, hypertrophic scars on the face and joints are recommended to be improved through surgery to avoid causing serious functional disorders."

Atrophic scars or precancerous lesions

"Atrophic scars are common after large-scale third-degree burns, skin avulsions, chronic ulcers, etc., which produce unstable scar tissue due to wounds involving the entire layer of skin and fat layer." Director Wang said that this kind of scar tissue has a very thin epidermis and feels hard to the touch. It has strong contractility and will pull the adjacent skin. It is easy to rupture after external friction and does not heal for a long time, thus causing mobility disorders and the possibility of cancer in the late stage.

This type of scar does not protrude from the surface, but is very flat. It has only a layer of atrophic epithelial cells on the outside and a small amount of connective tissue underneath. A large amount of collagen fibers are formed at the bottom of the scar, which adhere to and pull the muscles, tendons, bones, nerves, and blood vessels, thus causing more serious contracture dysfunction.

"Therefore, for large areas of skin defects caused by burns, or repeated wound infections or chronic ulcers, it is recommended to perform skin grafting surgery as early as possible to avoid the formation of difficult-to-treat atrophic scars," Director Wang reminded.

Keloid, a benign skin tumor

Director Wang said that keloids are similar in appearance to hypertrophic scars, they protrude from the surface of the skin, and are rich in capillaries. They are a benign skin fibrous tissue tumor.

Clinically, because of the massive proliferation of fibrous tissue in the dermis, it can continuously expand to the surrounding normal skin, thus forming a crab-like hyperplasia, which is red in color, hard in texture, and sometimes connected in a band-like shape. When stimulated by trauma, it is also prone to inflammation and suppurative infection, and even fistula formation, which does not heal for a long time. Some keloids will stop proliferating and expanding to the surrounding area, the itching and pain symptoms will be alleviated, and the color will gradually fade and the texture will also begin to soften.

Studies have found that keloids are more common among young people. People with dark skin are also more likely to develop keloids due to their high sulfur content. Moreover, the ears, upper neck, shoulders, upper arms, and chest are the most common areas for keloids. For example, piercing the ears is prone to keloids.

"Because keloids are prone to recurrence after surgery, many patients worry about cancer. In fact, the cancer rate of this type of keloid is low, so patients do not need to worry too much, but they should pay attention to prevention and early detection." Director Wang reminded.

People with scar-prone constitution should be careful to prevent various injuries.

"Once scars appear, many people cannot judge what type of scars they have, so it is best to find a doctor for differential diagnosis." Director Wang reminded that if scars need treatment, it is best to find a professional doctor for diagnosis and treatment, and never blindly remove them. Otherwise, the scars may become larger and larger. At the same time, although the proportion of people with scar constitution is relatively small in the population, if you have a scar constitution, you are more likely to develop hypertrophic scars, atrophic scars, and keloids due to ear piercing or a little trauma than the average person, so you should pay attention to prevention.

So, how do you determine whether you have a scar-prone constitution? Director Wang said,

1. You can do allergy tests such as scratch tests. If the scratch test is positive, it means that you may have a scar-prone constitution.

2. If you develop blisters and leave scars after being bitten by mosquitoes or other insects, you should be careful.

Third, you can also check whether your previous skin wounds healed and whether there were scars that were higher than the skin, felt hard, and possibly itchy, similar to centipedes or earthworms. If so, you should pay special attention to it.

Text/ Fat Bear Picture/ Online Review/ Wang Shengqiang

Original article, please do not reprint without authorization

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