White scars and hypopigmentation (loss of skin color) can result from trauma to the skin.
The scars take on a white appearance because the production of melanocytes has been affected. Melanocytes produce melanin, the pigment that gives skin its color. If the melanocytes are damaged, so is the skin’s ability to produce darker skin tones.
After skin damage, whether or not hypopigmentation or white scarring occurs depends on how the injury occurred.
Causes of hypopigmentation and white scars
For example, if you were riding a bike and fell and only scraped your knee, this would have created a superficial abrasion on the skin. A scab would develop to protect the wound. Over the course of a few days, the scab would fall off. Once the scab fell off, the skin would produce pigment in response to sun exposure, and eventually the color of the scar would match the rest of the skin.
On the other hand, if the fall from the bicycle involved a deep cut to the knee, most of the pigment-producing layers of the upper part of the skin would be damaged, while the deeper layers of the skin would need to repair the injured tissue .
To begin the dermal repair process, the skin would bind collagen and elastin to protect the blood vessels under the skin. If blood vessel damage were to occur, the wound healing process would be accompanied by an increased amount of inflammation. Under these circumstances, a mild form of fibrosis or excessive scarring may occur due to increased skin damage and inflammation.
With this buildup of scar tissue, the melanocytes may not reach the surface of the skin where they produce melanin and give the skin its color. This results in thick, white scar tissue.
Laser resurfacing and hypopigmentation
Unlike bicycle accidents, laser resurfacing is a form of intentional healing. Since laser resurfacing corrects skin damage by inflicting small wounds on the skin, laser treatments can cause hypopigmentation. Sometimes hypopigmented spots may not appear until two to six months after laser treatment.
Treatments for white scars and hypopigmentation
Treatments for white scars that result from acne scars or accidents include vitiligo medications. Vitiligo is a skin disorder of unknown cause that involves loss of pigmentation in patches of otherwise normal skin.
The dermatologist Dr. RW Urbanek, informed E News about skin and allergies that a product known as V-Tar helps combat the effects of hypopigmentation. According to Dr. Urbanek, this compound causes the skin to produce melanocytes, which, in turn, create melanin and restore normal skin pigmentation.
Dr. Urbanek has seen improvements with the use of V-Tar in as few as eight applications daily. However, side effects of V-Tar include a burning sensation when exposed to direct sunlight. This can be mitigated with the use of a sunscreen. You can ask your doctor for V-Tar.
Ironically, when hypopigmentation results from skin resurfacing, treatment may include more laser resurfacing. In a study published in dermatological surgeryDr. James E. Fulton revealed his method for treating hypopigmentation resulting from laser or chemical skin resurfacing.
Dr. Fulton gave 22 patients who had hypopigmented scars a pretreatment with vitamin A and glycolic acid lotion. The patients then received a series of laser and chemical resurfacing treatments. After the resurfacing treatments, the researchers specially bandaged the treated hypopigmented scars and allowed them to heal.
At the end of the study, the melanocytes returned to the previously hypopigmented area and eventually the skin blemish blended with the rest of the natural skin tone.
Prevention of hypopigmentation and white scars
Since hypopigmentation and white scars have historically proven difficult to cure, the best treatment really is prevention. You can help prevent hypopigmentation by properly dressing deep wounds immediately after they occur. In the case of skin rejuvenation, ask your healthcare professional what steps they are taking to avoid further hypopigmentation and what you can do, in addition to using a good sunscreen, to prevent possible hypopigmentation.
Sources:
Norra Mac Done. Tar product addresses hypopigmentation quickly. E-Skin and Allergy News: March 2002, Vol 33, no 3, p 39.
Fulton JE, AD Rahimi; S. Mansoor; P. Helton; P. Shitabata. Treatment of hypopigmentation after skin rejuvenation. Dermatological Surgery. January 2004, Vol 30, no 1, pp 95-101(7).
