Not a single day in our consultations goes without people coming in complaining of a visible scar. These scars are usually located on the face, neck, arms, legs or any body part of individual concern. They are usually from a past burn injury, road traffic accident, healed skin condition, skin cuts of any type, etc. People with such bothersome visible scars come to consult if they can be removed for reasons such as; they don’t like it, stigma from peers or workmates, sadly with some people reporting to have lost their job(s) as a result of their visible scars, and considered not representable enough for certain job positions. Unfortunately, most of these have normal well-healed scars, some of which can’t be really greatly improved further despite their desires and huge expectations from plastic surgery. Most times, reassuring such a person that their scar is there to stay isn’t gratifying enough. By the time most people come to consult, they have already desperately spent huge sums of money on many different expensive products available on market, with no significant change. Almost everyone gets an injury or injuries in life on different body parts, which result in a wound. As pain and all the bothersome symptoms associated with the fresh wound start to resolve, depending on the size and location, the worry about the wound gradually changes to about how the scar will appear. The more unfortunate bit about this is that the scar might take longer on the body, or in most cases last forever. As the scar matures (time goes by), it becomes flatter and less visible, or even seems to fade away depending on; skin colour, location, size and cause of the wound/ scar. Some people are genetically at a risk of forming more noticeable scars than others. Some scars might tend to become larger than the initial wound size, and these are called keloids, and are a result of abnormal wound healing. These happen in about 15% of all wounds, generally more common in dark skin tone and women (possibly due to multiple cosmetic piercings). These keloids aren’t normal scars and can be treated. It is important to know that a normal scar is one’s friend and not an enemy, and was the only way one had to survive the painful and disastrous wound they had. It should thus be associated with victory than sorrow, and one should learn to embrace it than hate it. Of course, this is never easy to accept and takes time given the continuous pressure from the surrounding, especially for children and teenagers. Parents have a huge role to play for these children in order to accept their scars and learn to live with them without social stigma, which might affect them for a big part of their life if not dealt with early enough. Some parents never or take long to accept their children’s scars even after they have been explained to by health care providers, and this might give their children the image that their scars are shameful, and a disability which will be harder to change in their older or adult life. Once one has accepted their scar, they can decide to show it to people or talk about it freely, but this shouldn’t be done out of pressure from anyone. Some scars can be from sensitive causes such as child assault, attempted suicide, and one has to choose who to tell and when they feel safe and comfortable with them about such information. Sharing stories with other people who have lived with scars for some time might help one to cope with their struggles with the same issue. If one feels too much stigma and very unhappy with themselves due to a visible scar, they shouldn’t hesitate to consult a psychologist or counsellor for therapy as this greatly helps. It is important to understand that anyone can get a scar anywhere at any time, and employers, peers and workmates can help one towards overcoming their stigma due to such scars by; not focusing on their scars, not making fun of them, as well as not discriminated them when it comes to job positions. It is, however, important to know that some scars can be improved to look better, and so one should consult a doctor (plastic surgeon, if possible) to review their wound or scar and assess if surgery or other therapies can help, as some therapies work best when used early before the scar matures fully. Dr Ian Shyaka, Resident Plastic Surgery Rwanda Military Hospital
