Scarring of the skin is a huge problem. It has been estimated that there are 100 million new scars each year in the developed world alone. Most arise from operations, but at least a quarter arise from trauma. The repercussions are dramatic, both to the individual and society as a whole. There is some evidence that both the public and the medical profession dismiss patients with problematic scars as less debilitated or deserving than individuals with other medical conditions. It is not uncommon for patients to be told that they must ‘live with their scar’, that they are not offered conventional treatments or that they are not referred on for specialist care.
For the individual, a problematic scar may be because of the symptoms it triggers. These may be pain, itching, altered sensation and stiffness. These may be so severe as to interfere with sleep, mood and concentration. The appearance of a scar may be devastating with low self-esteem, depression and post-traumatic stress disorder. The reaction that visible scars can provoke may result in avoidance behaviour. Consequently, patients sometimes with even quite small scars may go to great lengths to hide them, both in terms of the clothes that they wear and withdrawing from the work place, hobbies and other places of social interaction. At a very fundamental level, a tight scar may start to distort the surrounding skin and this can have a wide range of harmful effects, from limiting the range of motion of a joint to the prevention of intimate relationships.
The effects on society of treated and untreated scarring are profound but hard to quantify. Currently, we have established that as a nation little of our total health budget is spent on treating scarring. The absence of an individual from the workplace due to the physical and psychological effects of scarring may amount to millions of pounds every year. We feel that it is a marker of a just society that those with visible disfigurement are accepted and encouraged rather than stigmatised and marginalised.