Scars and Souvenirs

This morning, out of curiosity, I counted my scars. I did a head-to-toe survey, the way I was taught in paramedic school, and came up with a grand total of fifteen scars I’ve accumulated while strolling (and stumbling) down this road of life.

I find scars fascinating. They tell stories; they speak of the past. They are small (and sometimes gruesome) reminders of events in our lives. Some are accidental (where I tore my finger open on a hydrant during the fire academy); some intentional (the faint line in my belly button from a tubal ligation); and some are simply consequential – like the chicken pox scar on my forehead. They mark moments in life that are indelibly etched onto our bodies.

So what are scars and how are they different from normal tissue? Let’s start with a scenario:

Say you’re strolling down the beach and you fail to notice the broken bottle some drunken cretin has tossed into the surf. The bottle has now washed ashore, landing right in your flight path. The next thing you know, your foot is laid open and you’re hobbled. Two things happen. First, if you’re like me, you curse like a sailor and proclaim your hatred for the common litterbug. Second, your body responds to the insult by forming a clot around the wound and sending fibroblasts, which help rebuild tissue, to the site. As the fibroblasts break down the clot, they replace it with proteins – primarily collagen – that will eventually form the scar tissue.

Scars are made up of the same tissue as normal skin, it’s just the arrangement of the collagen fibers that sets them apart. In normal skin, the collagen is arranged randomly. In scar tissue, however, the fibers are generally aligned in a single direction. This is why scars look and feel different from the surrounding tissue. And here’s an interesting tidbit: scars lack hair, sweat glands, and a normal blood supply (think of them as middle-aged men, except for that part about the sweating).

External scars are fairly benign. Although they lack the flexibility of normal tissue, they typically just dot our landscape and remind us of bygone events. It’s when scar tissue forms on the inside of the body that the real trouble begins, and some of our most common diseases are linked to scarring.

Heart attacks (technically called myocardial infarctions), occur when a blockage in a heart vessel leads to death of the surrounding tissue. The damaged tissue can scar, which can then lead to arrhythmias (irregular beats or rates). Arrhythmias, such as atrial fibrillation, can subsequently lead to stroke. Scar tissue within the heart has also been linked to sudden cardiac death in people with certain preexisting conditions, such as cardiomyopathy.

Diabetes is also linked to scarring, as those who neglect to regulate the amount of sugar in their blood can suffer on multiple fronts. High sugar levels cause the smallest of blood vessels to burst, which can lead to scarring, and scarring around organs, such as the kidneys, can lead to failure, which is never a good thing.

One of the scariest diseases involving scarring is called scleroderma. Scleroderma results from an overproduction of collagen, those same fibers that create scars. These fibers can accumulate on or within the body, wreaking havoc along the way. Affected fingertips can develop pitting and sores and, in extreme cases, this leads to gangrene requiring amputation. In the digestive system, scarring can cause acid reflux, along with poo extremes – alternating bouts of constipation and diarrhea. Scleroderma can even affect our sex lives. Men who suffer often experience erectile dysfunction whereas in women, it can cause constriction of the vagina.

But scars can also be a thing of beauty. In fact, in many cultures, including ours, people intentionally scar their bodies. Scarification is a common practice among aboriginal populations in Africa and New Zealand, who cut or brand their skin in decorative designs. For men, the scars intensify their appearance, which comes in handy in battle. But they are also used as a means of attracting women. (Is there no limit to what you guys will do?)

In the US, scarification started cropping up in the 1980s, but it's also slowly spreading across Europe and Australia. It's achieved by cutting or burning into the skin, much like tattooing. And like tattoos, these scars are used as a means of self-expression and can be quite beautiful (and quite scary). Scarification artists even have their own conference, aptly entitled, "Scar Wars."

Scars are friend and foe. They can produce deadly results when they intrude on healthy tissue, but when functioning properly, are a means for the body to heal itself. They are a reminder of our experiences – both good and bad. So flaunt your scars and share your stories; for who wants a perfect body, anyway?

Post Script: I borrowed this blog title from one of my favorite bands' (Theory of a Deadman) CD. Gotta love the beautiful transverse fracture of the humerus.