Get slashed and you end up with a scar. Thus it has been since, well … forever.
When I as very young my brother and I had a sort of competition going for a while. Who had more stitches. Whether you put that down to us being Boys or it being the 1950s or whatever it was us. I was older and had an edge on him. Then, around 5, his foot got caught in an escalator . . . and he jumped ahead so far I didn’t want to catch up. And luckily I haven’t.
We start out life with smooth, relatively feature-free, skin. As we grow and experience life we bump into things, fall down, get injured and there’s often a recording on our skin. In scars. So later on we can say ‘This was when the knife slipped’ and ‘That was when the cat freaked out’. Or have little boy competitions.
Storied scars are one thing but not all scars are to be proud of and many we’d rather not be sporting for the rest of our lives. Scars that disfigure, especially the face, profoundly change the way the world perceives you and not usually in a good way. Your life can take a completely different path, options available to your cohort become implicitly or explicitly denied to you because of your appearance. Like is hard enough without all these added negative things is it not?
Why is the skin tissue that grows into the space left behind so different from the skin tissue that is already there? Why doesn’t the same kind of tissue grow into it?
It turns out that the type of tissue that grows back contains a lot of myofibroblasts. These cells are good for wound repair because they can utilize mechanical contraction via smooth muscle type actin-myosin complex. Essentially this means they can attach and pull. But unlike fat cells found in normal skin tissue the resulting tissue is a scar.
This myofibroblast rich tissue also doesn’t allow for hair growth and in looking into that researchers have figured out a few things which may lead to greatly reduced disfigurement from scars.
When they looked at regenerating hair follicles in the area of damage they found that chemical signals from the follicles were making the myofibroblasts change into adipocytes (fat cells). This is another example of cell reprograming with chemistry without the need to resort to stem cells. I’ve posted a number of times on this technique in the past.
The chemical in this case is Bone Morphogenetic Protein. The researchers see more utility for this technique beyond scars. A condition where tissue becomes adipocyte lean happens with HIV patients. Adipocyte loss is also an effect of the aging process where it leads to permanent deep wrinkles not currently treatable. If this process could be ameliorated or better managed the visually unappealing facial effects of aging might one day be a relic of a bygone era. Considering the amount of money spent on fighting the effects of again on appearance I cannot imagine that research into this will starve for funding.
This is all lab research now but it shows a possible path forward. Better living through biochemistry.
Find out more about all that in this article on ScienceDaily.
Atrophic scars are sunken partly because of the loss of fat or muscle tissue under the skin (the atrophy). The technique described in this post redresses fat tissue loss so possibly it will be informative on dealing with scars like this in the future. And maybe no one will live the rest of their life showing what acne they had as a teenager. OR that they had Chicken Pox.
In this Wikipedia article on Wound healing the process is described in 4 phases. The 3rd phase is where the activities of the fibroblasts create the collagen extra-cellular matrix and the myofibroblasts perform wound closure. Any treatments derived from the technique in this article would likely be concerned with this phase of wound repair.
The extra-cellular matrix is all the stuff that appears between cells to provide physical scaffolding and biochemical support. If your body was an office building and the cells were the workers in the offices then the ECM would be the actual building: the floors, walls, plumbing and cable runs. Fibroblasts facilitate the growth of a few things that make this structure – collagen being the bulk of it. In wound repair it would appear that the way this happens differs from the way tissue grows normally. Think about what autobody repair by poorly equipped, untrained or in-a-hurry service people looks like. Looks a bit like scars doesn’t it?
Fibroblasts and their precursor, mesochyme, are mobile cells. That makes sense when you think of them as builders of 3 dimensional constructs. They excrete chemical signals to say ‘make this material here’. Most of the time it is collagen being called for. How they go about excreting what substances and where and when are likely driven by chemistry in their local environment and, as the article delves into, altering that chemistry would alter their behaviour and the final product of their activities. Some chemicals tell cells what to make while others tell them what to remake themselves into.
It would appear that the forecast for the future will be clear skin and youthful appearance. That may be wishful thinking now but eventually it will just be a decision instead.