It’s common for scars to go through a series of color changes as they heal. Often, scars will appear red or purple initially. Over time, scars usually fade and become lighter. However, in some cases, scars may turn purple again months or years later. This is known as scar darkening or hyperpigmentation. There are several potential causes for purple scars, but they generally relate to melanin production and blood flow. Understanding why scars turn purple can help guide treatment approaches.
Common causes of purple scars
Here are some of the most common reasons scars may turn purple:
Increased melanin
Melanin is the pigment that gives skin its color. When skin is injured, it triggers increased melanin production as part of the healing process. This extra melanin is what causes scars to appear red or purple initially. In some people, melanin production remains high in the scar tissue even after healing. This results in the scar remaining dark or turning purple again later on. Factors like skin type, genetics, and sun exposure impact melanin production.
Blood vessel growth
During wound healing, the body grows new blood vessels to deliver nutrients and oxygen to the damaged tissue. In some cases, excessive blood vessels form in the scar. Having many blood vessels clustered together gives the scar a purple or red appearance. Vascular scars tend to feel bumpy or raised.
Inflammation
Inflammation during healing causes increased blood flow to the area, making scars look purple or red. If a scar becomes inflamed again later on, this can recreate the same color change. Inflammation may occur due to injury, infection, or skin conditions like eczema. Certain immune system disorders also cause inflammation that affects scarring.
Sun exposure
Too much sun exposure can cause purple discoloration in scars for two reasons. First, UV radiation increases melanin production, which darkens the scar. Second, sun exposure causes blood vessels to dilate and become more visible under the skin’s surface. This gives the scar a reddish-purple color. People with darker skin tones are especially prone to sun-related scar darkening.
Are purple scars permanent?
For many people, scar darkening is temporary. Often, with time, melanin production will decrease and blood flow will normalize, allowing purple scars to fade. However, it’s also possible for purple discoloration to be permanent, especially if there is continued irritation or sun damage. On average, mature scars achieve their final color within 1-2 years. But even old scars can suddenly turn purple or darken as a result of new triggers.
Treatments for purple scars
If you want to reduce the purple coloring of a scar, here are some treatment options to consider:
Silicone sheets or gel
Silicone is thought to hydrate scars and reduce collagen production. This can help flatten and lighten the scar tissue. Silicone sheets are worn over a scar, while gels are massaged in. Continuous use for several weeks or months offers the best results.
Compression
Gentle compression from tape, wraps or pads can help limit blood flow to purple vascular scars. This reduces the visibility of blood vessels under the skin over time. However, compression should be used carefully to avoid cutting off circulation.
Laser therapy
Vascular lasers and pulsed dye lasers target blood vessels in the scar to reduce redness. Fractional lasers work by creating small wounds in the skin that stimulate new collagen growth and remodeling of the scar. Multiple laser sessions are usually needed for significant improvement.
Steroid injections
Cortisone and other steroid injections directly into the scar can decrease inflammation that contributes to purple discoloration. However, results are often temporary.
Topical treatments
Over-the-counter hydroquinone creams may inhibit melanin production and fade dark scars. Other topical options include onion extract, vitamin C, kojic acid, licorice extract, and niacinamide. Topicals work best on smaller scars.
Cryotherapy
Applying liquid nitrogen to scars causes localized frostbite of the tissue. When the area thaws, increased blood flow results in collagen remodeling. This can help flatten and lighten purple scars. Multiple cryotherapy sessions are required.
Surgical revision
For wide or raised purple scars, surgeons can perform a revision to reshape the scar and interrupt blood flow. This involves cutting out the scar and rejoining the edges with very fine stitches. Dermabrasion and other resurfacing techniques may also be done.
Preventing purple scars
While it’s not always possible to prevent scars from turning purple, these tips may help:
– Use sun protection regularly on scars to limit melanin production and vascular changes.
– Massage scars with lotion to break up collagen and inhibit blood vessel growth.
– Avoid picking at scars so they don’t become re-injured or inflamed.
– Have raised or uneven scars revised early before blood vessels grow.
– Treat any underlying conditions, like eczema, that could cause recurring inflammation.
– Wear pressure garments or wraps to restrict blood flow to new surgery scars.
– Use silicone sheets or gel on new scars as soon as any initial oozing stops.
When to see a doctor
Consult a dermatologist or doctor if:
– A scar suddenly darkens for no clear reason. This could signal an underlying health issue.
– Your scar is very painful, swollen, or hot. This suggests inflammation or infection.
– Home treatments don’t improve the scar’s appearance after 6-12 months. Prescription treatments may be needed.
– The purple color bothers you for cosmetic reasons or affects your self-confidence.
Scar darkening in darker skin
People with darker skin tones are at higher risk of visible scarring and purple discoloration for two reasons:
1. They have more active melanin production, which can lead to excess pigmentation in scar tissue.
2. Scars tend to contrast more sharply against darker skin, making even subtle color changes more noticeable.
Here is a table comparing how scarring may differ in darker skin versus paler skin:
| Scarring factor | Darker skin | Paler skin |
|---|---|---|
| Melanin production | Higher | Lower |
| Risk of hyperpigmentation | Higher | Lower |
| Scar color contrast with normal skin | Higher | Lower |
| Noticeability of scar | More noticeable | Less noticeable |
To limit dark or purple scarring, people with darker complexions should be especially diligent about sun protection and treat scars as early as possible with silicone, injections, or laser therapy. Avoiding any irritation or delay in wound healing can also help minimize melanin deposition during the repair process.
When to worry about purple scars
In most cases, purple scarring is benign and more of a cosmetic concern. However, there are some instances when scar darkening warrants medical assessment:
The scar turns black
Black discoloration may be a sign of melanoma, a dangerous skin cancer. Other melanoma warning signs include irregular scar borders, bleeding, larger size, and changes in sensation.
The skin feels tight or硬結
A tight, thick, or hard scar that turns purple could indicate keloid scarring. Keloids are overgrown scars caused by too much collagen production during healing. They may keep enlarging and darkening over time.
You have a collagen vascular disease
Conditions like lupus and rheumatoid arthritis increase inflammation and can cause purple scars. Any unusual bruising or scarring should be evaluated.
You have a wound or scar infection
Signs like pus, increasing pain, heat, and swelling indicate infection. This requires antibiotic treatment to prevent serious complications.
The scar won’t heal
Scars that remain open or raw after 6-8 weeks of diligent wound care may signal an underlying issue hindering healing. See your doctor to identify potential causes.
You have a compromised immune system
People with weakened immune systems due to illness or medication may not heal normally. Any unusual scar appearance warrants a prompt medical review.
Coping with purple scars
For some people, the appearance of purple scars can feel embarrassing or affect self-confidence. Here are some healthy tips for managing thoughts and feelings about your scars:
– Remind yourself that purple coloring is very common early in the healing process. Over time, it will likely fade.
– Don’t judge your worth by your scars. You are so much more than your skin.
– Focus on your positive attributes to enhance self-esteem.
– Fill your social circle with people who appreciate you for you – not your appearance.
– Use makeup, clothing, or hairstyles to draw attention away from scars if desired. But also make peace with letting them show.
– Avoid unhelpful mental traps like dwelling on flaw or imperfections. Stay positive.
– Consider talking to a therapist if scar-related anxiety or depression persists despite your best efforts.
– Join a support community to share experiences and tips with others who have scars.
Learning to embrace your unique body and story is an ongoing journey for most. With time and patience, even visible scars often cease to bother you. The purple color will fade. But your beautiful spirit remains.
Conclusion
It’s common for scars to turn purple for a period early in the healing process. Excess melanin production, blood vessel growth, and inflammation can cause this temporary discoloration. While frustrating, purple scarring is usually not a major cause for concern and often fades with time. However, sudden color changes or poorly healing scars should be evaluated by a doctor. Treatments like silicone, lasers, steroid injections, and surgical revision can improve the appearance of purple scars if desired. With good sun protection and care, most scars will gradually lighten to blend in with your natural skin tone.