Scars and Skin Cancer

From Scars to Skin Cancer: Understanding the Hidden Risks

by Albert

Scars are more than just reminders of past injuries—they can sometimes signal deeper health concerns, including an increased risk of skin cancer. While most scars heal harmlessly, certain types can become unstable over time, potentially leading to malignant changes. In this blog post, we’ll explore how scars form, which ones raise red flags for skin cancer, and what you should watch for to protect your skin.


How Scars Form: The Body’s Repair Process

When your skin is injured—whether from surgery, burns, acne, or trauma—your body springs into action to repair the damage. This process involves:

1.  Inflammation: Blood clots form to stop bleeding, and immune cells clear debris.

2.  Proliferation: New tissue (granulation) fills the wound with collagen, a protein that gives skin strength.

3.  Remodeling: Over months or years, collagen reorganizes, and the scar matures.

Most scars fade and stabilize. But in some cases, the healing process goes awry, creating chronic wounds or unstable scars that never fully settle. These are the ones most linked to skin cancer risk.


When Scars Become Dangerous: The Cancer Connection

Not all scars are equal. Certain types are more prone to malignant transformation due to chronic irritation, poor healing, or DNA damage. Here’s what to know:

1. Marjolin’s Ulcer: Cancer in Chronic Scars

  What it is: A rare but aggressive form of squamous cell carcinoma (SCC) that develops in long-standing scars or ulcers.

  Common in:

  Old burn scars (especially deep burns)

  Chronic leg ulcers (e.g., from diabetes or venous stasis)

  Traumatic scars left untreated for decades

  Timeline: Can take 20–40 years to develop after the original injury.

  Warning signs:

  A non-healing sore or ulcer in the scar

  Bleeding, crusting, or foul-smelling discharge

  Rapid growth or raised, wart-like

2. Keloids and Hypertrophic Scars

  Keloids: Overgrown, raised scars that extend beyond the original wound.

  Hypertrophic scars: Thick, raised scars within the wound borders.

  While neither is cancerous, chronic irritation (rubbing, sun exposure) can trigger malignant changes in rare cases.

3. Sun-Exposed Scars

  Scars on the face, neck, or arms are more vulnerable to UV damage.

  Thin, atrophic (sunken) scars from acne or chickenpox can develop basal cell carcinoma (BCC) or actinic keratosis (pre-cancer).


Red Flags: When to See a Dermatologist

Don’t wait decades for a problem to appear. Any change in a scar warrants attention. See a doctor if you notice:

Persistent ulcers or open wound

Rapid growth of raised nodule

Bleeding or crusting

Color changes (red, black,brown)

Pain or itching

Prevention Tips: Protect Your Scars (and Skin)

1.  Sun protection is non-negotiable

  Use broad-spectrum SPF 50+ on scars daily.

  Cover with clothing or bandages if in direct sun.

2.  Keep scars moisturized

  Silicone gels or sheets reduce thickness and irritation.

3.  Avoid trauma

  Don’t pick, scratch, or rub old scars.

4.  Annual skin checks

  Especially if you have a history of burns, chronic wounds, or multiple scars.