Healing without Scars

Be it from when you tripped and fell as a kid, an accidental burn, or if you got your appendix removed, scars can be rather unpleasant and unsightly. And while scars can’t be completely removed at present, researchers at the University of Pennsylvania’s Department of Dermatology have found a way to make fresh wounds heal normal regenerated skin instead of permanent lasting scar tissue.

“Essentially, we can manipulate wound healing so that it leads to skin regeneration rather than scarring” said George Cotsarelis, MD, the chair of the Department of Dermatology and principal investigator of the project at Penn. “The secret is to regenerate hair follicles first. After that, the fat will regenerate in response to the signals from those follicles.”

The reason why scar tissue looks different to regular skin is due to the lack of fat cells and hair follicles. Skin that heals over small cuts around the body are filled with fat cells called adipocytes. The presence of adipocytes means that when the wound is healed, the two skin tones will eventually blend into each other.

Scar tissue, on the other hand, is composed almost entirely of myofibroblasts, completely lacking in fat cells. When this wound heals, scar tissue is left to remain permanently. Researchers have discovered that existing myofibroblasts can be converted into adipocytes, suggesting that while the wound heals it can be converted into regenerated skin instead.

The key lies in the presence of hair follicles. The study conducted by Cotsarelis and his team found that hair and fat develop separately but not independently. In the study researchers found that regenerating hair follicles converts surrounding myofibroblasts to regenerate as fat, leaving regular skin instead of scar tissue.

“Typically, myofibroblasts were thought to be incapable of becoming a different type of cell”, Cotsarelis said. “But our work shows we have the ability to influence these cells, and that they can be efficiently and stable converted into adipocytes.”

The Cotsarelis Lab have now shifted their focus to further skin regeneration mechanisms specifically dealing with hair follicle regeneration. It seems a future where wounds won’t heal into scars is around the corner, just don’t go rubbing Rogaine into your cuts in the pursuit of it though.