Skin Thinning After Wound Healing: Causes and Solutions

Wound healing issues - thinning of the skin?

Hello, doctor.
I previously sustained a deep cut from a chair and received stitches at the hospital.
After the wound healed, the skin in the injured area became thinner and is prone to bleeding with minor friction.
I would like to ask the doctor: 1.
Why does the skin become thinner after healing? In the past, I did not experience this issue after injuries, and the healed area feels indented when touched.
2.
Is there any way to restore the skin to its original thickness? Thank you, doctor.

KAIF, 20~29 year old female. Ask Date: 2021/09/28

Dr. Li Zhonghuai reply Surgery

Hello! It seems that at that time, there was a deeper abrasion on the skin, resulting in damage to both the epidermis and dermis.
The epidermis needs to regenerate, and the newly formed epidermis is more fragile and thinner.
The skin will gradually thicken, but if the underlying soft tissue was already depressed, it cannot become plump again.
Take care! Changhua Hospital cares about you!

Reply Date: 2021/09/28

More Info

Skin thinning after wound healing is a common concern, especially when the injury is deep and requires stitches. The process of wound healing involves several stages, including hemostasis, inflammation, proliferation, and remodeling. Each of these stages plays a crucial role in how the skin recovers, and the characteristics of the healed skin can vary based on several factors.

1. Why does the skin become thinner after healing?
When a wound occurs, especially a deep one, the skin undergoes significant changes. The initial injury disrupts the epidermis (the outer layer of skin) and the dermis (the deeper layer). As the wound heals, new tissue forms, but this new tissue is often different from the original skin. The newly formed skin may be thinner and more fragile due to several reasons:
- Collagen Remodeling: During the healing process, collagen, which provides structure and strength to the skin, is laid down in a disorganized manner. Initially, the collagen fibers may not be as dense or well-organized as in normal skin, leading to a thinner appearance.

- Loss of Skin Appendages: Hair follicles, sweat glands, and sebaceous glands may be damaged during the injury, which can affect the skin's overall integrity and thickness.

- Inflammation and Scarring: The inflammatory response can lead to scarring, which may not have the same thickness or elasticity as the surrounding skin. Scars can feel different (such as being indented or raised) and may not regain their original thickness.

2. Can the skin return to its original thickness?
While the skin can improve over time, it may not always return to its original thickness or texture. However, there are several approaches to promote healing and potentially improve the appearance and thickness of the skin:
- Moisturization: Keeping the area well-moisturized can help improve the elasticity and appearance of the skin. Products containing hyaluronic acid, glycerin, or other emollients can be beneficial.

- Silicone Gel Sheets or Ointments: These can help flatten and soften scars, which may improve the overall appearance of the skin.

- Topical Treatments: Certain topical treatments, such as those containing retinoids or vitamin E, may promote skin regeneration and improve texture.

- Microneedling or Laser Therapy: In some cases, dermatological procedures like microneedling or laser treatments can stimulate collagen production and improve the thickness and appearance of the skin.

- Consultation with a Dermatologist: If the thinning skin is a significant concern, consulting a dermatologist can provide personalized treatment options. They may recommend specific therapies based on the condition of your skin and the nature of the injury.

In conclusion, while skin thinning after a wound is a common occurrence, understanding the underlying mechanisms can help in managing expectations and exploring potential treatments. It’s essential to be patient, as skin healing and remodeling can take time, and the skin may gradually improve in thickness and appearance with appropriate care.

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