Scars

When people talk about self-harm scars often come up as one of the risks, but why are they a bad thing? A lot of people only talk about the way they look/cosmetics, which is important to some people but not everyone. People with scars also often face discrimination or uncomfortable questions about their scars.

These are not the only risks though, they can also affect someone physically. Scars can be painful and itchy even after healing, they can be very stiff and can limit a person ability to move or be more likely to get damaged, and since they are not skin and are missing many of the structures skin does have, they are unable to do a lot of the important things skin does, sucha as temprature regulation, feeling, keeping from drying out, etc.

Keloid scars are a type of scar that grows to be larger than the original injury that caused the scar, they can form from any size wound. These scars can be very painful, itchy, and distressing and for some people disabling. They can continue to grow for a very long time and sometimes need medical treatment like surgery to control them. What causes keloid scars is unknown, but they are more common in people with darker skin tones, young people, and people with a family members with keloid scars. Wounds on your abdomen, back, chest, ear, jaw, or shoulder are more likely to become keloid.

Preventing or minimising the amount of scarring left behind from self-harm can reduce the risk of other complications scars can cause. Here are some ways to prevent/minimise scarring…

• Avoid harming your lower legs, upper chest, shoulders, neck, chin, or ears. These areas are more prone to keloid scarring
• The smaller the wound the smaller the scar
• Proper wound care and bandaging
• Using wound closure strips or getting stitches for cuts that need them
• Keeping wounds moist by keeping them covered and using petroleum jelly/Vaseline/Aquaphor
• Getting enough protein, vitamin A, vitamin C, zinc, amino acids, and food
• Supplements are a good option if you struggle with food
• Collagen supplements can help as well

Scars can be difficult to get used to having or to accept, especially if they're associated with painful memories. You don't have to like your scars, but accepting them can really help your self-esteem. Changing Faces has a number of online self-help resources for people with visible differences (like scars), including on managing loss of identity and self-esteem.

Accept your self-harm

Accepting your self-harm does not mean not quitting or reducing harm from self-harm, you can do both and if you're able to I encourage it.

Self-harm scars are a physical reminder of your previous self-harm and if you cannot accept your self-harm, you won't be able to accept your scars. Self-harm can come with a lot of shame and stigma, but there is nothing morally wrong about hurting yourself, nor should it be shameful. It is often times someone’s only way of caring for themselves and there is nothing wrong with trying to care for yourself, even when others don't understand that. It's also ok if you self-harm(ed) for other reasons or don't know why you self-harm(ed) or even if you think you have no reason for self-harming.

You are not a bad person for hurting yourself, your self-harm does not have to be hidden.

Don't avoid them

Avoiding looking at your scars can make it more difficult in the long run to accept them, even if they can be difficult to adjust to or feel comfortable with at first. Even if you aren't ready to or don't want to show your scars around other people, you can still start getting more comfortable with them by spending time with them visible alone or around a few people you trust. It's also ok if you never become completely comfortable with them.

Think of your scars nuetrally or positively

Your scars don't have to be or represent a bad thing, some people like to think of their scars as reminders of things they have overcome or survived. Some people prefer to think of them more neutrally, as just marks on their body from healing. Challenging negative thoughts about your scars by replacing them with these ideas can help you feel more comfortable with your self-harm scars.

Some people draw on their scars to make them something more positive, this can also be helpful as an alternative to self-harm for some people.

Identity outside of scars

Scars and self-harm are very small parts of a person, even if you have a lot of scars, very visible, or noticeable scars they do not have to be a defining part of you. Remembering and focusing on other parts of yourself, like your interests or hobbies, when you're feeling insecure about your scars can help remind yourself of this.

Changing how you look in a non-harmful way can also help take your mind of your scars and feel better about your appearance. You could try different clothing or hair styles, paint your nails, draw on yourself with skin safe marker or henna, or something else.

Showing your scars can be difficult, if it's your first time or even if you've done it many times before. Either way preparing ahead of time can make it a lot easier.

Accepting your scars

Being more comfortable with your scars makes it a lot easier to show your scars, the more confident you seem the less likely people are to ask or talk about your scars as well. You can find info on accepting your scars in the section above.

Where, when, and who

Some people feel more comfortable starting showing their scars in familiar places and with familiar people who they can trust and feel supported by, like at home or when hanging out with friends. Others prefer to start showing them around people they don't know and whose possible judgments or comments don't matter, like going out for a walk alone or to a library. Whoever and wherever you choose to show your scars is fully up to you and there isn't any correct or incorrect way to go about it.

As well as where and with whom you choose to start showing your scars, when can make a big impact too. Showing your scars can bring up uncomfortable or painful memories, other people's reactions can also be hurtful so it's a good idea to choose to begin showing them when you are doing well, have ways to cope with any negative thoughts or feelings that come up, and aren't feeling pressured into showing them. It's ok to wait or even never show your scars if you don't feel comfortable or ready yet.

forewarning people

You of course do not have to warn people if you don't want to, but it can help if you are worried about surprising someone you know or them asking questions or commenting on your scars the first time they see them. Bringing it up first gives you more control of the conversation and when/where it takes place. For example, you could send the person a message letting them know ahead of time that you self-harm or used to and that you have scar so that you can answer any questions they might have or let the person know you are ok but don't want to talk about it.

Preparing for reactions

It is natural for people to notice differences that you don't see very often, like scarring, and then for people to comment on, ask questions about, or stare at your scars. Most people mean no harm, often times comments, questions, or starring can come from care, but this doesn't mean they can't be upsetting or be difficult to respond to. Planning a few different responses for if people do comment on or ask about your scars can make you feel more confident about showing our scars and make it easier to respond to these responses.

You can find many lists of ideas of things to say if people ask about your self-harm scars, many of these lists including lying about what your scars are which isn't wrong but can make it harder for you to talk about your self-harm and could reinforce shame and stigma around self-harm. If you are comfortable doing so, a simple response like just saying they're scars or self-harm scars and then changing the subject or saying you don't want to talk about it can work just as well while not making it seem like self-harm is something that should be hidden. Someone might also ask why you hurt yourself or if you're ok or still hurting yourself, you don't have to answer questions like this is you don't want to and just say you don't want to talk about it.

Changing Faces has advice on preparing for and coping with people's reactions to your visible differences.

Have a backup plan

When you aren't fully comfortable showing your scars it's might be a good idea to bring a change of clothes or extra layers that would cover your scars in case you change your mind and want to cover your scars. You can find ways to cover your scars in the last section.

Treating scars is not just about making them less visible, it can make them softer (making it easier to move) and less itchy and painful, as well. Some treatments can only be used on fully healed scars (not scabs), so remember to check that first. Here are some ways you can treat you’re scars…

• Silicone ointment or tape
• Hydrocolloid dressing
• Massaging with bio-oil, water based non-fragranced cream, emollient creams, rosehip oil, etc.
• Pressure dressings
• Use sunscreen or keep scars covered when outside, scars are especially prone to sunburn
• Talk to a doctor; some treatments for scars are only available by prescription or can only be done by a doctor

It is completely up to you if and when you do show or cover your scars. Not every method of covering scars is mentioned here (ex, cover up tattoos), see the above section for info on fading scars.