Fibrosis , also known as fibrotic scarring , is a pathological wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodelling and the formation of permanent scar tissue .
87-556: A scar (or scar tissue ) is an area of fibrous tissue that replaces normal skin after an injury . Scars result from the biological process of wound repair in the skin, as well as in other organs , and tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions , every wound (e.g., after accident , disease , or surgery ) results in some degree of scarring. An exception to this are animals with complete regeneration , which regrow tissue without scar formation. Scar tissue
174-416: A ketone ), the glycerol component of triglycerides can be converted into glucose , via gluconeogenesis by conversion into dihydroxyacetone phosphate and then into glyceraldehyde 3-phosphate , for brain fuel when it is broken down. Fat cells may also be broken down for that reason if the brain's needs ever outweigh the body's. Triglycerides cannot pass through cell membranes freely. Special enzymes on
261-643: A silk -derived sericin hydrogel dressing was undergoing research, the material was shown to prevent scar formation. By 2021, more people were paying attention to the possibility of scar revision and new technologies. In 2021, researchers found that, verteporfin , an FDA -approved drug for eye disease, could enable scar-free healing in mice. According to the study, the drug works by blocking mechanical stress signals in fibroblast cells. Fibrosis Repeated injuries, chronic inflammation and repair are susceptible to fibrosis, where an accidental excessive accumulation of extracellular matrix components, such as
348-419: A 7-day window on a monthly basis. All other adult tissues, upon rapid shedding or injury, can scar. Prolonged inflammation , as well as the fibroblast proliferation, can occur. Redness that often follows an injury to the skin is not a scar and is generally not permanent (see wound healing ). The time it takes for this redness to dissipate may, however, range from a few days to, in some serious and rare cases,
435-454: A collagen matrix. This collagen overexpression continues and crosslinks the fiber arrangement inside the collagen matrix, making the collagen dense. This densely packed collagen, morphing into an inelastic whitish collagen scar wall, blocks off cell communication and regeneration; as a result, the new tissue generated will have a different texture and quality than the surrounding unwounded tissue. This prolonged collagen-producing process results in
522-419: A cosmetic problem, keloid scars are only inert masses of collagen and therefore completely harmless and not cancerous. However, they can be itchy or painful in some individuals. They tend to be most common on the shoulders and chest . Hypertrophic scars and keloids tend to be more common in wounds closed by secondary intention. Surgical removal of keloid is risky and may exacerbate the condition and worsening of
609-422: A decreased risk of certain cancers, including breast and colorectal cancer, while other studies found no associations with cancer risk. Polyunsaturated fat supplementation was found to have no effect on the incidence of pregnancy-related disorders, such as hypertension or preeclampsia , but may increase the length of gestation slightly and decreased the incidence of early premature births. Expert panels in
696-662: A few essential fatty acids that must be included in the diet. Dietary fats are also the carriers of some flavor and aroma ingredients and vitamins that are not water-soluble . In humans and many animals, fats serve both as energy sources and as stores for energy in excess of what the body needs immediately. Each gram of fat when burned or metabolized releases about nine food calories (37 kJ = 8.8 kcal ). Fats are also sources of essential fatty acids , an important dietary requirement. Vitamins A , D , E , and K are fat-soluble, meaning they can only be digested, absorbed, and transported in conjunction with fats. Fats play
783-406: A few years. Elevated corticosteroid levels are implicated in striae development. Humans and other placental mammals have an umbilical scar (commonly referred to as a navel ) which starts to heal when the umbilical cord is cut after birth. Egg-laying animals have an umbilical scar which, depending on the species, may remain visible for life or disappear within a few days after birth. A scar
870-487: A few years. Scars form differently based on the location of the injury on the body and the age of the person who was injured. The worse the initial damage is, the worse the scar will generally be. Skin scars occur when the dermis (the deep, thick layer of skin) is damaged. Most skin scars are flat and leave a trace of the original injury that caused them. Wounds allowed to heal secondarily tend to scar worse than wounds from primary closure. An injury does not become
957-620: A form of body art within some cultures and subcultures. These forms of ritual and non-ritual scarring practices can be found in many groups and cultures around the world. First attested in English in the late 14th century, the word scar derives from a conflation of Old French escharre , from Late Latin eschara , which is the Latinisation of the Greek ἐσχάρα ( eskhara ), meaning "hearth, fireplace", but in medicine "scab, eschar on
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#17327797278541044-411: A fortuna scar. The scarring is created by fibroblast proliferation, a process that begins with a reaction to the clot. To mend the damage, fibroblasts slowly form the collagen scar. The fibroblast proliferation is circular and cyclically, the fibroblast proliferation lays down thick, whitish collagen inside the provisional and collagen matrix, resulting in the abundant production of packed collagen on
1131-434: A genetic connective tissue disorder, such as Ehlers–Danlos syndrome . Stretch marks (technically called striae ) are also a form of scarring. These are caused when the skin is stretched rapidly (for instance during pregnancy , significant weight gain , or adolescent growth spurts ), or when skin is put under tension during the healing process (usually near joints ). This type of scar usually improves in appearance after
1218-507: A higher proportion of unsaturated acids, although there are exceptions such as coconut oil and palm kernel oil . Foods containing unsaturated fats include avocado , nuts , olive oils , and vegetable oils such as canola . Many scientific studies have found that replacing saturated fats with cis unsaturated fats in the diet reduces risk of cardiovascular diseases (CVDs), diabetes , or death. These studies prompted many medical organizations and public health departments, including
1305-513: A large fraction of the population in developing countries. Concerns were also expressed at a 2010 conference of the American Dietetic Association that a blanket recommendation to avoid saturated fats could drive people to also reduce the amount of polyunsaturated fats, which may have health benefits, and/or replace fats by refined carbohydrates — which carry a high risk of obesity and heart disease. For these reasons,
1392-551: A more serious form of excessive scarring, because they can grow indefinitely into large, tumorous (although benign) neoplasms . Hypertrophic scars are often distinguished from keloid scars by their lack of growth outside the original wound area, but this commonly taught distinction can lead to confusion. Keloid scars can occur on anyone, but they are most common in dark-skinned people. They can be caused by surgery, cuts, accident, acne or, sometimes, body piercings . In some people, keloid scars form spontaneously. Although they can be
1479-405: A process called lipolysis . They are subsequently moved to absorptive enterocyte cells lining the intestines. The triglycerides are rebuilt in the enterocytes from their fragments and packaged together with cholesterol and proteins to form chylomicrons . These are excreted from the cells and collected by the lymph system and transported to the large vessels near the heart before being mixed into
1566-420: A progressive irreversible fibrotic response if tissue injury is severe or repetitive, or if the wound healing response itself becomes deregulated. Fibrosis can occur in many tissues within the body, typically as a result of inflammation or damage. Common sites of fibrosis include the lungs, liver, kidneys, brain, and heart: Myocardial fibrosis has two forms: Fibrosis reversal Historically, fibrosis
1653-430: A scar until the wound has completely healed; this can take many months, or years in the worst pathological cases, such as keloids. To begin to patch the damage, a clot is created; this clot is the beginning process that results in a provisional matrix. In the process, the first layer is a provisional matrix and is not a scar. Over time, the wounded body tissue overexpresses collagen inside the provisional matrix to create
1740-423: A significant relationship between saturated fat and high serum cholesterol levels, which in turn have been claimed to have a causal relation with increased risk of cardiovascular disease (the so-called lipid hypothesis ). However, high cholesterol may be caused by many factors. Other indicators, such as high LDL/HDL ratio, have proved to be more predictive. In a study of myocardial infarction in 52 countries,
1827-520: A type of calcium channel blocker, is considered a candidate drug for the treatment of hypertrophic scars. A study conducted by the Catholic University of Korea concluded that verapamil-releasing silicone gel is effective and is a superior alternative to the conventional silicone gel where decreased median SEI, fibroblast count, and collagen density in all verapamil-added treatment groups were observed. Gross morphologic features suggested that
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#17327797278541914-503: A vital role in maintaining healthy skin and hair , insulating body organs against shock, maintaining body temperature, and promoting healthy cell function. Fat also serves as a useful buffer against a host of diseases. When a particular substance, whether chemical or biotic, reaches unsafe levels in the bloodstream, the body can effectively dilute—or at least maintain equilibrium of—the offending substances by storing it in new fat tissue. This helps to protect vital organs, until such time as
2001-466: A water molecule H 2 O . Other less common types of fats include diglycerides and monoglycerides , where the esterification is limited to two or just one of glycerol's –OH groups. Other alcohols, such as cetyl alcohol (predominant in spermaceti ), may replace glycerol. In the phospholipids , one of the fatty acids is replaced by phosphoric acid or a monoester thereof. The benefits and risks of various amounts and types of dietary fats have been
2088-551: A weak atherogenic effect. Different saturated fatty acids have differing effects on various lipid levels. The evidence for a relation between saturated fat intake and cancer is significantly weaker, and there does not seem to be a clear medical consensus about it. Various animal studies have indicated that the intake of saturated fat has a negative effect on the mineral density of bones . One study suggested that men may be particularly vulnerable. Studies have shown that substituting monounsaturated fatty acids for saturated ones
2175-494: A wound caused by burning or otherwise", and Middle English skar ("cut, crack, incision"), which is from Old Norse skarð ("notch, gap"). The conflation helped to form the English meaning. Compare the place name Scarborough for evolution of skarð to scar . Research, before 2009, focused on scar improvements with research into molecular mechanisms. Treatments involving molecular mechanisms including avotermin, ribosomal s6 kinase (RSK), and osteopontin were investigated at
2262-451: Is a triglyceride , an ester of the triple alcohol glycerol H(–CHOH–) 3 H and three fatty acids. The molecule of a triglyceride can be described as resulting from a condensation reaction (specifically, esterification ) between each of glycerol's –OH groups and the HO– part of the carboxyl group HO(O=)C− of each fatty acid, forming an ester bridge −O−(O=)C− with elimination of
2349-741: Is about 75% monounsaturated fat. The high oleic variety sunflower oil contains at least 70% monounsaturated fat. Canola oil and cashews are both about 58% monounsaturated fat. Tallow (beef fat) is about 50% monounsaturated fat, and lard is about 40% monounsaturated fat. Other sources include hazelnut , avocado oil , macadamia nut oil , grapeseed oil , groundnut oil ( peanut oil ), sesame oil , corn oil , popcorn , whole grain wheat , cereal , oatmeal , almond oil , hemp oil , and tea-oil camellia . Polyunsaturated fatty acids can be found mostly in nuts, seeds, fish, seed oils, and oysters . Food sources of polyunsaturated fats include: MUFAs (especially oleic acid) have been found to lower
2436-508: Is also used to lessen the appearance of severe glabella lines, though its effectiveness in this application is debatable. Essentially the process involves separating the skin tissue in the affected area from the deeper scar tissue. This allows the blood to pool under the affected area, eventually causing the deep rolling scar to level off with the rest of the skin area. Once the skin has leveled, treatments such as laser resurfacing , microdermabrasion or chemical peels can be used to smooth out
2523-459: Is associated with increased daily physical activity and resting energy expenditure. More physical activity, less anger, and less irritability were associated with a higher-oleic acid diet than one of a palmitic acid diet. The most common fatty acids in human diet are unsaturated or mono-unsaturated. Monounsaturated fats are found in animal flesh such as red meat , whole milk products, nuts, and high fat fruits such as olives and avocados. Olive oil
2610-509: Is composed of the same collagen as the tissue it has replaced, but the composition of the scar tissue, compared to the normal tissue, is different. Scar tissue also lacks elasticity unlike normal tissue which distributes fiber elasticity . Scars differ in the amounts of collagen overexpressed. Labels have been applied to the differences in overexpression. Two of the most common types are hypertrophic and keloid scarring, both of which experience excessive stiff collagen bundled growth overextending
2697-460: Is composed of the same protein ( collagen ) as the tissue that it replaces, but the fiber composition of the protein is different; instead of a random basketweave formation of the collagen fibers found in normal tissue, in fibrosis the collagen cross-links and forms a pronounced alignment in a single direction. This collagen scar tissue alignment is usually of inferior functional quality to the normal collagen randomised alignment. For example, scars in
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2784-607: Is contrary to the suggestion that polyunsaturated fats are shown to be protective against insulin resistance. The large scale KANWU study found that increasing MUFA and decreasing SFA intake could improve insulin sensitivity, but only when the overall fat intake of the diet was low. However, some MUFAs may promote insulin resistance (like the SFAs), whereas PUFAs may protect against it. Levels of oleic acid along with other MUFAs in red blood cell membranes were positively associated with breast cancer risk. The saturation index (SI) of
2871-401: Is convenient to apply, and shows enhanced results. A long-term course of corticosteroid injections into the scar may help flatten and soften the appearance of keloid or hypertrophic scars. Topical steroids are ineffective. However, clobetasol propionate can be used as an alternative treatment for keloid scars. Topical steroid applied immediately after fractionated CO 2 laser treatment
2958-468: Is however very effective (and more efficacious than laser treatment alone) and has shown benefit in numerous clinical studies. Scar revision is a process of cutting the scar tissue out. After the excision, the new wound is usually closed up to heal by primary intention , instead of secondary intention . Deeper cuts need a multilayered closure to heal optimally, otherwise depressed or dented scars can result. Surgical excision of hypertrophic or keloid scars
3045-426: Is often associated to other methods, such as pressotherapy or silicone gel sheeting. Lone excision of keloid scars, however, shows a recurrence rate close to 45%. A clinical study is currently ongoing to assess the benefits of a treatment combining surgery and laser-assisted healing in hypertrophic or keloid scars. Subcision is a process used to treat deep rolling scars left behind by acne or other skin diseases. It
3132-521: Is partially modulated by dietary fat ratios ( omega−3 / 6 / 9 ) with both omega−3 and −9 thought to be anti-inflammatory, and omega−6 pro-inflammatory (as well as by numerous other dietary components, particularly polyphenols and exercise, with both of these anti-inflammatory). Although both pro- and anti-inflammatory types of fat are biologically necessary, fat dietary ratios in most US diets are skewed towards omega−6, with subsequent disinhibition of inflammation and potentiation of insulin resistance. This
3219-627: Is similar to the process of scarring, in that both involve stimulated fibroblasts laying down connective tissue , including collagen and glycosaminoglycans . The process is initiated when immune cells such as macrophages release soluble factors that stimulate fibroblasts. The most well characterized pro-fibrotic mediator is TGF beta , which is released by macrophages as well as any damaged tissue between surfaces called interstitium . Other soluble mediators of fibrosis include CTGF , platelet-derived growth factor (PDGF), and interleukin 10 (IL-10). These initiate signal transduction pathways such as
3306-531: Is sometimes used to prevent recurrence of severe keloid and hypertrophic scarring. It is thought to be effective despite a lack of clinical trials, but only used in extreme cases due to the perceived risk of long-term side effects. Silicone scar treatments are commonly used in preventing scar formation and improving existing scar appearance. A meta-study by the Cochrane collaboration found weak evidence that silicone gel sheeting helps prevent scarring. However,
3393-530: Is the product of the body's repair mechanism after tissue injury. If a wound heals quickly within two weeks with new formation of skin, minimal collagen will be deposited and no scar will form. When the extracellular matrix senses elevated mechanical stress loading, tissue will scar, and scars can be limited by stress shielding wounds. Small full thickness wounds under 2mm reepithelize fast and heal scar free. Deep second-degree burns heal with scarring and hair loss . Sweat glands do not form in scar tissue, which impairs
3480-508: The ApoB / ApoA1 (related to LDL and HDL, respectively) ratio was the strongest predictor of CVD among all risk factors. There are other pathways involving obesity , triglyceride levels, insulin sensitivity , endothelial function , and thrombogenicity , among others, that play a role in CVD, although it seems, in the absence of an adverse blood lipid profile, the other known risk factors have only
3567-739: The Engrailed-1 genetic marker. EPFs are the primary contributors to all fibrotic outcomes after wounding. ENFs do not contribute to fibrotic outcomes. Mammalian wounds that involve the dermis of the skin heal by repair, not regeneration (except in 1st trimester inter-uterine wounds and in the regeneration of deer antlers). Full-thickness wounds heal by a combination of wound contracture and edge re-epitheliasation. Partial thickness wounds heal by edge re-epithelialisation and epidermal migration from adnexal structures (hair follicles, sweat glands and sebaceous glands). The site of keratinocyte stem cells remains unknown but stem cells are likely to reside in
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3654-468: The Mediterranean Sea area, includes more total fat than the diet of Northern European countries, but most of it is in the form of unsaturated fatty acids (specifically, monounsaturated and omega-3) from olive oil and fish, vegetables, and certain meats like lamb, while consumption of saturated fat is minimal in comparison. A 2017 review found evidence that a Mediterranean-style diet could reduce
3741-480: The World Health Organization (WHO), to officially issue that advice. Some countries with such recommendations include: A 2004 review concluded that "no lower safe limit of specific saturated fatty acid intakes has been identified" and recommended that the influence of varying saturated fatty acid intakes against a background of different individual lifestyles and genetic backgrounds should be
3828-493: The basal layer of the epidermis and below the bulge area of hair follicles. The fibroblast involved in scarring and contraction is the myofibroblast , which is a specialized contractile fibroblast. These cells express α-smooth muscle actin (α-SMA). The myofibroblasts are absent in the first trimester in the embryonic stage where damage heals scar-free; in small incisional or excision wounds less than 2 mm that also heal without scarring; and in adult unwounded tissues where
3915-434: The carbon dioxide laser (CO 2 ) or Er:YAG offer the best results for atrophic and acne scars. Like dermabrasion , ablative lasers work by removing the epidermis. Healing times for ablative therapy are much longer and the risk profile is greater compared to nonablative therapy; however, nonablative therapy offers only minor improvements in cosmetic appearance of atrophic and acne scars. Low-dose, superficial radiotherapy
4002-407: The circulation . These metabolic activities are regulated by several hormones (e.g., insulin , glucagon and epinephrine ). Adipose tissue also secretes the hormone leptin . A variety of chemical and physical techniques are used for the production and processing of fats, both industrially and in cottage or home settings. They include: The pancreatic lipase acts at the ester bond, hydrolyzing
4089-744: The rumen of these animals. CLA has two double bonds, one in the cis configuration and one in trans , which makes it simultaneously a cis - and a trans -fatty acid. Concerns about trans fatty acids in human diet were raised when they were found to be an unintentional byproduct of the partial hydrogenation of vegetable and fish oils. While these trans fatty acids (popularly called "trans fats") are edible, they have been implicated in many health problems. The hydrogenation process, invented and patented by Wilhelm Normann in 1902, made it possible to turn relatively cheap liquid fats such as whale or fish oil into more solid fats and to extend their shelf-life by preventing rancidification. (The source fat and
4176-863: The AHA estimated that replacement of saturated fat with polyunsaturated fat in the American diet could reduce the risk of cardiovascular diseases by 30%. The consumption of saturated fat is generally considered a risk factor for dyslipidemia —abnormal blood lipid levels, including high total cholesterol, high levels of triglycerides, high levels of low-density lipoprotein (LDL, "bad" cholesterol) or low levels of high-density lipoprotein (HDL, "good" cholesterol). These parameters in turn are believed to be risk indicators for some types of cardiovascular disease. These effects were observed in children too. Several meta-analyses (reviews and consolidations of multiple previously published experimental studies) have confirmed
4263-480: The AKT/mTOR and SMAD pathways that ultimately lead to the proliferation and activation of fibroblasts, which deposit extracellular matrix into the surrounding connective tissue. This process of tissue repair is a complex one, with tight regulation of extracellular matrix (ECM) synthesis and degradation ensuring maintenance of normal tissue architecture. However, the entire process, although necessary, can lead to
4350-582: The U.S. Food and Drug Administration , for example, recommends to consume at least 10% (7% for high-risk groups) of calories from saturated fat, with an average of 30% (or less) of total calories from all fat. A general 7% limit was recommended also by the American Heart Association (AHA) in 2006. The WHO/FAO report also recommended replacing fats so as to reduce the content of myristic and palmitic acids, specifically. The so-called Mediterranean diet , prevalent in many countries in
4437-726: The United States and Europe recommend that pregnant and lactating women consume higher amounts of polyunsaturated fats than the general population to enhance the DHA status of the fetus and newborn. In nature, unsaturated fatty acids generally have double bonds in cis configuration (with the adjacent C–C bonds on the same side) as opposed to trans . Nevertheless, trans fatty acids (TFAs) occur in small amounts in meat and milk of ruminants (such as cattle and sheep), typically 2–5% of total fat. Natural TFAs, which include conjugated linoleic acid (CLA) and vaccenic acid , originate in
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#17327797278544524-436: The blood. Various tissues can capture the chylomicrons, releasing the triglycerides to be used as a source of energy. Liver cells can synthesize and store triglycerides. When the body requires fatty acids as an energy source, the hormone glucagon signals the breakdown of the triglycerides by hormone-sensitive lipase to release free fatty acids. As the brain cannot utilize fatty acids as an energy source (unless converted to
4611-404: The body overproduces collagen , which causes the scar to be raised above the surrounding skin. Hypertrophic scars take the form of a red raised lump on the skin for lighter pigmented skin and the form of dark brown for darker pigmented skin. They usually occur within 4 to 8 weeks following wound infection or wound closure with excess tension and/or other traumatic skin injuries. Keloid scars are
4698-406: The bond and "releasing" the fatty acid. In triglyceride form, lipids cannot be absorbed by the duodenum . Fatty acids, monoglycerides (one glycerol, one fatty acid), and some diglycerides are absorbed by the duodenum, once the triglycerides have been broken down. In the intestine , following the secretion of lipases and bile , triglycerides are split into monoacylglycerol and free fatty acids in
4785-435: The collagen, is produced by fibroblasts, leading to the formation of a permanent fibrotic scar. In response to injury, this is called scarring , and if fibrosis arises from a single cell line, this is called a fibroma . Physiologically, fibrosis acts to deposit connective tissue, which can interfere with or totally inhibit the normal architecture and function of the underlying organ or tissue. Fibrosis can be used to describe
4872-480: The combination of verapamil and silicone improves the overall quality of hypertrophic scars by reducing scar height and redness. This was verified with quantifiable histomorphometric parameters; however, oral verapamil is not a good choice because of its effect of lowering blood pressure. Intralesional injection of verapamil is also suboptimal because of the required frequency for injections. Topical silicone gel combined with verapamil does not lead to systemic hypotension,
4959-438: The epidermis in a controlled manner, leading to exfoliation and the alleviation of certain skin conditions, including superficial acne scars. Various chemicals can be used depending upon the depth of the peel, and caution should be used, particularly for dark-skinned individuals and those individuals susceptible to keloid formation or with active infections. Filler injections of collagen can be used to raise atrophic scars to
5046-406: The fibers giving scars their uneven texture. Over time, the fibroblasts continue to crawl around the matrix, adjusting more fibers and, in the process, the scarring settles and becomes stiff. This fibroblast proliferation also contracts the tissue. In unwounded tissue, these fibers are not overexpressed with thick collagen and do not contract. EPF and ENF fibroblasts have been genetically traced with
5133-418: The fibroblast in itself is arrested; however, the myofibroblast is found in massive numbers in adult wound healing which heals with a scar. The myofibroblasts make up a high proportion of the fibroblasts proliferating in the postembryonic wound at the onset of healing. In the rat model, for instance, myofibroblasts can constitute up to 70% of the fibroblasts, and is responsible for fibrosis on tissue. Generally,
5220-490: The focus in future studies. This advice is often oversimplified by labeling the two kinds of fats as bad fats and good fats , respectively. However, since the fats and oils in most natural and traditionally processed foods contain both unsaturated and saturated fatty acids, the complete exclusion of saturated fat is unrealistic and possibly unwise. For instance, some foods rich in saturated fat, such as coconut and palm oil, are an important source of cheap dietary calories for
5307-408: The incidence of insulin resistance ; PUFAs (especially large amounts of arachidonic acid ) and SFAs (such as arachidic acid ) increased it. These ratios can be indexed in the phospholipids of human skeletal muscle and in other tissues as well. This relationship between dietary fats and insulin resistance is presumed secondary to the relationship between insulin resistance and inflammation , which
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#17327797278545394-416: The keloid. An atrophic scar takes the form of a sunken recess in the skin, which has a pitted appearance. These are caused when underlying structures supporting the skin, such as fat or muscle , are lost. This type of scarring is often associated with acne, chickenpox , other diseases (especially Staphylococcus infection), surgery, certain insect and spider bites, or accidents. It can also be caused by
5481-434: The level of surrounding skin. Risks vary based upon the filler used, and can include further disfigurement and allergic reaction . Nonablative lasers, such as the 585 nm pulsed dye laser , 1064 nm and 1320 nm Nd:YAG , or the 1540 nm Er:Glass are used as laser therapy for hypertrophic scars and keloids. There is tentative evidence for burn scars that they improve the appearance. Ablative lasers such as
5568-424: The main components of vegetable oils and of fatty tissue in animals; or, even more narrowly, to triglycerides that are solid or semisolid at room temperature, thus excluding oils . The term may also be used more broadly as a synonym of lipid —any substance of biological relevance, composed of carbon , hydrogen , or oxygen , that is insoluble in water but soluble in non-polar solvents . In this sense, besides
5655-419: The main components of common food products like milk , butter , tallow , lard , salt pork , and cooking oils . They are a major and dense source of food energy for many animals and play important structural and metabolic functions in most living beings, including energy storage, waterproofing, and thermal insulation . The human body can produce the fat it requires from other food ingredients, except for
5742-504: The merits of substituting polyunsaturated fats for saturated fats. The effect of saturated fat on cardiovascular disease has been extensively studied. The general consensus is that there is evidence of moderate-quality of a strong, consistent, and graded relationship between saturated fat intake, blood cholesterol levels, and the incidence of cardiovascular disease. The relationships are accepted as causal, including by many government and medical organizations. A 2017 review by
5829-486: The myofibroblasts disappear from the wound within 30 days, but can remain in pathological cases in hypertrophy , such as keloids. Myofibroblasts have plasticity and in mice can be transformed into fat cells, instead of scar tissue, via the regeneration of hair follicles. Wounds under 2mm generally do not scar but larger wounds generally do scar. In 2011 it was found that mechanical stress can stimulate scarring and that stress shielding can reduce scarring in wounds. In 2021 it
5916-1054: The object of much study, and are still highly controversial topics. There are two essential fatty acids (EFAs) in human nutrition: alpha-Linolenic acid (an omega-3 fatty acid ) and linoleic acid (an omega-6 fatty acid ). The adult body can synthesize other lipids that it needs from these two. Different foods contain different amounts of fat with different proportions of saturated and unsaturated fatty acids. Some animal products, like beef and dairy products made with whole or reduced fat milk like yogurt , ice cream , cheese and butter have mostly saturated fatty acids (and some have significant contents of dietary cholesterol ). Other animal products, like pork , poultry , eggs , and seafood have mostly unsaturated fats. Industrialized baked goods may use fats with high unsaturated fat contents as well, especially those containing partially hydrogenated oils , and processed foods that are deep-fried in hydrogenated oil are high in saturated fat content. Plants and fish oil generally contain
6003-416: The observed health impact of replacing dietary saturated fat with linoleic acid found that it increased rates of death from all causes, coronary heart disease, and cardiovascular disease. These studies have been disputed by many scientists, and the consensus in the medical community is that saturated fat and cardiovascular disease are closely related. Still, these discordant studies fueled debate over
6090-508: The offending substances can be metabolized or removed from the body by such means as excretion , urination , accidental or intentional bloodletting , sebum excretion, and hair growth. In animals, adipose tissue , or fatty tissue is the body's means of storing metabolic energy over extended periods of time. Adipocytes (fat cells) store fat derived from the diet and from liver metabolism . Under energy stress these cells may degrade their stored fat to supply fatty acids and also glycerol to
6177-403: The pathological state of excess deposition of fibrous tissue, as well as the process of connective tissue deposition in healing. Defined by the pathological accumulation of extracellular matrix (ECM) proteins, fibrosis results in scarring and thickening of the affected tissue — it is in essence a natural wound healing response which interferes with normal organ function. Fibrosis
6264-585: The pattern was reversed: the Hungarian product containing twice the trans fat of the New York product. Even within the United States, there was variation, with fries in New York containing 30% more trans fat than those from Atlanta . Numerous studies have found that consumption of TFAs increases risk of cardiovascular disease. The Harvard School of Public Health advises that replacing TFAs and saturated fats with cis monounsaturated and polyunsaturated fats
6351-432: The process were initially kept secret to avoid consumer distaste. ) This process was widely adopted by the food industry in the early 1900s; first for the production of margarine , a replacement for butter and shortening, and eventually for various other fats used in snack food, packaged baked goods, and deep fried products. Full hydrogenation of a fat or oil produces a fully saturated fat. However, hydrogenation generally
6438-411: The regulation of body temperature. Elastic fibers are generally not detected in scar tissue younger than 3 months old. In scars, rete pegs are lost; through a lack of rete pegs, scars tend to shear easier than normal tissue. The endometrium , the inner lining of the uterus, is the only adult tissue to undergo rapid cyclic shedding and regeneration without scarring, shedding and restoring roughly inside
6525-491: The risk of cardiovascular diseases, overall cancer incidence, neurodegenerative diseases, diabetes, and mortality rate. A 2018 review showed that a Mediterranean-like diet may improve overall health status, such as reduced risk of non-communicable diseases. It also may reduce the social and economic costs of diet-related illnesses. A small number of contemporary reviews have challenged this negative view of saturated fats. For example, an evaluation of evidence from 1966 to 1973 of
6612-532: The same membranes was inversely associated with breast cancer risk. MUFAs and low SI in erythrocyte membranes are predictors of postmenopausal breast cancer. Both of these variables depend on the activity of the enzyme delta-9 desaturase (Δ9-d). Results from observational clinical trials on PUFA intake and cancer have been inconsistent and vary by numerous factors of cancer incidence, including gender and genetic risk. Some studies have shown associations between higher intakes and/or blood levels of omega-3 PUFAs and
6699-439: The scarred tissue. Research shows the use of vitamin E and onion extract (sold as Mederma ) as treatments for scars is ineffective. Vitamin E causes contact dermatitis in up to 33% of users and in some cases it may worsen scar appearance and could cause minor skin irritations, but Vitamin C and some of its esters fade the dark pigment associated with some scars. The permanence of scarring has led to its intentional use as
6786-437: The skin are less resistant to ultraviolet radiation , and sweat glands and hair follicles do not grow back within scar tissues. A myocardial infarction , commonly known as a heart attack, causes scar formation in the heart muscle, which leads to loss of muscular power and possibly heart failure . However, there are some tissues (e.g. bone ) that can heal without any structural or functional deterioration. All scarring
6873-442: The studies examining it were of poor quality and susceptible to bias. Pressure dressings are commonly used in managing burn and hypertrophic scars, although supporting evidence is lacking. Care providers commonly report improvements, however, and pressure therapy has been effective in treating ear keloids. The general acceptance of the treatment as effective may prevent it from being further studied in clinical trials. Verapamil ,
6960-611: The time. After successful phase I/II trials , human recombinant TGF-β3 (avotermin, planned trade name Juvista) failed in Phase III trials. In 2011, the scientific literature highlighted stress shielding a fresh wound through the wound healing process, brings significant scar improvement and smaller scars. By 2016, skin had been regenerated in vivo and in vitro . and scar-free healing had been operationalized and induced by four main regeneration techniques: by instrument, by materials, by drugs, and by in vitro 3-D printing. In 2018,
7047-449: The tissue, blocking off regeneration of tissues. Another form is atrophic scarring (sunken scarring), which also has an overexpression of collagen blocking regeneration. This scar type is sunken, because the collagen bundles do not overextend the tissue. Stretch marks (striae) are regarded as scars by some. High melanin levels and either African or Asian ancestry may make adverse scarring more noticeable. Hypertrophic scars occur when
7134-963: The total fat in those foods containing man-made trans fats formed by partially hydrogenating plant fats may be trans fat. Baking shortenings, unless reformulated, contain around 30% trans fats compared to their total fats. High-fat dairy products such as butter contain about 4%. Margarines not reformulated to reduce trans fats may contain up to 15% trans fat by weight, but some reformulated ones are less than 1% trans fat. High levels of TFAs have been recorded in popular "fast food" meals. An analysis of samples of McDonald's French fries collected in 2004 and 2005 found that fries served in New York City contained twice as much trans fat as in Hungary , and 28 times as much as in Denmark , where trans fats are restricted. For Kentucky Fried Chicken products,
7221-415: The triglycerides, the term would include several other types of compounds like mono- and diglycerides , phospholipids (such as lecithin ), sterols (such as cholesterol ), waxes (such as beeswax ), and free fatty acids, which are usually present in human diet in smaller amounts. Fats are one of the three main macronutrient groups in human diet , along with carbohydrates and proteins , and
7308-632: The walls of blood vessels called lipoprotein lipases must break down triglycerides into free fatty acids and glycerol. Fatty acids can then be taken up by cells via fatty acid transport proteins (FATPs). Triglycerides, as major components of very-low-density lipoprotein (VLDL) and chylomicrons , play an important role in metabolism as energy sources and transporters of dietary fat. They contain more than twice as much energy (approximately 9 kcal/g or 38 kJ /g) as carbohydrates (approximately 4 kcal/g or 17 kJ/g). The most common type of fat, in human diet and most living beings,
7395-500: Was considered an irreversible process. However, several recent studies have demonstrated reversal in liver and lung tissue, and in cases of renal, myocardial, and oral-submucosal fibrosis. Fat In nutrition , biology , and chemistry , fat usually means any ester of fatty acids , or a mixture of such compounds , most commonly those that occur in living beings or in food . The term often refers specifically to triglycerides (triple esters of glycerol ), that are
7482-441: Was found that using chemicals to manipulate fibroblasts to not sense mechanical stress brought scar-free healing. The scar-free healing also occurred when mechanical stress was placed onto a wound. Early and effective treatment of acne scarring can prevent severe acne and the scarring that often follows. In 2004, no prescription drugs for the treatment or prevention of scars were available. Chemical peels are chemicals which destroy
7569-781: Was interrupted before completion, to yield a fat product with specific melting point, hardness, and other properties. Partial hydrogenation turns some of the cis double bonds into trans bonds by an isomerization reaction . The trans configuration is favored because it is the lower energy form. This side reaction accounts for most of the trans fatty acids consumed today, by far. An analysis of some industrialized foods in 2006 found up to 30% "trans fats" in artificial shortening, 10% in breads and cake products, 8% in cookies and crackers, 4% in salty snacks, 7% in cake frostings and sweets, and 26% in margarine and other processed spreads. Another 2010 analysis however found only 0.2% of trans fats in margarine and other processed spreads. Up to 45% of
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