Healing: Understanding the Skin Repair Process

24/04/2025
CICATRICE-SUR-LE-DOS
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Whether it's a cut, a burn, a cosmetic procedure, or even an acne pimple, your skin may need to repair itself. Healing is the biological mechanism that allows it to restore itself. However, not all skin has the same regenerative capacity. Several factors, such as age, general health, and lifestyle, influence this repair process.

Managing healing properly isn't just about waiting for the wound to heal on its own, and poor management can lead to complications and visible scarring. It's therefore essential to understand the stages of healing and adopt the right techniques to optimize skin repair and minimize residual scarring.

The stages of healing

Not all wounds heal the same way . Superficial wounds, such as scratches, grazes, or small cuts, only affect the upper layers of the skin. They usually heal quickly , without scarring if they are well protected and monitored.

Conversely, deeper or more complex wounds : burns, surgical wounds, ulcers, bedsores or lesions affecting muscles or nerves, often require medical care . Their healing is slower and more delicate, because it involves deeper tissues, a high risk of infection and the formation of visible scars. In these cases, rigorous monitoring and appropriate care are essential to support skin regeneration and limit complications.

Regardless of the type of scar, the healing process takes place in three successive phases, each involving specific cells and biological mechanisms¹.

  • The vascular and inflammatory phase

    The first stage of healing begins immediately after an injury and lasts on average 4 days . Its role: to stop bleeding and prevent infection. First, blood vessels constrict (vasoconstriction) and platelets form a clot to limit bleeding. Then, the immune system intervenes to eliminate bacteria, clean the wound, and activate tissue repair.

    During this phase, the visible and felt symptoms are characteristic of inflammation, with redness, heat, swelling, and pain of varying intensity. Although they are unpleasant, they indicate that the healing process has begun.

  • Proliferative phase

    After the inflammatory phase, the skin enters the repair phase (from approximately day 4 to day 21) to restore healthy, functional skin tissue. Fibroblasts, cells expert in regeneration, produce collagen to form new tissue that fills the wound. This tissue, red and slightly swollen, is still fragile. At the same time, epidermal cells proliferate to cover the wound. This process of forming new tissue restores the skin barrier and prevents bacterial penetration.

  • The remodeling phase

    The final phase of healing is tissue remodeling . Beginning around the 21st day, it can last several months, or even up to two years in some cases.
    During this phase, the collagen reorganizes to strengthen the skin : the initial, more flexible collagen is replaced by more resistant collagen.

Added to this is the maturation of the scar , which evolves gradually. Initially red and raised due to strong vascularization, it becomes thinner, whiter and more supple . Its final appearance depends on each skin and the care provided: it can become discreet or, on the contrary, remain hypertrophic or atrophic.


Thanks to healing, the skin has an incredible capacity for regeneration! Although the healed area retains certain characteristics , such as a finer texture and slightly reduced flexibility, appropriate care can optimize its development and promote a discreet and resistant scar.

Symptoms of scarring

As you've probably experienced, healing is accompanied by many skin sensations. Some are completely normal and indicate good tissue repair, while others may indicate a complication².

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Normal signs of healing

In the first few days after an injury, the skin often experiences redness, warmth, and tightness. These symptoms are due to increased blood flow and gradually fade as the wound heals.

One of the most common signs of good healing is the sensation of itching. While sometimes unpleasant, it's a positive sign that skin tissue is regenerating. It's best to avoid scratching, as it can slow down the healing process and cause microtrauma and infections.

Why does the skin itch during healing?

  • During skin repair, some damaged nerve endings reform, causing tingling and itching.
  • The body also produces histamine, an inflammatory molecule that promotes healing and stimulates skin irritation receptors, making you want to scratch.
  • The new skin is often drier and thinner than the original skin, a condition that can cause itching.
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Abnormal signs of healing

If pain, redness, or inflammation persists beyond a few days or worsens, it may indicate a complication. Here are the main signs to look out for:

  • A growing or throbbing pain.
  • A spreading redness.
  • A purulent discharge or unusual odor.
  • Fever and general malaise.

If any of these symptoms appear, it is essential to consult a doctor or dermatologist.

What factors influence healing?

The speed and quality of healing depend on many factors, both internal and external. Some conditions slow the process and increase the risk of visible scarring, while others can promote rapid and optimal healing.³

Internal factors

  • Age: Young skin heals quickly due to its good cell renewal. With age, collagen production decreases, vascularization is less efficient, and immune defenses are sometimes weakened, which slows repair and promotes more pronounced scars.
  • Genetics: Certain genetic predispositions influence the quality of healing. Dark skin tends to develop keloid scars (thick and swollen), while very thin or sensitive skin may develop atrophic scars (which deepen).
  • Specific medical conditions: Certain illnesses slow down or alter the healing process, such as diabetes, inflammatory diseases (psoriasis, eczema, lupus, etc.) or circulatory disorders (venous insufficiency, arteritis).

External factors

1. Food:
For good healing, it is important to provide the skin, through diet, with the nutrients it needs, such as:

  • Vitamin C : Promotes collagen production and accelerates tissue repair.
  • Vitamin A : contributes to cell renewal.
  • Vitamin E : helps protect the skin against oxidative stress.
  • Zinc : enables cell multiplication and collagen synthesis.
  • Proteins : essential for the formation of new skin cells.

2. Location of the wound:

  • Wounds located on joints or mobile areas (knees, elbows, fingers, etc.), where the skin is subject to frequent traction, heal less easily.
  • Wounds in areas subject to less mechanical stress (cheeks, arms, stomach) heal better.

3. The environment:

  • Healing in a moist environment (with suitable dressings) promotes better skin repair and limits the formation of scabs.
  • UV rays are not good for skin healing . It is essential to protect the wound during healing and for as long as possible afterward to avoid hyperpigmentation and visible scarring.

The impact of scars on quality of life

Every year, 100 million people are affected by scarring. And regardless of their origin, scars can significantly impact the quality of life of these patients through their adverse physical, unsightly, or emotional effects.

In addition to physical discomfort, there are psychological discomforts that can be characterized as:

  • patient dissatisfaction with the visual appearance of their scars (for 50% of people),
  • a negative impact on privacy (for 50%),
  • or even the appearance of anxiety (for 20%).

Stretch marks are a form of scarring that also affects those affected. They affect 90% of women (including 75% of pregnant women) and 40% of men , and can significantly affect the lives of these people by promoting low self-esteem, anxiety, even depression, or even impacting social life.

To support patients in their daily lives, various medical tools , such as scar scales ( patient and observer scar assessment scale - POSAS) allow the impact of scars on quality of life to be assessed ⁴.

How to help healing?

Good reflexes, as soon as an injury occurs, promote rapid healing and minimize the appearance of visible scars. Here are some tips⁵.

  • Cleanse the skin well

    Clean skin is skin that heals better. To do this, as soon as the injury occurs:

    • Clean with mild soap and water to remove dirt.
    • Disinfect with an antiseptic to limit the risk of infection.

    Avoid : alcohol or hydrogen peroxide, which can be harsh on the skin and slow down healing.

  • Moisturize the wound well

    Contrary to popular belief, leaving a wound to air dry does not speed up healing. A moist environment promotes faster healing and limits the formation of thick scabs, which can then leave marks.

    A hydrocolloid dressing helps protect the wound and maintain an environment conducive to regeneration. Applying a healing cream helps moisturize the skin around the wound and promote healing.

    To avoid : excessive use of local antibiotics which can cause irritation or bacterial resistance.

    The Topicrem answer:

    To cleanse, soothe and repair damaged skin, discover the Soothing Repair Cream from our CICA+ range.

  • Protect the scar well

    Early sun exposure on a forming scar can lead to hyperpigmentation , leaving a brown mark that is difficult to fade.

    • Apply SPF 50 sunscreen to recent scars, even in winter.
    • Wear protective clothing if the scar is on an exposed area.

    The Topicrem answer:

    To effectively protect your skin, discover the Moisturizing Sun Milk SPF50+ from our SUN PROTECT range

  • Massage the skin well

    As soon as the scar is well closed (around 2 to 3 weeks after the injury), regular massages help to soften the skin and limit the appearance of adhesions or thick scars.

    • Gently massage with a healing cream or suitable oil. Gentle circular motions stimulate blood circulation and improve the flexibility of the scar tissue.
    • Continue this routine for several weeks for optimal results.

    The Topicrem answer:
    To soothe, moisturize and visibly reduce the appearance of scars, discover the Concentrated Oil from our CICA+ range, whose oil texture with a non-greasy and non-sticky finish promotes optimal massage of scars at all stages of life.

As you can see, healing is a wonderful and complex natural process , influenced by various factors. If not cared for properly, a scar can become complicated and unsightly, leaving a more or less significant visible mark. Thus, even if each skin is unique and heals differently , it is important to adopt a preventive approach as soon as a wound appears to maximize the quality of healing.

TOPICREM formulas have all been designed to provide protective hydration and preserve the skin barrier of sensitive skin for the whole family.
To do this, the laboratory relies on its expertise derived from pharmaceutical excellence:

  • Selection of high tolerance ingredients with proven effectiveness,
  • Development of formulas clinically tested on sensitive skin,
  • Effectiveness proven by science and approved by consumers.

Through the comfort and emotional well-being they provide, our treatments help you feel confident in your skin and in yourself, to better reveal yourself to others, and thus to fully enjoy every moment of life.

¹Lin X, Lai Y. Scarring Skin: Mechanisms and Therapies. Int J Mol Sci. 2024 Jan 25;25(3):1458. doi:10.3390/ijms25031458. PMID: 38338767; PMCID: PMC10855152.

²Bijlard E, Uiterwaal L, Kouwenberg CA, Mureau MA, Hovius SE, Huygen FJ. A Systematic Review on the Prevalence, Etiology, and Pathophysiology of Intrinsic Pain in Dermal Scar Tissue. Pain Physician. 2017 Feb;20(2):1-13. PMID: 28158149.

³El Kinani M, Duteille F. Scar Epidemiology and Consequences. 2020 Dec 8. In: Téot L, Mustoe TA, Middelkoop E, et al., editors. Textbook on Scar Management: State of the Art Management and Emerging Technologies [Internet]. Cham (CH): Springer; 2020. Chapter 6. Available from: https://www.ncbi.nlm.nih.gov/books/NBK586058/doi: 10.1007/978-3-030-44766-3_6

⁴Michelle E. Carrière, Anouk Pijpe, Paul PM van Zuijlen, Esther Middelkoop. Scales for assessing scars. French Journal of Healing, Volume 2, Issue 3. 2018. Pages 22-25. ISSN 2468-9114. https://doi.org/10.1016/j.refrac.2018.07.006.

⁵Monstrey S, Middelkoop E, Vranckx JJ, Bassetto F, Ziegler UE, Meaume S, Téot L. Updated scar management practical guidelines: non-invasive and invasive measures. J Plast Reconstr Aesthet Surg. 2014 Aug;67(8):1017-25. doi: 10.1016/j.bjps.2014.04.011. Epub 2014 May 14. PMID: 24888226.

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