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Impact of Visible Scars on Well Being and Quality of Life
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- This survey-based, international, epidemiological study examined the impact of visible scars on patients’ quality of life. Scars aged less than 3 months were significantly more impactful than those older than 12 months. The clinical symptoms of scars affected the survey participants' clothing choices, leisure activity, sexual life, and feelings of embarrassment.
- Visible scars, particularly recent (<3 months) and symptomatic (ie, pain, itch, burn) scars, have a significant impact on patients’ quality of life.
abstract
This abstract is available on the publisher's site.
Access this abstract nowINTRODUCTION
Scars are visible marks from various causes, including surgery, skin injury, burning or dermatological disease, and may impact the quality of life.
OBJECTIVE
To assess the impact of scars on quality of life (QoL).
MATERIAL AND METHODS
Data about sociodemography, presence, origin, and symptoms of scars were collected using an internet survey between April and May 2020. Overall, 11100 individuals answered the survey. In total, 48.5% of the responders had at least one scar of less than one year of age. Scars were mainly reported on the abdomen and face. Globally, 28.9% of subjects with recent scars reported pain, 23.7% reported burning, 35.0% reported itching and 44.1% reported redness. Subjects were most frequently bothered by the visibility of their scars and the presence of marks. Incidences were significantly higher than for those with older scars. The average DLQI score was 7.44; it decreased to 2.90 after one year. Subjects with scars aged less than 3 months had their QoL more frequently impacted (33.9%) than those with scars aged 12 months or more (10.2%). In subjects reporting skin discomfort, clinical symptoms significantly impacted body movement, choice of clothes, leisure activities and sexual life more than in those reporting no skin discomfort. Moreover, subjects felt significantly more impacted in their daily lives due to their skin discomfort. When feeling bothered by the visibility of their scars, significantly more subjects were also impacted in their body movement, choice of clothes, leisure activities and sexual life than those subjects who did not feel bothered. Moreover, significantly more subjects felt embarrassed.
CONCLUSION
Scars significantly impact the subjects' quality of life. This impact is even more important when caused by recent and visible scars, with a lower DLQI score in subjects with more aged than in those with recent scars.
Additional Info
Disclosure statements are available on the authors' profiles:
The impact of visible scars on wellbeing and quality of life: an international epidemiological survey in adults
J Eur Acad Dermatol Venereol 2023 Jan 12;[EPub Ahead of Print], JM Amici, C Taieb, C Le Floc'h, A Demessant, S Seité, O CogrelFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
In one of the largest cohorts to date, this international observational study provides a robust analysis of quality-of-life (QOL) indices for patients with scars. In total, 11,100 participants were queried regarding their perceptions of scars resulting from accidents, diseases, or surgery. The average age of participants was 43 years, with a near equal distribution of genders. Participants with newer scars (<3 months) reported more impairment to their QOL compared with those with older scars (>12 months). Those with newer scars also more frequently reported symptoms such as pain, burning, itching, and redness.
The authors utilized the Dermatology Life Quality Index (DLQI), which was previously employed as a standardized measurement of patient QOL for conditions such as atopic dermatitis and psoriasis.1 Higher scores denote a higher burden on QOL.2 In this study, there were significant differences in the DLQI scores reported by younger (<35 years), middle-aged (35–54 years), and older (>54 years) patients. No significant differences in DLQI scores were noted between genders. However, women were significantly more bothered by the visibility of their recent scars than men. Mean DLQI scores decreased over time potentially due to scar acceptance or maturation.
Several previous studies draw parallels in examining the negative impact on QOL indices for patients with scars. From the dermatologic surgery literature, similar trends were observed from postsurgical scar effect on patient QOL, with significant deficits reported in the early postoperative period that decreased over time, especially for younger patients and women.3 Similarly, a recent study on atrophic acne scar influence on QOL identified significant psychosocial detriments, including increased self-consciousness and embarrassment, irrespective of scar severity.4
Studying the significance of scars on QOL provides an important framework for clinicians and surgeons on how to best identify at-risk patients and to anticipate potential deficits in symptoms, appearance, and activities of daily living. These data can help guide patient encounters to enable clinicians to counsel and set realistic expectations to assuage negative patient experience and impairments to short- and long-term QOL.5,6 Furthermore, additional studies examining interventions on QOL such as patient counseling strategies, peer mentorship, and scar-mitigating treatments are warranted in this interesting and burgeoning body of research.
References