The scars are fibrous tissue covered by epithelium without hair follicles, sweat glands or pigment, produced from the healing of a wound. Injury to the dermis produces it, while superficial injuries involving only the epidermis do not produce a scar. They are permanent.
Good lighting is essential. The description should include their number, site, size, and shape, the level it bears to the body surface, fixed or free, smoothness or irregularity of the surface, color, and the presence or absence of glistening and tenderness. The condition of the ends, whether tapering or not, and the probable direction of original wound should be determined.
The application of heat, filtered ultraviolet light or surface friction, makes faint scars readily visible. Old ones may become unrecognizable. A magnifying glass is very useful. Suspected scars in the dead body can be proved by microscopy, by a section stained to show the elastic tissue, which is absent in a scar. Elastic tissue is present in striae gravidarum.
It may indicate the type of injury which produced them.
(1) Incised wounds produce linear ones. If healing is secondary, it is wider and thicker in the center than in the periphery.
(2) Scars from lacerated wounds, and from wounds which have suppurated are firmer, irregular, more prominent, and are attached to the deeper tissues.
(3) Stab wound due to a knife-blade produces oval, elliptical, triangular, or irregular scars which are depressed but may be elevated due to keloid formation.
(4) A bullet wound causes a circular depressed one.
(5) Those from scalds are spotted in appearance, tend to be continuous, often run downwards and show evidence of splashing about the main injury.
(6) Those due to corrosive acids, burns or radiation, cause irregular ones, and keloid may develop in the scar tissue, especially in Negroes.
(7) Vaccination scars are circular or oval, flat or slightly depressed.
(8) Many skin diseases, smallpox, syphilis, etc., cause multiple scars on the skin.
Those produced in childhood grow in size with the natural development of the individual, especially if situated on the chest or limbs.
Firm union occurs in from five to six days, producing a reddish or bluish ‘angry’ scar. By the end of 14 days, it becomes pale. It is still soft and sensitive; there is no further change up to the end of second month. In about two to six months, it becomes white and glistening, becomes tough and may be wrinkled. After this, there is no further change.
The scar can be erased by excision and skin grafting, or suture of the edges of the excised area. This results in a scar which is less clearly seen.
(1) They form important marks for identification of a person.
(2) The shape of the it may indicate the nature of weapon or agent that caused the injury.
(3) The age of it is important in a criminal offense, if the age of a wound corresponds with the date of the attack it may have value as circumstantial evidence.
(4) Linea albicantes may indicate previous pregnancy.
(5) If a person is disfigured due to scars, it becomes a grievous hurt.
(6) Scar causing contracture at or around a joint restricting movement or functions of the joint becomes grievous hurt.
(7) The accused may attribute scars of wounds to disease or therapeutic procedures.
(8) To charge an enemy with assault, a person may claim that scars due to disease are those of wounds.
Moles are usually round, brown or black, raised or flat with or without hair. The size and exact anatomical position also should be noted.