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iayork t1_iwr7ys1 wrote

Your premise is probably wrong: The face in general might be slightly over-represented as a place for chickenpox scars, but not by much. Only about 20% of children with chickenpox ended up with scars, and of those fewer than half had scars on their face; nearly 60% had scars on their abdomen.

>The scars were found on the face in 75 (40.8%), neck 2 (1.1%), shoulders 8 (4.3%), upper limbs 15 (8.2%), anterior thorax 50 (27.2%), abdomen 106 (57.6%), back 65 (35.3%), buttocks 9 (4.9%), and lower limbs 12 (6.5%) affected children. The mean number of scars in the 184 children was 2.8 (standard deviation 1.9).

--Scarring Resulting from Chickenpox

Obviously you're more likely to be looking at peoples' faces than their bare abdomens most days, so there's a lot of selection bias going on here.

As for why the scars end up in those locations, it's probably because those are the same places that the actual chickenpox lesions occur:

>The distribution of chickenpox lesions is typically central, with the greatest concentration on the trunk (2). Facial lesions are also common (2). The distribution of residual scars from chickenpox in the present study is in agreement with the anatomic distribution of chickenpox lesions.

--Scarring Resulting from Chickenpox

But that just moves it back a step because we don't really understand why chickenpox lesions tend to occur on the abdomen and face. A part of it is probably because of the type of skin cells involved, which changes the molecules on the cells and makes them more or less attractive to the virus (Molecular mechanisms of varicella zoster virus pathogenesis); this may explain why chickenpox lesions on the hands and feet are relatively rare, but I don't think it's understood why, say, the back is relatively under-represented.

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sometimes_interested t1_iwro75x wrote

Does every lesion lead to scarring though? Or is just where the person has excessively scratched and irritated it? Or is there some other factor?

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fucklawyers t1_iwrsbhm wrote

I’m old enough that I got pox partied (36. If you were the first in the mom group to get chickenpox, you got a bunch of playdates with all the kiddos that hadn’t had it yet). I REMEMBER being absolutely covered, I’m talking like at least four in a square inch. Anecdotally, I have zero scars.

Mine was not too itchy. I just remember being exhausted and dizzy/out of sorts.

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LordOverThis t1_iws29o7 wrote

Same age group here. Not pox partied but instead just childhood incidental exposure, but definitely also just covered in lesions.

I have one scar.

Now we’re at n=2 for data points that not all lesions lead to scars.

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Druidgoddess t1_iwryp2p wrote

Not scientific but when we were kids were told not to scratch them as that's what causes the scarring. The face ones are easy to access, see and absently scratch when sleeping. I figure its likely more that than anything.

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iayork t1_iwrumwd wrote

If you will read the second sentence in my post, you will see that “Only about 20% of children with chickenpox ended up with scars.”

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naturalalchemy t1_iws1m7a wrote

I'm assuming this is due to the infected person's own reaction to the infection rather than any particular variation in the virus?

I have two kids who got infected within a week of each other (probably older kid got it at nursery and passed on to younger child), so very likely the same strain of the virus. One got very few spots (less than 10), but almost all scarred. The other was covered in hundreds of spots, but with no scarring.

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JJnanajuana t1_iws1y60 wrote

Can only answer for me. Had chicken pox, lesions all over, was told not to scratch them to prevent scaring, itchy af, avoided scratching face (as much as possible, still did a bit) to avoid fac e scaring, scratched body constantly. only scar I have is one exactly where op described.

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[deleted] OP t1_iwrhc3h wrote

[removed]

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iayork t1_iwrvzbk wrote

Facial scars occur in 40% of the <20% of children who had scars, which is therefore less than 8% of the unvaccinated population, who are mainly over 30 at this point, so that’s now about 5% of the US population, not 40. And since most the scars are not lifelong, probably fewer than 2% of the population of the US carries chickenpox scars on their face. That’s not incredibly common.

You’re trying to force reality into your preconception, but it doesn’t work.

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[deleted] OP t1_iwqlsey wrote

[removed]

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Invisible_Sharks t1_iwr18jm wrote

Please remember the r/AskScience guidelines when commenting.

  • Top level comments (direct replies to a question, not a reply to another user's comment) must be an answer to the question posed, or a follow-up question to the post.
  • No medical advice, speculation, or personal anecdotes.
  • Answers should be supported by reputable sources and scientific research. Do not cite yourself as a source.

Comments that don’t meet these guidelines will be deleted. It’s actively unhelpful to the person asking the question to have 200 people describing a scar they once saw.

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