The process by which tension leads to increased scarring is incredibly complex and involves multiple pathways, including activation of mechanoreceptors which interact with calcium channels. Together the various mechanisms lead to a plethora of chemical and neurological signaling, changes in genetic expression, and alterations in cellular morphology and function.
The ultimate result is that increased mechanical tension drives excess collagen deposition and prolongation of the inflammatory phase of wound healing. For the patient this means widening of wounds, thickening of wounds, more discoloration of wounds, and pathological scars such as hypertrophic pathological scars and keloids.