Scars are a natural part of the body’s healing process after the skin has been injured. Whether from cuts, burns, surgery, or acne, scars are marks that remain after a wound heals. While it’s a common misconception that scars can be completely eliminated, most scars do fade significantly over time. This fading process can take up to two years or more. However, there are various strategies and treatments available to help improve the appearance of scars and support the skin’s natural healing.
Understanding Scars and How They Form
A scar is essentially the body’s way of repairing damaged skin. When the skin is injured, the body produces collagen to mend the wound. This collagen, while essential for repair, can sometimes lead to a different texture and appearance compared to the original skin. Scars form differently depending on several factors, including the depth and size of the wound, the location of the injury, your age, your genes, and your ethnicity.
There are several types of scars, each with distinct characteristics:
- Fine-line scars: These are the most common type, often resulting from minor cuts or surgical incisions. They may be slightly raised initially but typically flatten and fade over time.
- Atrophic scars: These scars appear as sunken depressions in the skin. They are frequently caused by acne or chickenpox, where there’s a loss of tissue beneath the skin.
- Keloid scars: Keloids are raised, thick scars that extend beyond the original wound site. They are often shiny and rubbery and can be itchy or painful. Keloids occur due to an overproduction of collagen.
- Hypertrophic scars: Similar to keloids, hypertrophic scars are raised, but they remain within the boundaries of the original wound. They may also be firm and can fade over time, though this can take years.
- Contracture scars: These scars occur when the skin tightens, often after burns. Contracture scars can restrict movement, especially if they form over joints.
Understanding the type of scar you have is the first step in managing its appearance effectively.
Home Care and Management for Scars
For newly formed or older scars, several at-home care techniques can help improve their appearance and promote healing.
Scar Massage
Gentle massage can significantly improve scar texture and flexibility. Once the wound is fully healed, usually after about two weeks, begin massaging the scar a few times a day for about 5 to 10 minutes each session. Use a water-based, non-fragranced cream like aqueous cream or E45 cream to lubricate the area. Massage helps to break down collagen and improve blood flow, which can soften and flatten the scar over time. Use circular motions and gentle pressure, ensuring not to cause pain or reopen the wound.
Sun Protection
Protecting scars from sun exposure is crucial for at least a year. UV radiation can cause scars to darken and become more prominent. When outdoors, cover the scar with clothing or a dressing. When clothing isn’t feasible, apply a broad-spectrum sunscreen with an SPF of 30 or higher to the scar area. Consistent sun protection can prevent discoloration and help the scar fade more effectively.
Over-the-Counter Remedies and Pharmacist Advice
Pharmacists are excellent resources for advice on scar management. They can recommend several over-the-counter products, including:
- Silicone dressings or gels: These are widely recommended by dermatologists and are available in gels or adhesive sheets. Silicone helps to hydrate the scar tissue and regulate collagen production, which can improve the scar’s texture, color, and overall appearance. Apply silicone gels or dressings daily as directed by the product instructions.
- Scar massage creams: Pharmacists can also suggest specific creams designed for scar massage, often containing ingredients like vitamin E, onion extract, or hyaluronic acid. While scientific evidence supporting the effectiveness of some of these ingredients is still developing, many individuals find them helpful in keeping the scar moisturized and promoting massage benefits.
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Professional Treatments for Scars
When home remedies are not enough, or for more prominent or bothersome scars, various professional treatments are available. Consulting with a dermatologist or GP is recommended to determine the best approach for your specific scar type and skin.
Skin Camouflage
For scars that are particularly noticeable or cause cosmetic concern, skin camouflage makeup can be an effective solution. Specialized creams and powders are designed to match your skin tone and effectively conceal scars. A GP can refer you to a skin camouflage service, or you can often find these services online. Trained professionals will help you color-match products to your skin and teach you how to apply them for natural-looking coverage. These products can often be obtained on prescription or purchased directly.
Medical Treatments
For more severe scarring, medical treatments offered by dermatologists or specialists can significantly improve scar appearance. These treatments include:
- Steroid injections or creams: Corticosteroid injections can help reduce inflammation and flatten raised scars like keloids and hypertrophic scars. Steroid creams may also be prescribed for milder cases.
- Cryotherapy: This treatment involves freezing the scar tissue, often using liquid nitrogen. Cryotherapy is particularly effective for keloid scars and can help to flatten and reduce their size and discomfort.
- Laser therapy: Various types of laser treatments are used to improve scars. Ablative lasers work by removing outer layers of damaged skin, while non-ablative lasers stimulate collagen production in the deeper layers of skin without damaging the surface. Laser therapy can improve scar color, texture, and flexibility.
- Surgical scar revision: In some cases, surgical procedures may be recommended to physically remove or reposition a scar to make it less noticeable. This might be considered for wide or contracted scars.
- Talk therapy: It’s also important to acknowledge the emotional impact scars can have. If a scar is affecting your mental health or self-esteem, your GP can refer you for talking therapy or counseling.
When to Seek Medical Advice for Scars
While most scars are a cosmetic concern, some require medical attention. Consult a GP if you experience any of the following:
- Painful or bothersome scars: If a scar is causing you pain, itching, or significant discomfort.
- Signs of infection: If a scar becomes swollen, painful, warm to the touch, or has pus discharge, it could be infected and needs urgent medical attention.
- Scars affecting movement: Contracture scars, particularly after burns, may restrict movement and require specialized treatment.
- Emotional distress: If your scar is significantly impacting your mental health or quality of life.
Urgent Advice: Seek an urgent GP appointment or contact NHS 111 immediately if a scar shows signs of infection such as increased pain, swelling, warmth, or pus.
Types of Scars and What They Look Like
| Type | Symptoms |
|---|---|
| Fine-line scar | Can be slightly raised to start, but usually flattens and fades over time without treatment. |
| Atrophic scar | Can be a deep, small hole in the skin that looks like a deep pore, or it can be a larger and slightly sunken mark; usually happens after acne or chickenpox. |
| Keloid scar | Usually raised, hard, and smooth, it grows to be bigger than the original wound, and the area where the scar is may be uncomfortable or difficult to move; it does not usually flatten or fade without treatment. |
| Hypertrophic scar | Usually raised and firm, it does not grow to be bigger than the original wound; the area where the scar is may be uncomfortable or difficult to move; it usually fades and flattens over time. |
| Contracture scar | Feels tight, and the area where the scar is may be difficult or painful to move; it usually happens after a burn. |
While you cannot entirely get rid of scars, understanding the available treatments and management options can significantly improve their appearance and minimize their impact on your life. With consistent care and appropriate treatments, scars can become less noticeable, allowing you to feel more confident and comfortable in your skin.
Page last reviewed: 18 September 2023
Next review due: 18 September 2026
