Ways to prevent and treat scars that actually work

If you were burned, cut or had acne, you might have a lasting reminder: a scar — or several — you’d hoped would be gone by now.

A scar is your body’s way of healing after a wound. It can be an injury from a traumatic fall, a surgical scar after an operation, a burn from an oven or as mundane as a pesky mosquito bite that you scratched or an acne blemish that you couldn’t keep from picking. Just as there’s a range of circumstances for why you have a scar, there’s a range in how your skin heals with a scar.

Why scars happen as skin heals

Healing involves an intricate balance of inflammatory cells, collagen production and blood flow. Every scar is unique. How your skin heals and what your scars will look like depend on a whole host of factors, including your skin type, the depth of the wound, the cause of the wound, your general health and the wound care you followed during the healing process. No two wounds will heal the same way, even on the same person.

Some scars will fade to the point of disappearing, while others may remain more prominent and harder to hide. Some scars are considered hypertrophic and thickened, often feeling tender, itchy or even painful. Raised keloid scars can be a range of color — often pink and inflamed in lighter skin tones versus darkened or hyperpigmented in skin of color. Examples include hypertrophic scars after surgeries and keloid scars after ear piercings.

Atrophic scars are the opposite end of the spectrum. Those scars heal with an indentation below the rest of the surrounding skin because of significant injury to various layers of skin. An example would be pitted facial scars from cystic acne or a pitted chicken pox scar.

The deeper the wound, the more likely it will heal with a visible scar, which is why surgical incisions through many layers of the skin will routinely leave a scar. Stretch marks, where the skin is stretched to the point where the elastic fibers are broken, are also unlikely to disappear. Examples include stretch marks from pregnancy or stretch marks after rapid changes in weight (especially rapid weight gain followed by weight loss).

If you have a wound that’s healing, you can’t eliminate scars, but there may be ways to help minimize them.

Scar treatment that can work:

Prevent scars while the wound is healing

Follow simple wound care instructions: Try to prevent scars while the wound is healing. Gently cleanse the area with soap and water and apply Aquaphor or Vaseline with a bandage daily. Maintaining a moist wound surface is key, rather than crusted, dry scabs.

Avoid topical, over-the-counter antibiotic ointments, such as Neosporin, if you’ve never used them before. Approximately 10% of the population is allergic and can develop an allergic contact dermatitis rash from them.

Massage the scar once your wound has healed

Massage helps break up scar tissue related to increased collagen production. Direct pressure with gentle circular massaging of the skin 15 minutes, three times a day can help.

Topical scar treatments can help if used early

Mederma, which is made from an onion skin extract; silicone gels; and vitamin E oils can help with the scar process, improve texture and reduce redness in the early stages after the scar forms.

Corticosteroid injections

Corticosteroid injections into the scar can help with hypertrophic or keloid scars, particularly if they’re pink, raised, thickened, painful or itchy. Steroid shots directly into the scars can help flatten out raised scars and improve pain or itching associated with the scar.

Dermabrasion

Dermabrasion is a technique that “sands down” the superficial layers of the skin, often used to treat acne pitted scars, particularly related to acne scarring or surgery. Removing the superficial outer layer of skin in a controlled manner gives rise to a smoother skin surface. Be aware that the skin will be temporarily red with swelling and will involve 1-2 weeks of downtime for healing.

Microneedling

Microneedling involves pricking the skin with tiny needles on a roller, which induces increased collagen production leading to a reduction in the appearance of scars.

Laser treatment

Laser treatment is an excellent treatment option for a variety of different scars. Lasers can decrease risk of scar formation if used soon after surgery; treat hypertrophic scars that are thickened, reddened, painful scars; and treat atrophic pitted scarring such as with acne facial scarring. Lasers use specific wavelengths of light and can be used clinically for specific targets. Certain nonablative lasers target blood vessels and collagen under the skin, ideal for raised, itchy and painful scars, while ablative lasers will remove the superficial layers of the skin to be replaced by new, healthy skin, ideal for pitted scars.

How to eat to promote healing

What typically doesn’t work:

Over-the-counter lotions for stretch marks

Don’t believe the hype regarding topical products touting either prevention of stretch marks or treatment for stretch marks. These products can’t prevent stretch marks, nor will they able to repair your skin’s elastic fibers.

Over-the-counter scar reduction lotions

While some over-the-counter options, such as honey or aloe vera, have medicinal properties when it comes to healing wounds, the majority of skin reduction lotions are rarely effective in the treatment of scars. Not harmful, but also not helpful.

Scars are a natural part of wound healing. There are ways to minimize and treat scars. You may want to consider an evaluation with a board-certified dermatologist to explore appropriate options for any concerns regarding your scars.

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