Whether from an injury, surgery, or a skin problem such as acne, scars are something almost everyone has to deal with at some point or other. Although unsightly, they're an amazing example of the miraculous way skin heals itself when injured.
Scars may be flat or raised, practically invisible or obvious, but what you do to assist the skin as it heals—and how you treat the scarred area afterwards—makes a big difference in how the scar looks.
Before you learn how to treat scars, you need to understand how they form, how to care for injured skin to minimise scarring, and what type of scar you're dealing with.
Types of Scars
Depending on your genetic makeup and the depth and type of tear in your skin, scarring can range from a slightly reddish discoloration to a thick, raised red or dark scar. There are three main types of scars, generally described as flat, indented, or raised.
Flat scars are the most common, and usually occur from everyday injuries or minor burns. Depending on your skin color, flat scars may be pink to red (and eventually fade to very light pink or white) or tan to deep brown or black (eventually becoming lighter).
Note: The flat, pink-to-red or tan-to-brown marks left from a breakout are technically not scars. These marks are known as post-inflammatory hyperpigmentation. Read about how to treat these marks here.
Indented (atrophic) scars often result from cystic acne or a bout with the chickenpox virus. If you've ever had a deep, painful breakout or chickenpox, chances are you have at least one of these scars. Other names for indented scars are pockmarks, ice pick scars, and depressed scars. These scars result from destruction of the skin's underlying support structure, which is why they don't heal as well as flat or raised scars.
Raised (hypertrophic) scars result from overproduction of collagen in response to injured skin. This type of scarring can result from a slight tear in the skin or from a deep wound, and everything in between. Sometimes referred to as keloid scars, these are more common in persons with dark skin. Raised scars flatten over time, but can take years to resolve. We explain how you can help this process along in the next section: Scar Treatments. Stubborn or large/long raised scars may require medical or surgical treatment.
Even when you take the proper steps to minimize scarring, once the wound has healed, you'll likely want to keep treating the scar to make it even less noticeable. You'll be happy to know there are products and medical procedures that can help—a lot!
Even if you choose to do nothing, a scar continues to heal and change (for the better) for up to two years after the fact. With ongoing gentle skin care, sun protection, and patience (that's the hardest part), most scars get better, becoming less apparent over time. If you don't want to wait it out, here are some things you can do to treat the scars you have now:
Apply a silicone-based scar treatment gel or serum loaded with skin-healing ingredients and antioxidants. Eight weeks of twice-daily application can make the scar less noticeable, especially if it's a fresh scar. This type of product shows the best results on flat scars, but also can be helpful on raised and indented scars. Always treat the skin gently and protect the scar with a sunscreen rated SPF50.
Raised scars can be flattened to some extent with daily application of a silicone-based scar treatment gel and/or a silicone gel sheet, such as Kelocote.
Indented scars respond best to a series of in-office treatments including dermal fillers or medical microneedling. How much an indented scar improves depends on its depth and on how well your skin responds to treatments. Although it's not realistic to expect 100% improvement, a good noticeable improvement is usually possible.