Skin is a seamless organ, like a fine cloth protecting valuable assets underneath. When it's damaged by a burn, injury, or other trauma, like surgery, a scar can form.
Most scars will never go away completely, but smaller ones might fade over time. For larger or more noticeable scars, there are some treatments that can help reduce their size or make them less noticeable.
How Do You Get Scars?
Scarring is a natural part of the healing process after an injury. When skin is damaged, your body creates new tissue to close the wound. This scar tissue, made mostly from the protein collagen, gives support and structure to the affected area.
Scar tissue is thicker and more fibrous than normal skin, which is why it often looks and feels a bit different. How your scar heals will depend on several factors, including how deep and how big the wound is; where it is on your body; and your age, genes, sex, and ethnicity.
Types of Scars
These are several types of scars, including:
Keloid scars. These are scars that grow bigger than the original wound. Instead of stopping when the skin is healed, the body keeps making collagen for months — or even years — after the injury, creating a raised scar. These types of scars can form anywhere but are most common on the abdomen, back, chest, ear, jaw, or shoulders. People with dark skin or red hair are more likely to get a keloid scar.
Contracture scars. If your skin has been burned, you may have a contracture scar. These scars tighten the skin, which might make it harder to move the affected part of your body. If the scar is deep, it may also affect the muscles and nerves underneath.
Hypertrophic scars. Also called raised scars, these scars may shrink over time but never completely flatten out. They're similar to keloids but don't grow beyond the boundary of the injury.
Flat scars. These are the most common types of scar. As the name suggests, these scars flatten and become less noticeable as they heal.
Depressed scars. Severe acne or chickenpox can leave behind small indentations in the skin that look like tiny holes or punctures, similar to marks left by an ice pick (which is why they're often called ice pick scars). Depressed scars can also make your skin look uneven or wavy and may sometimes form deeper craters with defined edges.
There are many ways to treat scars. The option that's best for you will depend on the type, size, and severity of the scar.
Over-the-Counter (OTC) and Prescription Scar Treatments
There are many creams, ointments, gels, and bandages that can help fade scars caused by cuts, wounds, or other injuries. Products with ingredients like alpha hydroxy acid, hydrocortisone, or retinoic acid may help lighten a scar, while gels made with silicone can shrink scars or even prevent them from forming in the first place. If your scar is itchy, your doctor might recommend an oral antihistamine. Steroid creams may also help with the healing process.
It's worth noting that while many of these products can make a scar less noticeable, they won't cause it to go away entirely. Talk to your doctor, surgeon, or dermatologist about which OTC or prescription treatments might be right for you.
Injectable Scar Treatments
Injections can improve how some scars look or ease discomfort. These treatments may include:
Corticosteroid injections. Steroid injections are often used to treat raised scars, like keloids or hypertrophic scars. The steroids are injected directly into the scar to break down collagen fibers, making the scar smaller, flatter, and softer. Because steroids lower inflammation, these injections can also help with swelling and itching. Your doctor may use this on its own or combine it with other treatments.
Bleomycin or fluorouracil. While these drugs are most commonly used to treat certain types of cancer, they can also help flatten scars and relieve itching and pain that they cause.
Dermal fillers. Injecting collagen, fat, or hyaluronic acid can help fill in the indentations left behind by severe acne. These fillers are injected beneath the scar to add volume and lift the skin, making the surface look smoother and more even. The results can last months, or even years, but they are temporary.
Light Therapy for Scar Removal
Laser therapy uses heat and light to make scars less noticeable. There are two types of lasers used for treatment:
Ablative lasers. This type of laser removes the outer layers of scarred skin and encourages new, healthier skin to grow in its place. This can make the scar look lighter and smoother. Types of ablative lasers include carbon dioxide lasers, which use short, continuous pulses of light to remove layers of skin, and erbium lasers, which remove scarred skin with less damage to the surrounding tissue.
Non-ablative lasers. Non-ablative lasers are less aggressive because they heat the skin without damaging its surface. The heat encourages your body to make more collagen, which can help fade smaller scars. Pulsed dye lasers are a common type of non-ablative lasers, which use light to shrink blood vessels in scar tissue, reducing redness and discoloration over time.
If you have a keloid scar that hasn't improved with other treatments, your doctor might suggest superficial external beam radiotherapy. This treatment uses high-focused beams of light to destroy the cells that produce excess collagen. Because the light only reaches the surface layer of the skin, they won't damage healthy skin tissue underneath.
Surgical Scar Treatments
For larger, deeper scars that limit your movement or cause other problems, surgery might be the best way to treat them. Types of surgical treatments include:
Skin grafts. In a skin graft, your surgeon takes healthy skin from one part of your body and uses it to cover or replace damaged skin. After a few days, the transplanted skin forms blood vessels and attaches to the surrounding area. This surgery is often used with people who have had burns.
Skin flap surgery. Skin flap surgery is similar to a skin graft but uses a thicker piece of healthy skin that includes blood vessels, fat, and sometimes muscle. This surgery is often used for scars that are on parts of the body with poor blood supply or where the damage has affected the existing blood vessels.
Z-plasty or W-plasty. If your scar is painful or limiting your movement, your surgeon may reshape the scarred skin into a "Z" or "W" pattern. This makes the skin more flexible once it heals.
Tissue expansion. During this procedure, a balloon-like device is placed under the skin near the scar and slowly filled with saltwater. This causes the skin around it to stretch and grow. This new skin is then used to replace scar tissue. This is often done together with skin flap surgery.
Cryotherapy. Your doctor might use liquid nitrogen to freeze and remove scar tissue. This treatment is often used for keloid scars and is usually combined with steroid injections or surgery.
Dermabrasion. Although it's not always considered to be a surgery, dermabrasion uses a special device to gently sand the surface of the skin. By removing the top layers, it encourages new, healthier skin to grow. This can help with acne scars.
Does Insurance Cover Scar Removal?
If your scar physically impairs you in any way, you may be able to get coverage from your health insurer. Ask your doctor to write a letter detailing your particular case. Your doctor can also take photos to support your case.
If you are undergoing scar treatment for cosmetic purposes, you will most likely have to pay for it all yourself. If you have scars from cosmetic surgery, make sure you know what your insurer will cover. Health insurers usually don't pay for any cosmetic surgery that isn't medically necessary.
Scar Treatment Results
While treatment can make a scar less noticeable and ease any related symptoms, there's no way to completely remove one once it has formed. How effective your treatment is will depend on the size, depth, and location of your scar, but it is often possible to improve its color, shape, and texture.
Laser treatment is a popular choice for smoothing and lightening scars, but it can occasionally cause hyperpigmentation, in which some areas of the skin become darker than the surrounding area. Injections meant to improve a scar's size or texture also carry a small risk of hyperpigmentation and, in some cases, may cause the skin around the scar to shrink, making it look sunken. If you decide to have surgery, there's always a risk that the scar will come back or that a new scar may form.
Takeaways
Scars form as part of your body's natural healing process. They can look different depending on the location of the injury, your age, genetics, and skin type. While scars can't be completely removed, there are many treatments that can make them less noticeable. Each treatment has its pros and cons, so it's important to talk to a doctor or dermatologist to find the best one for you.
Scar Treatments FAQs
Which surgery is best for scar removal?
Each type of surgery comes with benefits and drawbacks. Which one is best for you will depend on the type, size, and location of your scar.
Is there a specific age suitable for scar removal?
There's no specific age for scar removal, but your doctor might suggest waiting until a scar finishes healing before treating it. This can take months or even years.
Can laser therapy remove old scars?
Older scars are harder to treat, but laser therapy may make them less noticeable. This usually takes multiple sessions.
How can I get rid of acne scars?
Acne scars can be treated with prescription creams, laser therapy, skin injections, or dermabrasion, depending on their severity and type.
How can I remove surgery scars?
While surgery scars can't be completely removed, treatments like creams and laser therapy can help improve their color and texture.
