Scars are a natural part of the skin’s healing process. When the deep layer of the skin (the dermis) is damaged or cut, the body begins forming new collagen fibres to repair the damaged area. The new tissue pulls the wound together, and this causes the tissue to have a different texture from the surrounding skin. A scar fully forms after the wound is completely healed.
Scar tissue will differ in appearance depending on the type of injury, the location on the body and the type of skin it's on. Scars may appear flat, sunken, raised, stretched, or coloured. Over time, you may notice subtle changes in the way scars look, as the colour often fades.
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Almost everyone will develop scars. Any type of injury can cause scarring, but it can also be a result of surgery or other events including:
Everyone’s skin is different, so not all of the above events will result in scars. When a scar first appears on lighter skin, it is usually pink or red. The pinkish colour fades over time, and the scar becomes slightly darker or lighter than the skin's colour. Scars frequently appear as dark spots on people with dark skin.
Depending on the size and location, the appearance of a scar may change. Scars can fade so much that they are barely noticeable, or they may change colour, but you can’t get rid of scars completely. It’s also possible for scars to become painful or itchy several months or even years after healing. This is because nerve endings grow back.
This process can take up to 2 years. You cannot get rid of scars entirely, so you'll be left with a visible mark or line, but you can fade the appearance of scar marks. With the right treatment, you can shrink many types of scars, flatten raised scars, and encourage scarring to fade.
There are many different types of scars that can form. The type of injury or event that caused the wound and the treatment applied to it will affect how the scar tissue develops.
Common types of scars include:
A minor wound like a cut will usually heal to leave a raised line, which will gradually fade and flatten over time. Fine line scars often occur following surgery or cuts. In most cases, these types of scars are itchy but not painful.
Keloid scars are raised above the skin. They stem from the overgrowth of tissue that happens when too much collagen is produced at the site of a wound. They often appear darker in colour and occur more frequently on darker skin due to the higher levels of melanin.
Pitted scars, also known as atrophic or ‘ice-pick’ scars, have a sunken appearance or look like rounded pits or small indentations in the skin. They are commonly caused by acne scars or chicken pox and often develop on the face.
When a large area of skin is damaged (through a burn, for instance), contractures can occur. As the skin heals, the edges are tightly pulled together, and this can decrease the amount of movement you have in that area, especially where muscles, joints and tendons are affected.
When skin expands or shrinks quickly, the connective tissues under the skin can be damaged, and this causes stretch marks. They are fine lines that commonly appear all over the body as white, purple, pink or flesh-coloured marks during puberty or pregnancy or after weight gain or weight loss.
Although scars cannot be prevented entirely since they are a natural part of the skin’s healing process following damage to the dermis, there are scar treatments available that can improve how they appear on the skin’s surface, such as:
Silicone gels can be used on old and new scars. They work by helping soften and flatten scars and can relieve itching and discomfort. Kelo-Cote Scar Gel is suited to scars up to 4 years old including fine line scars, keloids, and contractures. It can also be used under makeup and sunscreen. Dermatix Silicone Scar Gel is designed to support the moisture in the skin to encourage efficient healing following surgery, burns, or injury. This transparent gel dries quickly to flatten and soften scar tissue, effectively fading dark, red, or angry scars.
If you want to prevent scarring during the healing process, an elastic bandage, dressing or stocking can be applied to the area to put pressure on the wound. The pressure prevents a scar from forming (or at least decreases its size).
If you have irregularities in your scars, dermabrasion can soften and smooth the skin to improve scar formation. This treatment involves gently removing the top layer of skin to blend irregularities such as raised areas.
Scar-revision surgery (also known as skin grafting) is useful for replacing particularly large scars. The procedure involves transplanting skin from another area, and though it will still leave some scarring, it should be preferable to the original scarring.
In some cases, injections can be made directly into scars (especially keloid scars) to reduce their size, flatten the skin and reduce itching.
Yes, every scar can be treated in some way, but there are several factors that will affect the results. Old scars and large areas of scar tissue can be harder to treat, for instance, meaning that you shouldn’t have high expectations when trying to reduce their visibility.
Most scars can’t be anticipated, but if you foresee a risk of scarring (or know it’s going to occur, such as through surgery), you should take preventative measures to reduce the chances of scars forming. Additionally, if you act quickly when you have a fresh wound, you can reduce the likelihood of a scar forming.
You should do the following to reduce the possibility of scarring when you’ve suffered a wound:
Authored by
Scott is one of the two founders of The Independent Pharmacy. He is a registered pharmacist and the registered manager of our service with the CQC.
Reviewed by
Andy is a co-founder and the Superintendent Pharmacist and Director at The Independent Pharmacy.
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