Why does a scar stay?
After skin is injured, the body builds new tissue to close the wound. Scar tissue consists mainly of collagen, a protein that gives skin support and strength. That repair tissue remains even when its colour and shape change. Cuts, burns, surgery, acne and infections such as chickenpox can all leave scars. The final appearance depends on the wound's depth, size and location, how long healing takes, your age and your inherited tendency to scar.145
Which scars fade, and which usually stay noticeable?
| Scar type | What it looks like | What to expect |
|---|---|---|
| Fine line | A line that can start slightly raised. | Usually flattens and fades without treatment. |
| Hypertrophic | A raised scar confined to the original wound. | Often gets flatter and less noticeable over time. |
| Keloid | A raised growth extending beyond the original wound. | Persists without treatment and can return after treatment. |
| Atrophic | A sunken pit or indentation, often after acne or chickenpox. | Sunken acne scars do not fade naturally and can become more noticeable with age. |
| Contracture | Tight scar tissue, usually after a burn. | Can make movement difficult or painful and needs assessment if it limits movement. |
A keloid can develop months to years after an injury, rather than appearing as soon as the wound closes. Keloids are more likely in people with darker skin or a biological relative who develops them. If a raised scar is growing beyond the wound, have a clinician assess it rather than assuming more waiting will flatten it.56
What can you do for a healed scar?
- Massage only once the wound is fully healed. Use a water based cream a few times daily, for up to 10 minutes each time.
- Keep the scar covered in the sun for at least one year, using clothing or a dressing. Apply sunscreen with SPF 30 or more.
- Ask a pharmacist about silicone gels or dressings to improve the scar's appearance, and follow the product's instructions.
For raised scars, scar dressings commonly need 12 to 24 hours of wear each day for at least eight to twelve weeks, sometimes longer. These treatments require sustained use rather than a single application. If you are prone to keloids, avoid unnecessary cosmetic procedures that injure the skin.6
Can treatment remove a scar completely?
Treatment can speed fading or reduce a scar's size and visibility. The choice depends on its type, size, location and age, and whether it hurts or restricts movement. Options include injections, laser treatment, dermabrasion to smooth the skin, and surgery. Scar revision replaces one scar with another, so the name is doing a little administrative work. Laser treatment can cause skin darkening or lightening in darker skin; discuss those risks before treatment.134
Keloids often need more than one treatment, and treated keloids can return. Surgery alone can trigger a larger keloid, so removal needs a specialist plan rather than simply cutting away the raised tissue.5
Skin camouflage covers the mark rather than removing it, which is at least a clear job description. Special creams and powders can be colour matched by a trained professional who also shows you how to apply them.2
When should you get a scar checked?
Arrange an appointment if a scar bothers you, affects your mental health or limits movement. Seek urgent medical advice for swelling, pain, warmth or pus coming from a scar.25
Where this answer comes from
- 1Scar | Keloid Scarmedlineplus.gov
- 2Scarsnhs.uk
- 3Scars: Will my scar go away?aad.org
- 4Scars: Treatment and Causemy.clevelandclinic.org
- 5Keloid Scar: What It Is, Symptoms, Treatment & Removalmy.clevelandclinic.org
- 6Hypertrophic Scars and Keloids: A Complete Overviewdermnetnz.org
