What Treatments Work to Get Rid of Scars?
Key takeaways:
There are many treatments available to minimize the appearance of scarring, but not all of them are effective.
If you want to try an over-the-counter product, silicone gel or silicone sheets have the best evidence they can help reduce the appearance of scars.
For more serious scars like keloids, other treatments like cryotherapy, laser resurfacing, or scar removal surgery may be an option.
Most people have at least one scar. Whether the result of a mundane accident or a traumatic injury, scars can be a permanent reminder of your past.
There is often not a medical reason to remove scars. But you may still want to reduce how visible they are. When you compare potential options, however, you may see many claims about scar removal products and procedures. But what really works?
In this article, we will discuss the options available to help reduce the appearance of scarring, from gels and creams to surgery.
What causes scarring?
During the body’s natural healing process, scarring can result when your skin injury goes deeper than the first layer of skin. As your body heals an injury, a new skin layer is formed to repair the tissue damage.
There are several types of scars. Some scars are flat and might be a different color than the surrounding skin but are not as noticeable. But you may also have more visible scars, such as:
Hypertrophic scars: A hypertrophic scar is a raised scar that may be itchy and painful. These scars are usually the result of skin trauma that reaches a deeper layer of skin, such as burns, deep cuts, or surgery. If a large hypertrophic scar is located on a joint, elbow, or shoulder, it can reduce flexibility and movement.
Keloids: A keloid scar is also a raised scar that can be itchy, painful, or hard. These form right over your injury and keep going, covering the areas outside the injury site, too. Keloids will often develop over time — sometimes over 3 months or longer — as opposed to right after your injury heals. Keloids are particularly common if you have a darker skin tone.
Atrophic scars: Acne, which is a common skin condition that occurs when oil glands get clogged, can also result in scarring if the acne doesn’t clear or heal properly. These scars, also called atrophic scars, can appear as sunken in or as pockmarks.
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What is the best treatment for scar removal?
Since not all scars are the same, it is important to see your healthcare provider or a dermatologist before starting any type of scar removal treatment. A provider will be able to diagnose the type of scar you have. They can also rule out any evidence of skin cancer or other skin conditions.
Based on your provider’s assessment and the type of scar, size, location, and skin involvement, a treatment plan can be created to help reduce the appearance of your scar. Depending on the type of scar you have, it may include one or more of the following treatment procedures:
Topical scar treatment
There are many creams, oils, lotions, and gels that claim to reduce the effects of scarring. Often these are available over the counter and may include ingredients such as onion extract, vitamin A, or vitamin E. However, there is not currently much evidence these products are effective.
The American Academy of Dermatology (AAD) does recommend silicone sheets or gel. These are also available over the counter from several brands. The silicone gel or sheets are applied directly over your scar. They usually must be used daily for up to 3 months for you to see the most benefit.
The evidence on how well silicone works still isn’t certain, so ask your healthcare provider or a dermatologist for recommendations. They can point you toward products and brands with the best reputation.
If you have scarring as a result of acne, your provider may recommend retinoids, a topical treatment available as a gel, cream, or lotion. Most retinoids are only available by prescription. Some common retinoids include:
Adapalene (a low-dose version is available over the counter)
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Scar injection treatments
Your provider may recommend corticosteroid injections to reduce your scarring. Steroid injection treatments are often recommended first for raised hypertrophic or keloid scars. The injections are given right into your scar. This can help flatten scars as well as reduce pain or itchiness.
Studies suggest injections help to reduce the size of scars by 50%, on average. You may need more than one injection, and it can take time to see results. Injections may be combined with other treatments to increase their effectiveness. There’s also the risk of scars coming back after steroid injection treatment.
Scar removal surgery
Surgical scar treatments to remove a scar may be considered when other, less invasive treatments do not work. Scars that might need surgery also tend to be larger, raised, and cause complications it’s best to treat. Some of those complications may include:
Pain
Itchiness not addressed by other treatments
Decreased flexibility and movement if a scar is located on or near a joint
Cosmetic issues, like a big scar on your face, for example
The most common types of surgical procedures to remove or shrink scars include:
Cryotherapy: This treatment freezes off scar tissues, much like your provider might freeze off a wart. Cryotherapy is usually recommended for smaller, raised scars. Studies suggest up to 75% of people who get this treatment see improvement in their scars.
Laser treatment: Laser treatment uses infrared light to help smooth a raised scar and change the color so it blends better with the skin around it. Research is still unclear about which lasers are best for which types of scars. You’ll likely need multiple laser resurfacing treatments using different types of lasers to get the best result.
Surgical scar revision: This process involves surgically removing your entire scar and then repairing the skin. Your provider may use a skin graft — taking healthy skin from another area of your body — to replace the old scar tissue. If you have surgery for a keloid, your provider may also recommend radiation treatment right after to help prevent the keloid from returning.
Many of these surgical treatments can be done at your provider’s office. Keep in mind there is no guarantee that a scar will be fully removed or will not return.
The bottom line
Although a scar is usually permanent, you may be able to minimize the appearance of even the largest and most complex scars. Available treatment options may include a combination of over-the-counter products, injections, cryotherapy, laser treatments, or surgery. Before starting any scar treatment, you’ll first want to visit your healthcare provider or a dermatologist. They can help you determine the type of scar you have and recommend a potential treatment plan.
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References
American Academy of Dermatology Association. (n.d.). Keloids: Overview.
American Academy of Dermatology Association. (n.d.). Scars: Diagnosis and treatment.
American Academy of Dermatology Association. (n.d.). Scars: Signs and symptoms.
American Academy of Dermatology Association. (n.d.). 10 things to know before having laser treatment for your scar.
American Osteopathic College of Dermatology. (n.d.). Keloids and hypertrophic scars.
Juckett, G., et al. (2009). Management of keloids and hypertrophic scars. American Family Physician.
Kundu, R. V., et al. (2013). Dermatologic conditions in skin of color: Part II. Disorders occurring predominantly in skin of color. American Family Physician.
Marshall, C. D., et al. (2018). Cutaneous scarring: Basic science, current treatments, and future directions. Advances in Wound Care.
O’Brien, L., et al. (2013). Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database of Systematic Reviews.
Tan, J., et al. (2019). The role of topical retinoids in prevention and treatment of atrophic acne scarring: Understanding the importance of early effective treatment. Journal of Drugs in Dermatology.
