Dermatologists Break Down How to Heal Scars, Including Old Ones
Plus, three products that will speed up the process.
Despite what you may have heard, you can't fix split ends, and shaving your hair won't make it grow back thicker. In Myth Busters, we debunk common beauty misconceptions and set the record straight.
We're all for embracing your scars, but if your scars do bother you, we understand that, too. If a long line on your back or acne scars dotting your cheeks are impacting your confidence, by all means, let's help you change that. And that doesn't just apply to new scars—old scars can be treated, too.
"When scars are new and pink, the skin goes through collagen remodeling, so it is easier to make improvements and fade the scar," dermatologist Mona Gohara, M.D., tells HelloGiggles. "Once a scar turns white, it becomes more challenging to treat—but it is still possible."
"Once formed, our body constantly refines and reconfigures the scar, resulting in the scar becoming paler and flatter over time," further explains board-certified plastic surgeon Samuel Lin, M.D.. "However, on average, this only continues for up to 12 to 18 months, after which the scar matures and finalizes its appearance and form. For this reason, many plastic and reconstructive surgeons typically do not immediately recommend scar revision procedures for scars less than a year old."
Although they typically cannot be completely erased, both old and new scars can be healed and treated many ways. Below, dermatologists and plastic surgeons break down the different types of scars and how to heal them with products, procedures, and in-office treatments.
What are the different types of scars?
Like snowflakes, every scar is different. Dr. Gohara explains that since each scar is unique, every one needs to be evaluated differently. Having said that, there are four main categories dermatologists and plastic surgeons typically break scars into.
1. Keloid scar
If you seriously injure yourself, you'll likely have a keloid scar. "Keloids are painful and thick scars that form when a wound heals," dermatologist Marina Peredo, M.D., tells HelloGiggles. "Keloids occur due to an overproduction of collagen during the healing process. They are difficult to treat and are often permanent without proper treatment."
2. Hypertrophic scar
These are raised and red scars that do not extend beyond the boundary of the injury. "Hypertrophic scars are similar to keloids, but not as thick and have a quicker healing process," Dr. Peredo explains. "Hypertrophic scars may heal and flatten over time naturally."
3. Contracture scar
If you burn yourself while curling your hair or baking, you might have a contracture scar. "Contracture scars heal differently depending on the severity of the burn," Dr. Peredo says. "Most of the time, these scars require medical attention."
4. Acne scar
Ah, acne scars. As if having active cystic acne isn't bad enough, sometimes they leave their mark afterward, too. There are a wide variety of acne scars, ranging from indentations to redness.
How to heal scars:
So, you have a scar—now how do you heal it? Keloid and hypertrophic scars are treated similarly as they're similar in nature. However, contracture and acne scars are a different story. The below treatments can be done on any part of the body, but Dr. Lin suggests considering your pain tolerance when considering how to treat your scar, as some can be a little more painful than others.
- Laser resurfacing: Dr. Peredo explains that this type of treatment can heal keloid and hypertrophic scars by producing optimal collagen stimulation and diminishing the appearance of scars.
- Cortisone injection: "One of the easiest treatments for keloids is an injection of cortisone that helps break down scar tissue," says Dr. Gohara. "I'd recommend something as simple as a couple of shots into the lesion to break down the scar tissue over several treatments."
- Dermabrasion: Dr. Lin explains that this is an exfoliating technique that works to physically remove the outer skin layer by using a rapidly rotating device on the surface.
- Vascular laser treatment: "This treatment reduces redness of scars by destroying blood vessels supplying the scar tissue," Dr. Lin says.
- Skin bleaching: Before you get scared, know that using a very small percentage of bleach on skin is totally safe and can help even out tone.
"For contracture scars, I would recommend scheduling an appointment with a reconstructive plastic surgeon for healing contracture scars, due to how serious this type of scar can be," Dr. Peredo advises. "A contracture scar can affect your muscles, nerves beneath the skin, and limit body movement."
In the meantime, "Keeping contractures moisturized is essential to decrease contracture formation and to promote mobility at the site of contracture," Dr. Lin explains. "Petroleum jelly products are excellent at retaining moisture. Cream products containing allantoin, shea butter, and rosehip oil, as well as silicone gel sheets, can also be beneficial for contracture healing.
"If a contracture persists for more than 12 months, surgical excision with local skin flap reconstruction can release a contracture," says Dr. Lin. "Splinting, pressure dressings, and range of motion exercises are helpful for preventing re-contracture. Intralesional corticosteroid injection can also help decrease contracture re-formation."
If you want to try to heal your keloid or hypertrophic scar at home, check out these doctor-recommended products.
Products for healing scars:
When it comes to healing scars, silicone sheets and gels are your best friend. "Silicone is one of the big, heavy lifters when it comes to scar treatments," Dr. Gohara explains. "Silicone helps regulate collagen production so there's not too much collagen that the scar becomes keloid, and there's not too little collagen so it doesn't heal up. It has hydrating properties, which are really important because a wound heals best when it's well hydrated."
Additionally, Dr. Peredo adds that silicone helps heal and flatten scars over time.
Dr. Gohara highly recommends the new Avène Cicalfate+ Scar Gel, calling it the "Olympic team of scar treatments in one bottle." It's filled with silicone (which hydrates, protects, and restores the skin), thermal spring water (which keeps the environment hydrated), and a new postbiotic ingredient that aids skin restoration while preserving the skin's natural barrier.
For the best results, Dr. Gohara suggests massaging the product into the skin to increase skin mobilization. Massaging it in will help break down any potential collagen buildup, and it'll feel nice, too.
"I recommend massaging the Alastin Regenerating Skin Nectar into the skin to support your skin's recovery process," Dr. Peredo says. This product includes a blend of peptides that work to clear damaged elastin and collagen, and support the skin's natural ability to reproduce skin.
How to get rid of acne scars:
Since everyone's skin and scars are different, treatment options should be customized to you; work with your dermatologist to find the best treatment combination. "Depending on the severity of acne scars, alternating between different lasers and devices can help treat deeper and more superficial scars," Dr. Peredo says, so you may need a combination of treatments to get results.
In-office treatments for acne scars:
- Microneedling: Dr. Peredo explains that this non-invasive procedure promotes collagen production in your skin to help reduce the appearance of acne scars.
- Microdermabrasion: "Microdermabrasion is an effective treatment for treating acne and acne scars," she says. "It exfoliates and removes the damaged skin and stimulates collagen production."
- Fraxel lasering: This works to increase collagen production and can therefore improve pigmentation and texture issues.
- Skin resurfacing procedures: "These are effective, but there is often residual acne scarring that remains after treatment," Dr. Lin says. "For residual scarring, there are several options for treatment, including soft tissue fillers and additional laser treatments."
Scars on BIPOC
People with darker skin tones have more melanin in their skin, which means they are more susceptible to hyperpigmentation when exposed to trauma. BIPOC people are also more likely to have keloid scarring. Dr. Peredo explains that people with darker skin tones should take more take preventative measures seriously as they can be especially susceptible to stubborn hyperpigmentation. She suggests wearing sunscreen every day and getting professional treatments as needed to avoid scarring.
"When you have a darker skin tone, it's beneficial to use procedures that cause minimal damage to the skin and yield less risk for hyperpigmentation," Dr Lin says. "For example, fractional laser therapy, skin needling, and injectable fillers are good options."
What to avoid when healing scars:
- Sun exposure: "UV rays can worsen the appearance of scars by breaking down collagen," Dr. Peredo says. "Every time you go outside—or even sit near a window—make sure to apply sunscreen."
- Smoking: As if you needed another reason to stay away from tobacco, Dr. Lin explains that using it can delay wound healing and can cause decreased oxygenation of the skin, making it (and you!) unhealthier.
- Picking: Dr. Peredo explains that's it's important to be patient and refrain from picking at your skin, as doing so will slow down the healing process.
- Dehydration: "A moist environment has been proven to facilitate the healing process of skin by preventing dehydration and promoting breakdown of scar tissue," says Dr. Lin. Consider adding a humidifier to your bedroom and/or work area to avoid dry air.
Remember, all scars can be treated if desired, but they're all beautiful in their own way, too.