Every time your skin and the tissue beneath it gets cut or damaged, it heals with a scar. Scars can happen outside and inside your body. For example, you may have a scar on your skin after an injury, but you can also have scars in deeper tissues or on your internal organs where a cut has been made during surgery. This factsheet focuses on external skin scars only.
Any damage to your skin can cause a scar, including:
Usually, the worse the initial damage to the tissue is, the worse the scar will be. Your skin colour, age and site on your body all affect how your wound reacts to damage.
There are several different types of scars.
It’s important not to rush into a decision to have scar revision treatment. You may find it helpful to discuss your options with a clinician who is suitably qualified. Before deciding to have treatment, let him or her know what you're hoping to gain from the treatment and the result you can realistically expect. There are several points to consider when deciding on treatment.
There are many different places, such as hospitals, clinics and beauty therapy salons that offer scar revision treatments. However, many of the treatments available aren't regulated, so you need to do your homework. Find out as much as you can about any treatment you're thinking of having and what kind of training and experience the person who will give the treatment has. Speak to your GP, who may be able to recommend a suitably qualified surgeon or a health professional trained in aesthetic treatments.
It's also important to remember that clinics offering laser treatment have to be registered with the Healthcare Commission. Always ask for proof of registration before you have any treatment.
Scars are usually permanent, so you may choose to have a revision treatment. This doesn't guarantee that the scar will be removed, but the treatments aim to make it less obvious and reduce any tightness it may be causing. Your skin colour, age and the type of scarring will influence how much improvement you can expect.
The type of treatment you have will depend on the features of your particular scar, such as its size, location and if it's raised or depressed (sunken into your skin). A single type of treatment may be enough or you might need a combination of treatments to get the best results.
Some of the most common scar revision treatments are discussed here.
There are certain skin creams available on the market that claim to soften or fade scars, but there is limited clinical evidence to suggest that they are effective.
There are, however, gels and dressings that can help prevent keloid scarring after surgery. These contain silicone and have been shown to reduce the formation of this type of scar. Some studies have also shown that other treatments, known as retinoids, may help to reduce keloid scars if used regularly for three months.
Laser skin resurfacing is very effective at reducing mild scarring. A laser (which is a beam of high-energy light) is used to remove the outer layers of your skin and stimulate the growth of new tissue. As the area heals, new skin forms that is softer and less scarred. The procedure takes about 30 minutes. It’s not suitable for all skin scars and side-effects can include swelling, oozing, crusting and a burning sensation.
Chemical peels remove the outer layers of your scar and stimulate the growth of new tissue. Different types of chemical peels are available. Chemical peels containing glycolic acid or lactic acid aim to improve and smooth the texture of superficial scars (ones that aren’t too deep). Stronger peels containing phenols or trichloroacetic acid can help treat deeper scars.
Dermabrasion uses a rotating wire brush or an electric razor to skim off layers of your skin. The procedure can take up to an hour and is often done under local anaesthesia. You may need to have ointment and a dressing placed over the treated area for several days.
An alternative to dermabrasion is microdermabrasion, which uses tiny crystals to remove the surface layers of your skin. It’s most suitable for removing acne scars and doesn't require anaesthesia, but you may need multiple treatments.
A steroid-containing tape can be worn day and night for extended periods, or a strong steroid injected directly into the scar can help soften and shrink scar tissue. Steroid treatment can be used alone or in combination with other treatments to help reduce the appearance of a raised or red scar.
Surgery can help reduce the size of your scar, reposition it or reduce it’s tightness to make it more comfortable. Sometimes this involves cutting out your scar and replacing it with a skin graft from a healthy part of your body. If a skin graft is used after a scar is removed, you will always have a different patch of skin there instead of the scar. All new scars will be initially red and gradually fade over six to 24 months.
It’s difficult to prevent certain scars, but there are measures you can take to reduce your risk of scarring. For example, eating a healthy diet, drinking sensibly, giving up smoking and staying covered up in the sun help to keep your skin healthy. The healthier your skin, the better it will heal from an injury. It’s important not to scratch, or pick at your skin if you have had acne or chickenpox.
If you’re prone to scarring, or have a skin type that is more at risk of keloid scarring, and are having surgery, your surgeon may recommend you use a preventive gel or dressing. This may be particularly useful if you’re having surgery on an area such as you’re chest, where keloid scarring is more common. Using a pressure dressing or silicone gel sheeting on the healing wound can help prevent keloid scars.
Fully formed keloids are very difficult to treat, but there are several treatment options worth considering. Your surgeon may suggest a combination of treatments to flatten or remove your scars.
Keloid scars are an overgrowth of the scar tissue (collagen) that extends beyond the original injury. Keloid scars are most common in young people (aged 10 to 30) and people from Asia or Africa. Keloid scars are usually red and raised, and can be painful. They may flatten and become less noticeable over a period of several years.
If you have a family history of severe scarring, it’s important to tell your surgeon before you have an operation. There are a range of measures your surgeon can take to reduce your risk of forming keloid scars, such as using pressure dressing or silicone gel sheeting on your healing wound.
Fully formed keloid scars are very difficult to treat and have a tendency to reoccur. You may need to have repeat treatments every few years to improve the appearance of a keloid scar.
Treatment options include the following.
There are certain skin creams available on the market that claim to soften or fade scars, but there is no clinical evidence to suggest that they are effective.
Retinoic acid (a naturally occurring form of vitamin A) and vitamin E promote collagen repair. Skin creams that contain retinoic acid and vitamin E may help relieve symptoms of a dry and itchy scar. They may also help soften the scar and therefore reduce any tightness. However, there is only limited evidence to suggest these skin creams help fade or remove scars, but if used regularly they may help prevent stretch marks.
Depending on the character of the scar (whether it's raised, smooth, dark or jagged) it may be possible to tattoo over it. You should see a professional cosmetic tattoo artist for advice.
It may be possible to tattoo over an unwanted scar. For example, some women have the scars around their nipples tattooed to match their skin colour after breast augmentation. Areolas (the dark skin surrounding the nipple) are often tattooed onto reconstructed breasts.
If you're considering having a scar concealed by tattooing, it's important that you wait at least a year for the scar to heal fully, and then seek advice from a professional cosmetic tattoo artist who is experienced in treating scar tissue.