Overview
A scar is a mark on the skin after a wound or injury has healed. You cannot get rid of a scar, but most will fade over time. This can take up to 2 years or more, but there are some things you can do to help it heal or improve how it looks.
Things you can do if you have a scar
There are some things you can do to help most scars heal and improve how they look.
Do:
- massage your scar with a water-based cream (such as aqueous cream or E45 cream) a few times a day for up to 10 minutes each time - only massage your scar if the wound is fully healed
- try to keep your scar covered when you're in the sun for at least 1 year - wear clothing that covers it, or put a dressing over it
- use sunscreen with a sun protector factor (SPF) of 30 or more on your scar
A pharmacist can help with scars
A pharmacist can recommend some things for scars such as:
- silicon dressings or gels to help improve the appearance of your scar
- creams you can use to massage your scar
Find a pharmacy
Skin camouflage
There are special creams and powders (called skin camouflage) that you can apply to your skin to cover your scar so it's less noticeable.
A GP can refer you for an appointment to get skin camouflage products, or you can refer yourself online.
At your appointment, a trained professional will colour match the creams and powders to your skin and show you how to apply them.
You can get the products on a prescription or buy them.
See a GP if:
- you have a scar and it's painful or bothering you
Your GP may be able to recommend treatments that can help.
Ask for an urgent GP appointment or get help from NHS 111 if:
- a scar is swollen or painful
- a scar feels warm to the touch
- a scar has pus coming out of it
Treatment for scars
You cannot get rid of a scar, but most scars fade over time without any treatment.
If a scar is more severe or bothering you, a GP may be able to recommend treatments or refer you to a specialist. The aim of treatment is to help improve how the scar looks.
Depending on the type of scar you have, treatments may include:
- silicone dressings or gels
- steroid injection or cream
- cryotherapy (a treatment to freeze the scar)
- laser therapy
- skin camouflage (creams and powders you use to cover your scar)
A GP can refer you for talking therapy if a scar is affecting your mental health.
Types of scars
Scars can be many colours such as pink, red, purple, white, brown, skin-coloured or darker than the skin around it.
They can also be itchy, painful or uncomfortable.
Types of scars and what they look like
Fine-line scar - Can be slightly raised to start, but usually flattens and fades over time without treatment.
Atrophic scar - Can be a deep, small hole in the skin that looks like a deep pore, or it can be a larger and slightly sunken mark; usually happens after acne or chickenpox.
Keloid scar - Usually raised, hard and smooth, it grows to be bigger than the original wound, and the area where the scar is may be uncomfortable or difficult to move; it does not usually flatten or fade without treatment.
Hypertrophic scar - Usually raised and firm, it does not grow to be bigger than the original wound; the area where the scar is may be uncomfortable or difficult to move; it usually fades and flattens over time.
Contracture scar - Feels tight and the area where the scar is may be difficult or painful to move; it usually happens after a burn.
Treatment
A number of treatments are available if you hae a scar that's painful, itchy or unsightly, or if it restricts your movement.
Scars can't be removed completely, but they can often be made less visible.
Your GP may refer you to a dermatologist (skin specialist) or a plastic surgeon for treatment. Some treatments, such as laser therapy, and steroid injections, aren't widely available on the NHS, so you'll need to pay for them privately.
Skin camouflage (make-up)
You can buy make-up that's specially designed for covering scars from pharmacies. It can be particularly useful for facial scars.
The skin camouflage service isn't available in Wales and Northern Ireland. Find out about the further support services available in these countries.
Sometimes - for example, if you have a scar after having an operation or you have a disfiguring skin condition - you may be able to get camoflage make-up on the NHS. You should discuss this with a GP
Silicone gels or sheets
Silicone gels or sheets can be used on healing skin (not open wounds) to help soften and flatten a scar. They can also relieve itching and discomfort.
To be effective, silicone gels or sheets should be placed over the scar for 12 hours a day for at least three months. They can be washed and reused.
Ask your GP, dermatologist or pharmacist if they can recommend a suitable silicone-based scar treatment for you.
Steroids
Steroids can't remove scars completely, but they can improve their appearance.
Corticosteroid injections can be used to treat some keloid and hypertrophic scars.
The scar is injected a number of times to reduce any swelling and flatten it. Depending on the type of scar, the injections may need to be repeated.
Injections are usually given on three occasions, four to six weeks apart, to assess your body's response. Treatment may continue for several months if the scar is improving.
Steroid-impregnated tape can also be used to try to flatten keloid scars. It can be prescribed by a GP or dermatologist and is applied for 12 hours a day.
Laser therapy
Laser or light therapy (pulses of light) can reduce the redness in a scar by targeting the blood vessels in the excess scar tissue.
For some pitted scars, laser surgery (laser resurfacing) is used to try to make the scar flatter. This involves using a laser to remove the top layers of skin, which stimulates collagen production in the deeper layers.
But there aren't many long-term studies to prove the effectiveness and safety of laser therapy. If you have laser therapy, make sure the person doing it is a fully trained medical practitioner with experience in improving scars.
Cryotherapy
Liquid nitrogen can be used to freeze keloid scars. If cryotherapy is used in the early stages, it may flatten keloid scars and stop them growing. A side effect of treatment is that it can lighten the colour of the skin in the area being treated.
Dermal fillers
Dermal fillers are substances that can be injected to "plump up" pitted scars. Treatments can be costly and the results are usually temporary. Repeat treatments are needed to maintain the effect.
Skin needling
Skin needling, which involves rolling a small device covered in hundreds of tiny needles across the skin, can also help improve the appearance of scars. But repeat treatments are often needed to achieve an effect, and results vary considerably.
Surgery
Surgery can sometimes be used to improve a scar by:
- making it appear more natural
- making it less noticeable (by using a skin graft)
- releasing a tight scar that's close to a joint to improve movement
Scar reduction surgery is an invasive treatment that may not be suitable for everyone.
You should carefully consider the pros and cons before deciding to have surgery. As well as the normal risks of surgery, there's also a chance of making the scar worse.
If you're considering scar reduction surgery, make sure the plastic surgeon is fully trained and experienced in this type of surgery. You should fully discuss the procedure with your surgeon so you're aware of the risks and expected results.
If surgery is used to treat a keloid scar, you may need other treatments immediately afterwards to stop the scar growing back larger. These include steroid injections or radiotherapy
Pressure dressings
Pressure dressings are usually used under specialist supervision for treating large burn scars or after skin grafts. The aim is to flatten and soften the scars.
Pressure dressings are usually made from a stretchy, elastic material. They're worn over the scar 24 hours a day for around 6 to 12 months. They can also be used with silicone gel sheeting to improve the appearance of scars over a long period of time.
Scars and skin creams
Vitamin E cream is sometimes recommended for managing scars, but there's no medical evidence to suggest it has an effect.
But massaging a moisturiser like E45 into the scar will stop it becoming dry and help make it supple.
You should also apply sunscreen to your scar as it may be particularly sensitive to the sun.