Scarring is part of the body’s natural healing process, ensuring that skin injuries heal quickly and efficiently. However, this doesn’t mean that scars are aesthetically pleasing — on the contrary, for many people, scars are a significant source of insecurities.
Fortunately, thanks to technological advances, there are many ways to improve the appearance of scars. But not all scars respond equally to treatment.
In this guide from Nourishing Biologicals, we’ll go over the different types of scars and explain the most effective way to heal each one.
What Is a Scar?
A scar is the body’s natural way of healing damaged skin.
When you lose skin — like due to a sports accident or a surgical procedure — your skin will grow new tissue to pull the wound together. Because this new tissue is made up of mostly collagen, scars have a rough texture and uneven appearance compared to the surrounding skin.
There are various types of scars — which can happen anywhere on your body. Some scars may be flat and painless, while others can be raised and itchy. Some scars may be dark, while others may lose their color completely.
In many cases, scars fade on their own. However, some types of scars may get worse over time, which makes it important to treat them in time.
Of course, effective treatment depends on identifying which type of scarring you’ve developed. To help you do that, read on to to learn all about the different scar types.
What Are the Different Types of Scars?
There are roughly six different scar types. In this section, we’ll go over different types of scars, what causes them to form, and how they can best be treated.
1. Flat Scar
A flat scar is viewed as a “normal” scar, which you may be most familiar with. It may start raised and red but gradually flatten and fade over time.
Flat scars typically fade on their own until they’re barely visible. However, for some people, they can remain red or pink. Fortunately, treating flat scars is fairly straightforward and requires fading its darker color. These scars are common with piercings.
2. Keloid Scar
Unlike flat scars, keloid scars are raised from the skin’s surface. They are typically thick and misshapen, expanding beyond the wound site.
Keloid scars happen due to an overgrowth of collagen tissue. They can be uncomfortable, affecting movement. In addition, some people may consider them unsightly due to their darker appearance.
What makes keloid scars especially challenging to treat is that they don’t fade over time but increase in size. This process can continue for months or years after the original wound occurs.
Keloid scars can happen anywhere on the body, but they’re more common in areas with less fat, like the chest, back, and shoulders. Those with darker skin tones are more likely to develop keloids.
Treating keloid scars requires a different approach from treating flat scars. The number one priority is to keep the tissue from growing further, which can be achieved with certain injections. Another option is to remove the scar completely with lasers or surgery. After the scar is removed, you can work on reducing the hyperpigmentation that the scar has left behind.
3. Hypertrophic Scar
Hypertrophic scars are raised scars that are similar to keloid scars. They form due to an excess of collagen at the wound site. However, unlike keloids, hypertrophic scars won’t expand beyond the wound’s borders.
Unfortunately, it’s still possible for hypertrophic scars to grow over time. As the body continues to produce collagen, the scars can become more raised.
Like keloid scars, hypertrophic scars are more common in areas with less fat, like the back, chest, and shoulders. However, they can happen anywhere on the body.
Treating hypertrophic scars requires controlling their growth, which can be accomplished with certain injections. If they can’t be controlled with non-invasive procedures, it’s possible to cut them out with scar revision surgery. While this may also leave a scar, it won’t have the raised appearance of a hypertrophic scar.
4. Atrophic Scar
Atrophic scars are also known as depressed or “pitted” scars. They typically show up as small indentations in the skin and develop when the body cannot generate new tissue.
Atrophic scars commonly form due to acne. They are most common on the face, becoming more noticeable with time as the body’s collagen production process slows down.
Atrophic scars are very common on the face. Fortunately, there are many ways to treat atrophic scars, all of which require stimulating collagen production. This can be accomplished with over-the-counter products and in-office cosmetic procedures.
5. Contracture Scar
A contracture scar typically forms after a burn. When the skin is exposed to extremely high temperatures, it can tighten significantly, pulling tissue closer together during the healing process.
A contracture scar can be very uncomfortable as it restricts movement. Because it can affect the muscles, joints, and tendons, it can significantly lower someone’s quality of life.
To treat contracture scars, scarred tissue should be replaced with more elastic skin. This can be accomplished with procedures such as skin grafting, which takes healthy skin from another part of the body and attaches it to the damaged part. Another treatment option is tissue expansion, which uses certain injections to expand the constricted tissue.
6. Stretch Marks
Stretch marks happen when the skin expands quickly, most commonly affecting those who gain weight rapidly. When the skin expands too quickly, the connective tissue in its middle layers can get damaged, resulting in scarring.
Stretch marks can occur anytime the skin expands too quickly, like during puberty, pregnancy, or weight gain. Those who gain muscle quickly may also develop stretch marks.
Stretch marks can happen anywhere on the body, but they’re more common in areas with thinner skin, like the upper arms or inner thighs.
When stretch marks first form, they can be red, irritated, and itchy. However, over time, they may lose their color, becoming pale white.
Stretch marks respond best to treatment in their early stages. So, if you notice new stretch marks developing, it’s important to address them as soon as possible. Boosting collagen production is one of the best ways to fade the appearance of stretch marks, which can be accomplished with over-the-counter ingredients like retinol and in-office collagen-boosting procedures.
How Can You Treat Scars?
If you have small, flat scars, they can fade all on their own — given the proper amount of time and the right skin-nourishing ingredients (like those in our Moisturizing Body Lotion).
If your scars are fairly significant, they may be here to stay. In this case, it may be worthwhile to consider some professional scar treatments.
The best person to recommend scar treatments is, of course, your dermatologist. Thanks to years of training, they’re familiar with the different types of scars and which treatments they best respond to. However, it doesn’t hurt to know what your options are.
These are some of the scar treatment options you can consider:
1. Topical Ingredients
While topical skincare ingredients won’t provide dramatic results, like those of in-office procedures, they can still do a lot to improve uneven tone and texture to help fade the appearance of a scar. Many topicals accomplish this by sloughing off dead skin cells while promoting collagen fiber production.
Some evidence-based topicals for scars include retinol, glycolic acid, niacinamide, and growth factors. For a blend of effective topicals, look no further than our Scar Logic® Cream.
Over-the-counter chemical peels can also help improve the appearance of scars.
2. Silicone Gel
Silicone is a safe ingredient that’s a favorite for treating scars. When silicone gel sheets are applied to the skin, they can lock in moisture while stimulating fibroblasts. This may, in turn, promote collagen formation.
Silicone gel can be used to treat flat scars with discoloration. And, unlike other topicals, they may also help minimize the appearance of raised scar formations.
However, keep in mind: The older the scar, the less likely it will be to respond to silicone. So, it’s best to apply silicone gel patches in the early part of the healing process.
Microneedling is a procedure that uses a group of tiny needles to puncture the skin. This creates micro traumas that force the body to ramp up its collagen production.
Not only does microneedling help to reduce hyperpigmentation, but it’s also an excellent way to “fill in” pitted or sunken scars. Those who suffer from skin indentations caused by acne, chickenpox, or other conditions may especially benefit from microneedling.
Another popular dermatology treatment that operates in a similar way is dermabrasion. Dermabrasion must be administered by a licensed healthcare professional, and involves gently removing the outer layers of skin to shave away the appearance of scars and stimulate blood flow to the blood vessels in the affected area.
4. Laser Therapy
There are various types of lasers on the market that produce slightly different results. However, they all work in the same way: By delivering intense beams of light to the skin’s deeper layers.
Laser therapy can reduce the hyperpigmentation that accompanies scarring while smoothing out its uneven texture. Pulsed dye lasers can also reduce the pain and discomfort that comes with raised scars.
Laser treatment is generally considered to be safe with minimal side effects. But since there are so many types of laser resurfacing available, it’s best to consult with a dermatologist before settling on a treatment choice.
5. Corticosteroid Injections
Raised scars, like keloids, don’t respond all that well to traditional treatments. To help shrink them, you might need to get corticosteroid injections, which are powerful anti-inflammatories. It usually takes just several treatments to see a significant reduction in keloid scars and their side effects, like itching.
However, it’s important to keep in mind that corticosteroids are known for damaging healthy skin tissue. If administered too many times, steroid injections can cause the skin surrounding scars to atrophy, leading to a sunken appearance. That’s why corticosteroids should be injected very sparingly.
Cryotherapy involves using extremely low temperatures to freeze a scar. This effectively destroys the scar tissue, causing it to fall off.
Cryotherapy is mainly reserved for raised scars, such as keloids. In addition to helping to reduce their size, cryotherapy can help to alleviate pain, itchiness, and discomfort.
7. Scar Surgery
If your scar is significant enough, you may consider getting it surgically removed. Of course, scar excision surgery will also leave a surgical scar, which is why this is often the last resort. However, the scar left behind by a skilled plastic surgeon will be much less visible than the original.
It’s important to keep in mind that scars may return after being surgically removed. For this reason, following up surgery with pressure therapy (which we’ll discuss in the following section) is important.
8. Pressure Therapy
Pressure therapy involves using a pressure garment, like an elastic bandage, to prevent a scar from forming. This is usually done after another procedure, such as cryotherapy, to ensure that the scar doesn’t return.
Pressure therapy requires consistency to be effective. You may need to wear your pressure garment for up to a year after getting your scar removed. Of course, this depends on the size and severity of your scar, with smaller scars requiring you to wear the garment for less time.
Fading Scars With Nourishing Biologicals
Scars are extremely common. However, that doesn’t mean you have to like them. If you’re dealing with scars that make you dislike some aspect of your appearance, then you have plenty of options for reducing them.
Depending on what type of scarring you have, you may consider getting microneedling, laser therapy, cryotherapy, injections, or — as a last resort — surgery.
And don’t forget to apply topical treatments consistently. Various botanicals have been clinically shown to help fade scars, like those found in our Scar Logic® Cream. With consistent use, you may experience a significant reduction in your scars.
Retinoic acid and glycolic acid combination in the treatment of acne scars | PMC
The Efficacy of Silicone Gel for the Treatment of Hypertrophic Scars and Keloids | PMC