Scarring
How skin and tissue heal after injury
Quick Facts
- Type: Skin and tissue healing process
- Common triggers: Cuts, burns, surgery, acne
- Main types: Flat, raised, sunken, keloid
- Goal of care: Improve appearance and comfort
Overview
Scarring is the natural result of the body repairing damaged skin or tissue. When an injury goes deeper than the surface layer of skin, the body produces collagen to close the wound, and this new tissue forms a scar. Scars are a normal part of healing and almost always permanent, though they often fade and soften over time.
Scars vary widely in how they look and feel. Some are flat and pale, while others are raised, sunken, tight, or discolored. Most scars cause no medical problems, but some can be itchy, tender, or restrict movement, and many people seek treatment to improve their appearance.
Symptoms
Scars differ in texture, color, and sensation depending on the injury and how the skin heals.
- A flat, pale line or patch after a healed wound
- Raised, firm, or thickened tissue (hypertrophic or keloid scars)
- Sunken or pitted marks, often after acne or chickenpox
- Discoloration that is darker or lighter than surrounding skin
- Itching, tenderness, or tightness, especially in newer scars
- Reduced movement when a scar crosses a joint or pulls on the skin
New scars may be red or raised at first and often improve gradually over months.
Causes
Scarring occurs whenever the deeper layers of skin or other tissue are injured and repaired. Common causes include:
- Cuts and wounds: Accidental injuries, especially deeper ones
- Surgery: Incisions that heal into surgical scars
- Burns: Which can produce tight, contracted scars
- Acne and skin infections: Frequent causes of pitted or raised facial scars
- Inflammatory skin conditions: Repeated inflammation can leave marks
How a wound is treated, where it is located, its size and depth, and a person's individual healing tendencies all affect how noticeable the final scar becomes.
Risk Factors
- Deep, large, or jagged wounds
- Wounds under tension or over joints
- Burns and severe acne
- Wound infection or delayed healing
- A personal or family tendency toward keloid or raised scars
- Darker skin tones, which are more prone to keloids and pigment changes
- Younger age, when skin tends to form thicker scars
Diagnosis
Scars are usually diagnosed by their appearance, and no special tests are needed in most cases.
- Physical examination: A clinician looks at the scar's size, texture, color, and location and asks about how it formed.
- History: Information about the original injury, healing, and any symptoms such as itching or tightness.
- Biopsy: Rarely, a small sample is taken if it is unclear whether a growth is a scar, a keloid, or another skin change.
Treatment
Many treatments can improve how a scar looks and feels, though no method fully erases a scar. The best approach depends on the scar type.
- Silicone gels and sheets: Often recommended to flatten and soften raised scars over time.
- Moisturizers and massage: Can keep scars supple and may ease tightness.
- Steroid treatments: Injections can flatten thick or keloid scars.
- Laser therapy: May reduce redness and improve texture.
- Skin resurfacing: Techniques such as microneedling or chemical peels can help sunken acne scars.
- Surgical revision: Reshaping or repositioning a scar for cosmetic or functional reasons.
Sun protection is important for any scar, as ultraviolet light can darken healing tissue and make scars more noticeable.
Prevention
You cannot always prevent scarring, but good wound care can make scars less noticeable:
- Keep wounds clean, moist, and covered while they heal
- Avoid picking at scabs or squeezing acne
- Protect healing skin from the sun and use sunscreen once the wound has closed
- Follow care instructions after surgery or injury
- Seek early care for deep, gaping, or infected wounds, which may need professional closure
When to See a Doctor
See a doctor if a scar becomes increasingly raised, painful, or itchy, grows beyond the original wound, or limits movement. A dermatologist can suggest treatments to improve troublesome scars.
Seek prompt care if a wound shows signs of infection, such as spreading redness, warmth, pus, or fever, since infection can worsen scarring. Also have any scar checked that changes in size, color, or texture without explanation, to rule out other skin conditions.
Frequently Asked Questions
Do scars ever go away completely?
Most scars are permanent, but they usually fade and flatten over months to a couple of years. Treatments can improve how a scar looks and feels, though none can erase it entirely.
How can I make a scar less noticeable?
Keeping new wounds clean and moist, using silicone gels or sheets, massaging the area, and protecting it from the sun can all help. For stubborn scars, a dermatologist may suggest steroid injections, laser therapy, or resurfacing treatments.
Why is my scar raised and growing?
A scar that becomes thick and raised may be a hypertrophic scar or a keloid, which can grow beyond the original wound. People with a family tendency or darker skin are more prone to keloids, and treatment from a dermatologist can help.
Should I keep a healing wound covered or let it air out?
Keeping a wound clean, moist, and covered generally supports healing and tends to produce a less noticeable scar than letting it dry out and scab heavily. Avoid picking at scabs.
When should a scar be checked by a doctor?
Have a scar evaluated if it grows, becomes painful or very itchy, limits movement, or changes in color or texture without reason. Signs of infection in a healing wound, such as spreading redness or pus, also need prompt care.
References
- American Academy of Dermatology Association. Scars: Diagnosis and treatment.
- Mayo Clinic. Scars.
- MedlinePlus, U.S. National Library of Medicine. Scars.