Understanding the Different Types of Skin Scars and How to Treat Them

Scars are a natural part of the healing process when the skin is injured. Whether from acne, surgery, burns, or cuts, most people will develop a scar at some point in their lives. While scars can fade over time, some become more prominent and may cause discomfort or affect self-confidence. Understanding the different types of skin scars—and the treatments available—can help you manage them more effectively.

How Scars Form

When the deep layers of the skin (dermis) are damaged, the body produces collagen to repair the wound. This new tissue, while strong, often looks and feels different from the surrounding skin. The resulting mark is what we recognize as a scar. The appearance of a scar depends on factors such as the type and depth of the injury, location on the body, genetics, age, and skin tone.

Types of Skin Scars

Not all scars are the same. Here are the most common types:

1. Hypertrophic Scars

These scars are raised and red, forming directly at the site of the injury. They occur when the body produces too much collagen during healing. Unlike keloids, hypertrophic scars do not extend beyond the original wound area and may gradually shrink over time, although they can take several years to improve.

2. Keloid Scars

Keloids are larger, more aggressive overgrowths of scar tissue that extend beyond the boundaries of the original wound. They are more common in people with darker skin tones and often occur on the chest, shoulders, earlobes, and cheeks. Keloids can continue to grow slowly and may cause itching, tenderness, or discomfort.

3. Atrophic Scars

These scars appear as indentations or pits in the skin. They form when underlying structures (such as fat or muscle) are lost during the healing process. Atrophic scars are commonly associated with acne (often called “ice pick” or “boxcar” scars) or chickenpox. They are typically found on the face.

4. Contracture Scars

Contracture scars usually result from burns. As the skin heals, it tightens and pulls together, which can restrict movement—especially if the scar crosses a joint. These scars may also affect underlying muscles and nerves.

5. Stretch Marks (Striae)

Although not true scars, stretch marks are a form of skin damage caused by rapid stretching of the skin—such as during pregnancy, puberty, or significant weight gain. They appear as streaks or lines, initially red or purple, then fading to white or silver over time.

How to Treat and Improve the Appearance of Scars

While most scars cannot be completely removed, many treatment options can significantly improve their appearance and texture.

1. Topical Treatments

• Silicone gels or sheets: Often used for hypertrophic and keloid scars, silicone helps flatten and soften scars.
• Onion extract creams: Some over-the-counter scar gels contain onion extract to reduce redness and inflammation.
• Vitamin E: Commonly used, though research on its effectiveness is mixed. It may help moisturize the skin but should be used cautiously, as it can irritate some people.

2. Medical Procedures

• Corticosteroid Injections: Effective for keloids and hypertrophic scars, these injections help reduce inflammation and flatten the scar.
• Laser Therapy: Different types of lasers can improve scar color, texture, and reduce itchiness. Pulsed dye lasers target redness, while fractional lasers promote collagen remodeling.
• Dermabrasion and Microdermabrasion: These techniques remove the top layers of skin to improve the texture of atrophic scars.
• Microneedling: Involves tiny needles that stimulate collagen production, helping to fill in depressed scars like acne scars.
• Surgical Revision: In some cases, removing the scar surgically and re-closing the wound with precise techniques can improve appearance—especially for wide or uneven scars.

3. Fillers

Injectable fillers such as hyaluronic acid can temporarily plump up atrophic scars, making them less noticeable. Results are not permanent and usually last 6–12 months.

4. Cryotherapy

Used primarily for keloids, cryotherapy (freezing the scar tissue) can reduce the size and hardness of the scar, though it may cause skin discoloration.

Preventing Scars

While not all scars can be prevented, you can minimize their appearance by:

• Keeping wounds clean and moist.
• Avoiding picking at scabs or acne.
• Protecting healing skin from sun exposure with sunscreen or clothing.
• Seeking early treatment for acne or skin infections.

When to See a Doctor

Consult a dermatologist or plastic surgeon if:

• The scar is painful, itchy, or growing.
• The scar affects movement or function.
• You’re unhappy with the scar’s appearance and want professional treatment options.

Final Thoughts

Scars are a sign that your body has healed from an injury. While they may not disappear entirely, advances in dermatology offer many effective ways to reduce their appearance and boost your confidence. Understanding your scar type is the first step toward choosing the right treatment plan. With patience and the right care, healthier, smoother skin is within reach.

Disclaimer: This article is for informational purposes only and does not replace professional medical advice. Always consult a healthcare provider for personalized diagnosis and treatment.