Consider the type of scar
Anytime the bottom skin layer, or dermis, is injured, the body heals by producing a scar, explains board-certified plastic surgeon Alexis Parcells, MD. She adds that while most people with a scar experience this natural healing process, there are several different types of scars that can occur depending on the insulting injury and an individual’s genetics. Here, Dr. Parcells breaks them down:
- Hypertrophic scars: While all scars will have a period of being raised and red, these particular types of scars maintain that appearance due to the increased production of collagen during healing.
- Keloids: Similar to hypertrophic scarring, keloids will extend beyond the borders of the original wound and may continue to grow with time. These scars are caused by an overproduction of collagen. Keloids tend to be genetic and can be itchy and uncomfortable.
- Atrophic scars: These scars often look sunken and are attributed to the loss of fat or muscle under the scar. Acne scars are a known type of atrophic scar.
- Contracture: Commonly seen along joints, on the hands, and face, these scars commonly occur after a large area of the skin is burned. In an effort to heal the surrounding area, the edges of the injury are pulled together tightly to form a scar, limiting mobility.
- Striae (or stretch marks): Though not necessarily a scar, these marks are seen during periods of rapid growth of the skin.
Evaluate the ingredients
“A scar cream can work to soften, fade, smooth, and flatten scars,” says Dr. Parcells, listing a few of the most common ingredients that you’ll find in scar creams:
- Silicone*: Creates a protective barrier over the scar, keeping it hydrated, which will reduce redness and thickness over time. (*Gold standard scar treatment.)
- Vitamin E: Moisturizes and may help with collagen production.
- Aloe vera: Soothes your skin and has anti-inflammation properties.
- Onion extract: May reduce inflammation and improve scar appearance.
- Allantoin: Helps with skin regeneration and is soothing.
Just note that according to the American Academy of Dermatology, a lot of non-prescription scar treatments contain ingredients such as onion extract, vitamin A, and vitamin E—excluding silicone—and research on how well these ingredients work is limited.
Understand that consistency is key
In order to treat a scar and get the most benefits out of your scar cream, you need to be very diligent about applying it. “Silicone sheets are highly effective for scars but because they have to be worn for a minimum of 12 hours daily, compliance is an issue with this treatment, especially in visible areas such as on the face,” says Dr. Natoli. And when it comes to scar creams, most are indicated for twice-daily use, every single day.
Dr. Parcells says that for most patients who will experience normal scarring, “you can start a scar cream or gel approximately three to four weeks after injury or surgery, and continue for up to two years when a scar is mature.”