How can I make my scar disappear?

I get asked this question a lot, and unfortunately there is no way to make a scar completely disappear. As human beings, our skin heals by a scarring rather than regeneration which would lead to scarless wound healing.

While genetics play a large part in how scars ultimately look, here are some tactics I recommend to my patients in order to make as good of scars their bodies allow:

Massage

After stitches are out and the wound has been given enough time to heal in the early stages, I recommend that my patients begin massage with a moisturizing ointment of their choice. I typically suggest a plain petroleum jelly, but many options are available. You will want to stay away from lotions and moisturizers with a lot of fragrances as the added chemicals can be irritating to the skin if used for a long period of time. In the same spirit, I don't recommend prolonged use of antibiotic ointment (though there are certain circumstances where short courses are appropriate) as an allergy can develop on the skin from these added ingredients.

The technique is to put a small amount of moisturizer on the healing tissue and gently massage. I usually recommend 15 minutes at a stretch three times a day and adjust accordingly. This may be the routine for 3 months, 6 months, or longer depending on how much swelling and toughness there is in the area.

Sunscreen

The wound really needs to be protected from sun exposure for the whole first year after surgery or injury. During this time, the scar runs the risk of developing permanent color changes that can make the scar noticeable.

As general advice, sunscreen really should be part of everyones daily regimen regardless of baseline skin tone. Daily protection against harmful ultraviolet rays will help limit signs of aging and more importantly help prevent skin cancers from developing.

I would typically use an SPF of 30 or higher with liberal reapplication. If you know your scar is going to be exposed, you may want to consider using something to cover the scar completely (zinc oxide, hats, or opaque bandaids) .

Silicone

While the science on scar improvement is limited, there is some evidence behind using silicon as a sheet on your scars. A number of generic brands of silicon sheets are available at major drug stores. They tend to be self adhesive and can be cut to size and reused until they no longer stick. The longer you use them, the more benefit you will get. I recommend my patients start the scar regimen once the stitches are out and to continue it as long as they can (3months, 6 months or longer). There are some liquid silicone products available for topical use that can be helpful if the sheets aren't sticking or are you find them difficult to use.

Procedures (revisions, dermabrasion, steroid injection)

Depending on the circumstances of the original injury or surgery, scar revisions or other types of medical scar treatments do exist. As mentioned above, much of scarring process is out of our control, and in some patients, the scar revision can make no noticeable difference. Patients who tend to benefit are patients who didn't have the wound closed initially, or had an issue during the initial healing process.

Keloid scars are a very specific and challenging problem that are beyond what we have discussed. If you are looking for treatment of your keloid scar, I recommend seeing a board-certified plastic surgeon or dermatologist.

Unless a major breakthrough occurs in scarring and wound healing, these are the interventions that tend to carry the most bang for the buck.

Happy healing,

• Aparajit Naram, MD

As always, you should always discuss with a medical professional before following any of the advice in this article.