Raised scars can be flattened and softened through a range of treatments, from at-home silicone products to in-office procedures like steroid injections and laser therapy. The right approach depends on your scar’s size, age, and type. Most people see meaningful improvement without surgery, especially when treatment starts early.
Know What Type of Raised Scar You Have
Not all raised scars behave the same way, and the distinction matters because it changes which treatments work best. The two main types are hypertrophic scars and keloids.
Hypertrophic scars stay within the borders of the original wound. They typically appear four to eight weeks after the wound closes, grow over the next six to eight months, then stop progressing. Many flatten on their own over time, though the process can take years without treatment.
Keloids spread beyond the original wound edges into surrounding skin. They can show up anywhere from three months to several years after an injury, they rarely stop growing on their own, and they don’t follow the same pattern of eventually settling down. If your scar is creeping past where the wound originally was, you’re likely dealing with a keloid, which typically requires professional treatment and is harder to resolve permanently.
Start With Silicone Products
Silicone is the most accessible first-line treatment for raised scars and has decades of clinical backing. It works by increasing hydration in the top layer of skin, which signals the cells underneath to slow down collagen production. Less excess collagen means a softer, flatter scar over time.
Silicone comes in two main forms: adhesive sheets you place over the scar and topical gels you apply as a thin film. Sheets are ideal for flat body areas where they’ll stay in place, while gels work better on joints, the face, or anywhere a sheet would peel off. For best results, apply silicone for at least 12 hours per day. Gel formulations are typically applied twice daily as a thin layer. You’ll need to keep this up consistently for several months to see real changes, so pick whichever format you’ll actually stick with.
Try Scar Massage
Regular massage can break up the dense collagen bundles that make a scar feel thick and rigid. The most effective techniques are deep and superficial cross-friction movements, where you rub firmly across the scar rather than along it. This helps the tissue beneath the scar glide more freely and can gradually reduce height and stiffness.
The most commonly recommended routine is three times a day for five minutes, continued for about 12 weeks. You can start once the wound is fully closed, typically two to three weeks after surgery or injury. If the skin is still fragile or not completely healed, wait until it’s sealed before applying any pressure.
Steroid Injections for Stubborn Scars
When silicone and massage aren’t enough, corticosteroid injections are the standard next step. A dermatologist injects a steroid solution directly into the scar tissue, which reduces inflammation and breaks down excess collagen. The scar softens and flattens over a series of sessions, usually spaced four to six weeks apart.
This approach works well for both hypertrophic scars and keloids. In clinical studies, the majority of patients treated with steroid injections achieved over 50% improvement in scar appearance. The injections can sting, and some people experience temporary skin thinning or lightening at the injection site, but these effects are generally manageable. Your dermatologist adjusts the concentration based on how thick and firm your scar is.
Laser Treatments
Lasers offer two distinct benefits depending on the type used. Pulsed dye lasers target the blood vessels feeding the scar, which makes them especially effective at reducing redness and discoloration. Fractional CO2 lasers create tiny controlled injuries in the scar tissue, prompting your body to remodel the collagen into a flatter, more pliable arrangement.
In a head-to-head comparison of the two approaches on hypertrophic scars, fractional CO2 laser produced significantly better results for scar height and flexibility, while pulsed dye laser was better at reducing redness. Some dermatologists combine both types. Treatments are typically done once a month, and many patients see noticeable improvement within three sessions. The average cost of a laser skin resurfacing session is around $1,829, though prices vary based on scar size and location.
Cryotherapy
Intralesional cryotherapy is a newer option that freezes scar tissue from the inside using a thin probe. Unlike surface freezing, which only reaches the outer layers, this technique delivers cold directly into the core of the scar. Studies consistently show scar volume reductions of 50 to 67% after a single treatment, with some patients achieving near-complete flattening. One study reported an average volume reduction of 93.5% after four months. Pain and itching, two common complaints with raised scars, also improve significantly after treatment.
Pressure Therapy for Burn Scars
If your raised scar resulted from a burn, custom pressure garments can help. These are fitted sleeves, vests, or wraps that apply steady compression to the scar. The effective pressure range is 15 to 25 mmHg. Below 15 mmHg, there’s little therapeutic benefit; above 40 mmHg, the pressure becomes painful and potentially harmful.
Clinical evidence shows that pressure therapy at 15 to 25 mmHg significantly improves scar thickness, hardness, redness, and pigmentation compared to no compression. These garments need to be worn for most of the day over a period of months, which can be uncomfortable, but they’re one of the few treatments specifically validated for widespread burn scarring.
Why Surgery Alone Often Isn’t Enough
Surgical excision might seem like the most direct solution: just cut the scar out. But for keloids especially, surgery alone has a recurrence rate of 50 to 80%. The same biology that created the original keloid tends to produce another one in the surgical wound. For this reason, surgeons almost always pair excision with follow-up treatment, typically steroid injections, radiation therapy, or both, to suppress regrowth. If a provider recommends surgery for your scar, ask specifically about what post-operative plan they’ll use to prevent recurrence.
Timing Makes a Difference
The earlier you start treating a raised scar, the better your outcome. Clinical guidelines recommend beginning silicone application and scar massage two to three weeks after the wound has closed. At this stage, the scar is still actively forming, and early intervention can prevent it from becoming thick and rigid in the first place. Silicone should ideally be worn at least 12 hours per day starting around two weeks post-surgery.
If your scar is already mature, these treatments still work, but they take longer and you may need to combine multiple approaches. A common strategy is pairing silicone with steroid injections, or following laser sessions with consistent at-home silicone use. Many dermatologists layer treatments in this way to address both the internal collagen structure and the surface appearance of the scar.