Getting rid of scars completely isn’t always possible, but most scars can be significantly improved with the right approach. The best strategy depends on what type of scar you have, how old it is, and how deep it goes. Options range from simple at-home treatments like silicone sheets to professional procedures like laser resurfacing, which can improve scar texture by 50 to 80%.
Why Your Scar Type Matters
Not all scars respond to the same treatments, so identifying what you’re dealing with is the first step. Scars generally fall into a few categories based on how your body healed the original wound.
Atrophic (pitted) scars sit below the surface of surrounding skin. These are the indented scars left behind by acne, chickenpox, or certain surgeries. They form when the body doesn’t produce enough collagen during healing, leaving a depression. Acne scars come in subtypes (icepick, boxcar, and rolling) that each respond differently to treatment.
Hypertrophic scars are raised, pink-to-red, and slightly thick, but they stay within the borders of the original wound. They tend to form when a healing wound is under a lot of tension. The good news is that hypertrophic scars are more likely to flatten and fade on their own over time compared to other raised scars.
Keloid scars are firm, smooth, raised growths that extend beyond the original wound area. They’re purplish-red, often itchy, and can develop months or even years after an injury. Keloids form from an overproduction of collagen and are more common in people with darker skin tones. Minor triggers like insect bites, piercings, acne, or vaccinations can cause them.
Contracture scars result from burns. The skin tightens and pulls inward as it heals, which can restrict movement if the scar covers a joint.
How Scars Heal on Their Own
Your body heals wounds in four overlapping phases, and the entire process takes up to a year. Inflammation kicks in within minutes to hours and can last up to two weeks. Then the proliferation phase, where your body lays down new tissue, starts around day four and continues for about 30 days. The final remodeling phase begins at roughly four weeks and lasts nine to 12 months.
During remodeling, your body reorganizes the collagen it laid down during healing. This is why scars that look angry and red at three months can look dramatically better at one year. Any scar treatment works best after you’ve given this natural process time to progress, though some interventions (like silicone sheets) can start early to guide healing in the right direction.
Preventing Scars Before They Form
If you have a fresh wound, how you care for it in the first weeks has a major impact on how the scar turns out. The American Academy of Dermatology recommends keeping wounds moist with petroleum jelly rather than letting them dry out and scab over. Wounds that form scabs take longer to heal and tend to produce larger, deeper, itchier scars. Cover the area with an adhesive bandage after applying ointment, and for larger wounds, consider hydrogel or silicone gel sheets.
Once the wound has closed, protect it from the sun. UV exposure darkens scars and slows fading. Use a broad-spectrum sunscreen with SPF 30 or higher on the healed area and reapply frequently. This alone can make a noticeable difference in how red or brown a scar appears over time.
Silicone Sheets and Gels
Silicone gel sheeting is one of the most well-studied at-home scar treatments, particularly for raised scars. In one study using an animal model, silicone sheets reduced hypertrophic scar formation by 80%. In clinical practice, about 40% of plastic surgeons reported that silicone-based products produced noticeable improvement in 50 to 75% of their patients with hypertrophic scars and keloids.
The mechanism isn’t fully understood, but the leading theory is that silicone works by mimicking the skin’s natural barrier and locking in moisture. This hydration appears to influence the chemical signals that drive scar tissue production. You wear the sheets over the scar for several hours a day, typically for weeks to months. Silicone gels that dry into a thin film are a more convenient alternative for areas where sheets won’t stick easily, like the face or joints. Both are available over the counter and are worth trying before moving to more invasive options.
Microneedling for Pitted Scars
Microneedling uses a device covered in fine needles to create tiny, controlled punctures in the skin. This triggers your body’s wound-healing response and stimulates new collagen production in the scarred area. It’s one of the most effective treatments for atrophic acne scars.
A review of 33 studies covering over 1,000 patients found that three months after the final session, more than 95% of patients improved by at least one grade on a clinical scarring scale. Nearly 18% of patients saw 75 to 100% improvement in their acne scarring, about 24% saw 50 to 74% improvement, and 55% saw 25 to 49% improvement. Rolling and boxcar scars responded better than icepick scars, especially when microneedling was combined with a technique called subcision, where a needle is used to release the scar from the tissue pulling it down.
Professional microneedling typically requires multiple sessions spaced four to six weeks apart. At-home derma rollers exist but use shorter needles and produce more modest results. For significant scarring, professional treatment is more effective.
Laser Resurfacing
Fractional CO2 laser treatment is considered one of the most powerful tools for atrophic scars. The laser creates microscopic columns of damage in the skin, leaving surrounding tissue intact so healing is faster. As the skin repairs these micro-wounds, it remodels the scar tissue underneath.
Clinical studies show 50 to 80% improvement in atrophic acne scar texture. Most patients need one to three sessions spaced four to six weeks apart, though some treatment plans call for up to four sessions depending on scar severity. Recovery involves several days of redness, swelling, and peeling. The skin remains sensitive for weeks afterward, and strict sun protection is essential during healing.
Laser treatments are less effective for raised scars and carry a risk of pigment changes, particularly in darker skin tones. Your dermatologist can help determine whether your skin type and scar type are a good match.
Chemical Peels and the CROSS Technique
For deep, narrow acne scars, a specialized technique called CROSS (chemical reconstruction of skin scars) can be highly effective. A concentrated acid solution is applied directly into each individual scar using a fine-tipped applicator. This triggers an intense healing response at the base of the scar, thickening the dermis and boosting collagen production to raise the depressed area.
The method works on all types of deep acne scars, including icepick, boxcar, and rolling scars. It has also been used successfully on chickenpox scars, depressed surgical scars, and even dilated pores. Improvement is cumulative, meaning results get better with each session. Multiple treatment sessions are typically needed, and your provider will determine the appropriate concentration and number of rounds based on scar depth.
Steroid Injections for Raised Scars
Keloids and stubborn hypertrophic scars are often treated with steroid injections directly into the scar tissue. The steroid reduces inflammation and slows collagen production, causing the scar to soften and flatten over time. Injections are typically repeated every few weeks until the scar responds.
For keloids that are surgically removed, steroid injections immediately after excision are critical. Without them, the recurrence rate for excised keloids ranges from 45 to 100%. Adding post-surgical steroid injections drops recurrence below 50%. Injections given at the time of surgery appear to be more effective than those started a week later. Even with treatment, keloids are notoriously difficult to eliminate permanently and may require combination approaches.
What About Vitamin E and Home Remedies?
Vitamin E is one of the most commonly recommended home remedies for scars, but the clinical evidence is weak. A systematic review of randomized trials found that topical vitamin E may help surgical wounds heal in children, but showed no benefit for adults. Some people also develop contact dermatitis (an itchy, red rash) from applying vitamin E directly to skin, which can actually worsen the appearance of a healing scar.
Other popular home remedies like coconut oil, honey, aloe vera, and lemon juice lack strong clinical evidence for scar reduction. They won’t cause harm in most cases, but if you’re looking for measurable improvement, your time and money are better spent on silicone products or professional treatments with proven track records.
Choosing the Right Approach
For fresh scars less than a year old, start with the basics: keep the area moisturized, protect it from the sun, and consider silicone sheets or gel. Many scars improve dramatically during the natural remodeling phase, and these simple steps can make the difference between a visible scar and one that’s barely noticeable.
For older scars that have already matured, the right treatment depends on the type. Pitted scars respond well to microneedling, laser resurfacing, or the CROSS technique. Raised hypertrophic scars often improve with silicone products and, if needed, steroid injections. Keloids typically require a combination of steroid injections with other interventions. Most professional treatments require multiple sessions and patience. Results build gradually over months as your skin produces new collagen and remodels the treated area.