Burn scars can be improved significantly, but they take time and usually a combination of approaches. Most burn scars peak in severity around six months after the injury and continue maturing for 12 to 18 months. That maturation window is when treatment has the greatest impact, so starting early matters.
What works best depends on the type of scar you’re dealing with and how much it affects your movement or appearance. Here’s what actually helps, from simple at-home options to procedures for more severe scarring.
Know What Type of Scar You Have
Not all burn scars behave the same way, and the type you have determines which treatments are worth pursuing.
Hypertrophic scars are thick, raised, and pink to red. They stay within the boundaries of the original burn and typically develop one to two months after the injury. These are the most common type of burn scar, and they’re also the most responsive to treatment. Many become less noticeable on their own over time.
Keloid scars grow beyond the edges of the original wound, sometimes becoming quite large. They tend to be darker, ranging from red to purple, and can take months or even years to develop. Keloids never resolve without treatment and have a high recurrence rate even after intervention.
Contracture scars form when a burn scar tightens over a joint or across a large area of skin, restricting movement. These are especially common after deep burns and often require more aggressive treatment to restore range of motion.
Silicone Sheets and Gel
Silicone-based products are the most widely recommended first-line treatment for raised burn scars. They come as adhesive sheets you place directly over the scar or as a gel you apply like a cream. Both work by hydrating the scar tissue and creating a barrier that helps regulate how collagen rebuilds underneath.
Treatment durations in clinical studies range from 3 to 12 months. A Cochrane review found that silicone sheets may slightly reduce scar severity compared to onion extract products, though the overall evidence base remains limited. There doesn’t appear to be a meaningful difference between silicone sheets and silicone gel in terms of outcomes, so you can choose whichever format is easier to stick with. Consistency matters more than the format. Most dermatologists recommend wearing sheets for as many hours per day as you can manage, removing them only to clean the skin.
Pressure Garments
Custom-fitted pressure garments are a standard treatment for burn scars, particularly after larger burns. They work by applying steady compression to the scar tissue, which helps flatten raised scars and reduces redness over time.
The target pressure is around 24 to 25 mmHg, enough to exceed the pressure inside the tiny blood vessels feeding the scar. For this to work, the garments need to be worn essentially around the clock, removed only for bathing, for a period of 12 to 18 months depending on the severity of the burn. That’s a serious commitment, and fit matters. A garment that’s too loose won’t deliver enough pressure, and one that’s too tight can cause skin breakdown. These are typically prescribed and custom-made through a burn rehabilitation clinic.
Laser Treatment
Fractional CO2 laser therapy is one of the more effective options for improving the texture, color, and flexibility of burn scars. The laser creates thousands of tiny channels in the scar tissue, triggering the skin to remodel itself with healthier collagen.
A typical course involves about four sessions spaced four to six weeks apart. In a prospective study of burn patients, laser treatment produced significant improvements in scar flexibility, blood vessel appearance, and pigmentation. The results are cumulative, meaning each session builds on the last. Some redness and swelling after each session is normal and typically resolves within a week or two. Laser works best on mature scars, so your provider may recommend waiting until the scar has stabilized before starting.
Surgical Options for Contractures
When a burn scar restricts movement, especially across joints like the hand, elbow, or neck, surgery may be the only way to restore full function. The specific technique depends on how the scar is structured.
For linear scar bands that pull the skin tight, a technique called z-plasty is commonly used. The surgeon cuts a Z-shaped pattern into the scar and rearranges the flaps of skin, which effectively lengthens the contracted area. For broader areas of scarring, the contracted tissue is released and the resulting gap is covered with a skin graft or a flap of skin moved from a nearby area. Full-thickness skin grafts work well when the tissue underneath has good blood supply, regardless of the size of the area being repaired.
Recovery from these procedures varies widely based on the location and extent of the surgery, but physical therapy afterward is almost always part of the plan to maintain the range of motion that was restored.
What to Put on Your Scar at Home
Beyond silicone, a few other topical ingredients show up in scar products. Onion extract (the active ingredient in products like Mederma) has some evidence behind it. In one study, patches containing onion extract improved pigmentation, surface texture, and flexibility of scars compared to no treatment, at least when assessed by clinicians. Patients themselves didn’t report a noticeable difference, which suggests the improvements are real but subtle.
Vitamin E is one of the most popular home remedies for scars, but the evidence is not encouraging. One study found that up to 33% of patients who applied vitamin E topically developed contact dermatitis, an itchy, red skin reaction that can actually make the scar look worse. If you want to try it, patch-test on a small area first, but silicone products are a better-supported choice.
Protect Your Scar From the Sun
New burn scars are highly vulnerable to permanent pigment changes from UV exposure. A scar that darkens unevenly from sun exposure can become much more noticeable than it would have been otherwise, and those color changes can be permanent.
Use a broad-spectrum sunscreen with SPF 30 or higher on any exposed scar tissue for at least one full year after the burn. Reapply frequently, especially if you’re sweating or swimming. Physical coverage with clothing is even more reliable than sunscreen when possible. Don’t forget your lips if the burn is on or near your face: use a lip balm with SPF 30 or higher.
Nutrition During Healing
Your body needs extra building blocks to repair burned skin. Protein is the most important one. Healing skin demands substantially more protein than your normal diet provides, because collagen (the structural protein in skin) has to be manufactured from scratch. Prioritizing protein-rich foods like eggs, fish, poultry, legumes, and dairy during the healing period gives your body the raw materials it needs.
Vitamin C plays a direct role in collagen production, and zinc supports immune function and tissue repair. Both are involved in every stage of wound healing. You can get adequate amounts from a varied diet that includes citrus fruits, bell peppers, nuts, seeds, and whole grains, or from a basic multivitamin. Nutritional support matters most during the active healing phase, roughly the first several months after a burn.
The Healing Timeline
Burn scars follow a predictable arc. Scarring typically begins within the first few months, worsens and peaks around six months, then gradually softens and fades over the following 12 to 18 months as the scar matures. During that maturation window, the scar is actively remodeling, which is why treatments like silicone, pressure therapy, and massage are most effective when started early and maintained consistently.
After a scar has fully matured, it becomes less responsive to conservative treatments. That doesn’t mean nothing can be done. Laser therapy, surgery, and other procedures can still produce meaningful improvements in mature scars. But the best outcomes come from combining early intervention with patience, because the biology of scar healing simply takes time.