Scar tissue never fully disappears, but it can become dramatically less visible and more flexible with the right approach. How much improvement you can expect depends on the type of scar you have, how old it is, and which treatments you use. A fresh scar that’s still in its remodeling phase (roughly 6 to 12 months after injury) responds much more readily than a scar that’s been settled for years, though older scars can still improve with more intensive methods.
Why Scars Form and When They’re Easiest to Treat
After a wound closes, your body lays down collagen fibers to rebuild the damaged area. These fibers are thicker, less organized, and less elastic than normal skin, which is why scars look and feel different. The final stage of healing, called remodeling, begins about six weeks after the wound closes and continues for 9 to 12 months. During this window, the collagen reorganizes itself and the scar tissue gradually becomes stronger and more flexible.
This remodeling phase is your best opportunity to influence how a scar turns out. Treatments started during this period work with your body’s natural repair process rather than trying to override a finished result. That said, scars that are years old can still be softened, flattened, or faded with more aggressive options like laser therapy, injections, or surgical revision.
Silicone Sheets and Gels
Medical-grade silicone is the most studied over-the-counter scar treatment available. Silicone sheets are thin, flexible strips you place directly over a scar for 12 or more hours a day. They work by trapping moisture against the skin surface, which helps regulate collagen production and flatten raised tissue. In laboratory models, silicone sheeting with proper occlusion reduced raised scar formation by 80 percent.
Silicone gels offer a similar effect in a more convenient format, especially for scars on the face or joints where a sheet won’t stay put. For either product, consistency matters more than brand. Plan on using silicone daily for at least two to three months before judging results. It works best on newer scars that are still red or raised, though older hypertrophic scars can also flatten over time.
Scar Massage
Massaging a scar is one of the simplest things you can do at home, and nearly all hand and wound therapists use it in clinical practice. In surveys of Australian hand therapists, 98 percent reported using scar massage to improve soft tissue movement, 92 percent to reduce sensitivity, and 84 percent to improve function. The formal research behind specific techniques is still catching up to clinical practice, but the general approach is straightforward.
Once your wound is fully closed (no scabs, no open areas), apply firm pressure with your fingers and move the scar tissue in multiple directions: circular motions, side to side, and lengthwise along the scar. The goal is to feel the tissue shifting beneath your fingers, not just sliding your skin over the surface. Five to ten minutes, two to three times a day, is a common recommendation. Use a plain moisturizer or oil to reduce friction. Over weeks, you should notice the scar becoming softer and more pliable.
Onion Extract Products
Gels containing onion extract (the active ingredient in products like Mederma) are widely marketed for scar reduction. The evidence is mixed. In clinical studies on cesarean section scars, patches containing onion extract improved pigmentation, relief, and pliability compared to untreated scars when evaluated by trained observers. A separate study found that a gel containing onion extract reduced scar thickness, pigmentation, and overall severity scores compared to placebo at 12 weeks.
However, patient self-assessments in some of these same studies showed no significant difference from baseline. This suggests the improvements may be subtle enough that you might not notice them yourself, even if objective measurements pick up changes. Onion extract is unlikely to transform a prominent scar on its own, but it’s a reasonable, low-risk addition to a broader routine that includes silicone and massage.
Steroid Injections for Raised Scars
Keloids and hypertrophic scars (raised, firm scars that sit above the surrounding skin) often respond well to corticosteroid injections. A dermatologist injects the medication directly into the scar tissue, which breaks down excess collagen and flattens the scar over time. According to the Mayo Clinic, you’ll typically need monthly injections for up to six months before seeing the scar flatten noticeably.
These injections work best on smaller keloids. Larger or more stubborn keloids may need a combination approach: injections paired with silicone sheeting, pressure therapy, or laser treatments. If a keloid returns after injection alone, your dermatologist may recommend excision followed by immediate post-surgical injections to prevent regrowth.
Laser and Light Treatments
Laser therapy is one of the most effective options for reducing scar redness, smoothing texture, and improving flexibility. Different lasers target different problems. Pulsed-dye lasers reduce redness and blood vessel visibility in newer scars. Fractional lasers create microscopic channels in the scar tissue, triggering your body to replace the damaged collagen with more normally organized fibers.
Most laser treatments require multiple sessions spaced four to six weeks apart. Downtime varies from a day or two of redness to a week of peeling, depending on the laser’s intensity. For acne scars, a newer device using focal point technology recently received FDA clearance for all skin types. In its clinical trial, more than 90 percent of participants showed visible improvement, with a median 50 percent reduction in scar severity. Redness and swelling resolved within one to two days. This is particularly notable because many older laser technologies carried a higher risk of discoloration on darker skin tones.
Microneedling for Depressed Scars
Depressed scars, like the pitted marks left by acne, sit below the surrounding skin surface. Microneedling addresses these by using a roller or pen device studded with fine needles (typically 1.5mm long) to create controlled micro-injuries in the scar. This triggers a fresh round of collagen production that gradually fills in the depression.
A typical treatment plan involves six sessions spaced two weeks apart, spanning about three months. Results build gradually over the weeks following each session as new collagen forms. Professional microneedling in a dermatologist’s office uses longer needles and reaches deeper than at-home dermarollers, which generally top out at 0.5mm and produce more modest results. If you have deep ice pick or boxcar acne scars, professional treatment is worth the investment.
Surgical Scar Revision
When a scar is wide, tight, or positioned in a way that restricts movement or sits at an unfavorable angle to your skin’s natural tension lines, surgical revision can reorient or resize it. One common technique involves cutting the scar into a zigzag pattern and repositioning the flaps so the new scar follows the skin’s natural creases more closely. This doesn’t eliminate the scar, but it makes it far less conspicuous and releases tightness that may be limiting your range of motion.
Scar revision is typically reserved for scars that have fully matured, meaning at least 12 months old. Operating too early risks creating a worse scar, since the tissue is still actively remodeling. Your surgeon will also want to address what caused the original scar to heal poorly, whether that was tension, infection, or genetics, to give the revision the best chance of healing well.
Protecting Your Scar From the Sun
UV exposure is one of the fastest ways to make a scar permanently darker than the surrounding skin. New scar tissue lacks the pigment-regulating ability of normal skin, so it absorbs UV radiation unevenly and can develop lasting discoloration. Keep any new scar completely shielded from the sun for six months to one year, until the scar matures and its color stabilizes.
This means physical coverage (clothing, bandages, or medical tape) whenever possible, plus broad-spectrum SPF 30 or higher sunscreen on exposed scars every time you go outside. This applies even on cloudy days and even if your scar is already faded. Skipping sun protection during the first year is one of the most common reasons scars end up more visible than they needed to be.
Combining Treatments for Best Results
No single treatment works perfectly on every scar. The best outcomes usually come from layering compatible approaches. A practical combination for a newer raised scar might look like daily silicone sheeting, regular massage, sun protection, and steroid injections if the scar remains thick after a few months. For older depressed acne scars, microneedling or fractional laser paired with a good skincare routine delivers more than either approach alone.
The type of scar matters more than its age when choosing a strategy. Raised scars (keloids, hypertrophic scars) respond to flattening approaches: silicone, pressure, injections, and certain lasers. Depressed scars need collagen-building treatments: microneedling, fractional lasers, or fillers. Flat but discolored scars benefit most from sun protection, topical treatments, and pulsed-dye laser for persistent redness. Identifying which category your scar falls into is the first step toward choosing treatments that will actually make a difference.