Most scars won’t disappear completely, but the right approach can make them significantly less noticeable. The key is matching your treatment to the type of scar you have and starting as early as possible. Flat, discolored scars respond to different strategies than raised or indented ones, so understanding what you’re working with determines which options will actually help.
Why Scars Form and What Affects Fading
When your skin is injured, it repairs itself by producing collagen fibers. These fibers are laid down in a single direction rather than the basket-weave pattern of normal skin, which is why scar tissue looks and feels different. How much collagen your body produces during healing determines whether your scar ends up flat, raised, or indented.
Several factors influence how prominent a scar becomes: the depth and size of the wound, where it is on your body (scars on the chest, shoulders, and earlobes tend to be worse), your age, your skin tone, and your genetics. Darker skin tones are more prone to keloids and hyperpigmentation. Scars on joints or areas with a lot of movement also tend to widen over time because of the constant tension on healing tissue.
Silicone: The Best-Supported At-Home Treatment
Silicone gel sheets and silicone-based gels are the most well-studied topical option for scar fading. International clinical guidelines list silicone as effective for both preventing and managing raised scars. It works by creating a barrier over the scar that mimics the moisture levels of normal skin. When a scar is healing, the new outer skin layer is immature and loses water too quickly. That dehydration triggers skin cells to send chemical signals that ramp up collagen production, which is exactly what makes scars thicken and raise. Silicone restores normal hydration, dialing down that overproduction.
For best results, cut a silicone sheet to the size of your scar and wear it for several hours a day or overnight. Plan to use it consistently for at least two to three months. Silicone gel (in tube form) is a good alternative for scars in areas where a sheet won’t stay put, like the face or joints. Both forms are available over the counter.
Scar Massage
Once a wound has fully closed, typically two to three weeks after surgery or injury, regular massage can help soften and flatten scar tissue. The pressure breaks down excess collagen fibers and increases blood flow to the area. For best results, massage your scar for at least 10 minutes, twice a day, for six months. Use firm, circular pressure with a fingertip, and work in multiple directions: up and down, side to side, and in circles. A small amount of moisturizer or oil helps your fingers glide without irritating the skin.
Treating Flat, Discolored Scars
Scars that are flat but darker or redder than surrounding skin are mostly a pigmentation or blood vessel issue. Red or pink scars contain extra blood vessels that formed during healing. These typically fade on their own over 6 to 18 months, though the process can feel slow. Sunscreen is essential during this period because UV exposure darkens scars and can make discoloration permanent. Use SPF 30 or higher on any scar that’s exposed to sunlight.
For stubborn redness, a pulsed dye laser works by targeting and destroying the small blood vessels responsible for the color. It’s considered a preferred treatment in international scar management guidelines. Dark or brown discoloration, more common in medium to deep skin tones, can respond to topical brightening agents that slow pigment production. Look for products containing ingredients like azelaic acid, niacinamide, or vitamin C. These are gentler than prescription options and available without a visit to a dermatologist.
Treating Raised Scars and Keloids
Hypertrophic scars stay within the boundaries of the original wound but are thick and raised. Keloids grow beyond the wound edges and can continue expanding over time. Both result from too much collagen, but keloids are more aggressive and harder to treat.
Silicone is a reasonable first step for hypertrophic scars. For keloids, corticosteroid injections are the preferred first-line treatment. A dermatologist injects a small amount of medication directly into the scar, which shrinks the tissue by reducing collagen production and inflammation. This approach achieves regression in 50% to 100% of cases, though recurrence rates range from 9% to 50%, which is why repeat sessions or combination treatments are common. The injections can be uncomfortable, but each session is brief.
Pressure therapy, using compression garments or silicone-lined bandages, has long been a standard approach for preventing raised scars after burns. If you’re recovering from a burn injury, your care team will likely recommend pressure garments worn for many hours each day.
Treating Indented (Atrophic) Scars
Acne scars, chickenpox scars, and some surgical scars leave depressions in the skin because too little collagen was produced during healing. These are the most common type of scar people want to improve, and they rarely improve much on their own.
Microneedling is one of the most accessible professional treatments for indented scars. A device with fine needles (typically 1.5 mm long) creates tiny punctures in the scar tissue, triggering your body to produce new collagen as it heals those micro-injuries. Results are gradual: patients typically see 15% to 20% improvement in scar appearance after one month, building to 51% to 60% improvement in scar appearance by three months. Most people need multiple sessions spaced four to six weeks apart.
For deep, narrow “ice pick” scars, a technique called TCA CROSS can be effective. A dermatologist applies a high-concentration acid (70% to 100%) directly into individual scars using a fine applicator. This triggers a controlled inflammatory response that stimulates new collagen at the base of each scar, gradually raising the depression to meet the surrounding skin. Multiple sessions are usually needed, spaced six to eight weeks apart.
Fractional CO2 laser is another option for textured and indented scars. It vaporizes tiny columns of scar tissue, which triggers the skin to rebuild with smoother, more normal collagen. This laser is particularly effective at refining texture, reducing thickness, and improving the pliability of scar tissue. Recovery involves several days of redness and peeling, and multiple sessions may be needed.
What Doesn’t Work as Well as You’d Think
Vitamin E is one of the most popular home remedies for scars, but the evidence doesn’t support it. A review of clinical studies found that only three out of six trials showed any improvement in scar appearance with topical vitamin E, and two of those used it combined with other treatments rather than on its own. As a standalone treatment, the results were inconsistent. Even more concerning, two studies reported side effects including contact dermatitis, itching, and rash. You’re better off spending that effort on silicone or massage.
Cocoa butter and coconut oil are similarly popular but lack strong clinical evidence for scar reduction. They moisturize the skin, which isn’t a bad thing, but they don’t provide the same occlusive, collagen-regulating effect that silicone does. If you enjoy using them as part of your massage routine, they won’t hurt, but don’t rely on them as your primary strategy.
Timing Matters More Than You Think
The window for influencing how a scar develops is widest in the first few months after injury. Starting silicone and massage early, once the wound is fully closed, gives you the best chance of preventing a scar from becoming thick or prominent in the first place. Prevention is significantly easier than correction.
That said, older scars can still be improved. Laser treatments, microneedling, and chemical techniques all work on mature scars, though you may need more sessions compared to treating a newer scar. If you have a scar that’s been stable for years and still bothers you, it’s worth exploring professional options. Most people see meaningful improvement even on scars that are a decade or more old.