Most scars fade significantly on their own, but the process takes up to a year and the final result depends heavily on what you do during that time. The single most effective at-home approach is keeping the scar hydrated and protected from the sun, while professional treatments like laser therapy and injectable fillers can take things further for stubborn or severe scars. What works best depends on whether your scar is raised, sunken, or flat but discolored.
How Scars Form and Mature
Understanding the timeline helps you pick the right treatment at the right time. After an injury or surgery, your body moves through three overlapping healing phases. Inflammation lasts from a few days up to two weeks, during which the wound is red, warm, and swollen. Then the proliferative phase kicks in around day three and continues for about 30 days, as new tissue fills the wound. Finally, the remodeling phase begins around week four and stretches to nine or twelve months, during which collagen fibers reorganize and the scar gradually softens, flattens, and lightens.
This means a scar that looks angry at two months may look dramatically better at ten months with no treatment at all. But several interventions can speed this process, improve the final appearance, or rescue scars that have healed poorly.
Silicone Sheets and Gels
Silicone is the most studied at-home scar treatment, and it works through a surprisingly simple mechanism. After a wound closes, the new outer skin layer is immature and lets moisture escape at abnormally high rates. Your body interprets that dehydration as a signal to produce more collagen, which rushes to the site and creates the thick, raised, discolored tissue you see in a bad scar. Silicone sheets mimic the barrier function of healthy skin, normalizing moisture levels and dialing down that excess collagen production.
You can find silicone in two forms: adhesive sheets you cut to size and wear over the scar, or a gel you apply like a thin lotion. Both work by the same occlusion principle. Sheets tend to be more effective for larger, linear scars because they maintain consistent contact, while gels are easier to use on the face or on joints where a sheet won’t stay put. For best results, start using silicone as soon as the wound is fully closed (no scabs or open areas) and wear it for at least 12 hours a day over several months.
Sun Protection Matters More Than You Think
New scar tissue is far more vulnerable to UV damage than surrounding skin. Sun exposure triggers pigment production in healing skin, which can leave a scar permanently darker than the tissue around it. This is especially true for people with medium to dark skin tones, where post-inflammatory hyperpigmentation is already a common concern.
Use a broad-spectrum sunscreen that covers both UVA and UVB, with an SPF of at least 30, every day the scar is exposed. Tinted sunscreens offer an added benefit: they block visible light, which also contributes to pigment changes and collagen breakdown. If your scar is on your body rather than your face, covering it with clothing is the simplest and most reliable option. This isn’t a short-term precaution. Protect the scar from the sun for the full remodeling period, roughly a year.
Scar Massage
Massaging a scar sounds too simple to be effective, but applying mechanical pressure during the remodeling phase directly influences how collagen fibers reorganize. The goal isn’t just to soften the tissue mechanically. The pressure actually changes cell behavior, encouraging fibers to lay down in a more organized, flatter pattern rather than the tangled bundles that make scars stiff and raised.
Research on burn scars has found improvements in pain, itching, and scar texture with sessions of about 30 minutes, two to three times per week, continued for 8 to 12 weeks. For a small surgical or injury scar, you can work in shorter sessions, spending about a minute per area of the scar, repeating three to five times in a sitting. Use firm but comfortable pressure and move in multiple directions: circles, lengthwise along the scar, and perpendicular across it. Too much force can cause micro-injuries and trigger new inflammation, so if the area becomes red or sore afterward, ease up.
Onion Extract Products
Onion extract gels are widely marketed for scar treatment, and they do have some evidence behind them, though it’s more modest than the packaging suggests. In a controlled study on surgical scars, the onion extract side showed statistically lower scar height compared to the untreated side by 12 weeks, with over half of patients seeing reduced elevation. However, scar redness and overall cosmetic appearance did not improve compared to the control. If you’re choosing between onion extract and silicone, silicone has a stronger evidence base. Some people use both, applying onion extract gel under a silicone sheet.
Professional Treatments for Stubborn Scars
Laser Resurfacing
Fractional lasers create thousands of microscopic channels in scar tissue, triggering your body to replace disorganized collagen with new, more normally structured skin. The “fractional” part means only a fraction of the surface is treated at a time, leaving surrounding tissue intact to speed healing. For raised (hypertrophic) scars, studies have found improvement rates around 50 to 55%, while sunken (atrophic) scars see more variable results depending on timing.
Timing turns out to be critical. Atrophic scars treated within six months of the original injury improved by about 35% on average, compared to just 12.5% when treatment started later. Many patients in these studies achieved significant improvement with just a single session, though your dermatologist may recommend up to six depending on the scar’s severity and depth.
Microneedling
Microneedling uses a device studded with fine needles to puncture the scar at controlled depths, stimulating collagen production in the process. For acne and other depressed scars, needles of 1.5 to 2 mm are typically used, reaching deep enough to break up the bundled scar collagen in the dermis. Shallower needles of 0.5 to 1 mm work for surface-level texture issues and fine lines but won’t reach deep scar tissue.
Professional microneedling devices allow the practitioner to adjust needle depth from 0.5 to 3.5 mm depending on the area being treated. Thinner skin around the eyes and mouth requires shorter needles, while thicker cheek skin can tolerate deeper penetration. One caution: over bony prominences like the jawline or forehead, excessive pressure with longer needles can create a “tram track” pattern of linear marks. A skilled practitioner adjusts pressure and needle length across different facial zones to avoid this.
Chemical Peels for Scars
For depressed acne scars, a technique called CROSS applies high-concentration acid directly into individual scars rather than across the whole face. This causes controlled damage at the base of the scar, prompting new collagen to fill it in from below. The procedure is typically repeated every few weeks over several sessions. Full-surface peels at lower concentrations can also improve overall skin texture and blend scar edges into surrounding skin, but they’re less targeted than the CROSS approach for deep individual scars.
Fillers for Sunken Scars
When a scar sits below the surface of surrounding skin, injectable fillers can physically lift it to the same level. Hyaluronic acid fillers are the most common choice, and they last significantly longer in scars than they do when used for cosmetic volume. A clinical trial found that filler injected into rolling atrophic facial scars maintained its improvement for the full two-year study period with no significant decline after the four-month mark. Because the scar tissue isn’t being repeatedly stretched or broken down the way filler in, say, lip tissue would be, the results tend to be unusually durable.
Raised Scars and Keloids
Hypertrophic scars (raised but confined to the wound’s borders) and keloids (raised and spreading beyond the wound) require a different approach than flat or sunken scars. The core problem is excess collagen, so treatments focus on breaking that tissue down or preventing its production.
Corticosteroid injections are the standard first-line treatment. A series of injections spaced every three to eight weeks can produce 50 to 100% regression of the raised tissue. In one long-term study following patients for ten years, 71% of keloids achieved full flattening and the remaining 29% achieved partial flattening with a course of four injections. The median number of injections needed is two, with a range of one to five depending on the keloid’s size and response.
The catch is recurrence. About one-third of keloids return within a year of treatment, and roughly half recur within five years. Combining injections with other approaches, like laser therapy or silicone sheeting afterward, can reduce the odds of the scar rebuilding itself. For ear keloids specifically, combining laser treatment with corticosteroid injections achieved a 75% or greater size reduction in most patients within two to five sessions.
What to Start With
If your scar is relatively fresh (under a year old), the most impactful combination is daily silicone sheet or gel use, consistent sun protection, and regular massage. These three cost little, carry no risk, and work with your body’s natural remodeling timeline. If the scar is older and you’re unhappy with how it settled, a dermatologist can assess whether laser, microneedling, fillers, or injections are the right next step based on whether the scar is raised, sunken, or primarily a color issue. Earlier professional intervention tends to produce better results, particularly for atrophic scars, so if home treatments aren’t making a noticeable difference after a few months, there’s good reason not to wait.