Self-harm scars can fade significantly with the right combination of time, at-home care, and professional treatments. No method erases scars completely, but most options can reduce their visibility enough that they blend more naturally with surrounding skin. The best approach depends on your scar type: whether scars are raised, flat, indented, red, or white.
Before pursuing any revision treatment, scars need to be fully mature. After a wound heals, the underlying tissue continues remodeling for 9 to 12 months. During that window, scars often change color, flatten, and soften on their own. Most dermatologists and plastic surgeons won’t perform revision procedures until that remodeling period is complete, because treating an actively changing scar can produce unpredictable results.
At-Home Options That Actually Help
Silicone products are considered the first-line treatment for raised (hypertrophic) scars. They come in two forms: adhesive sheets you place over the scar, and fluid gels you apply like a lotion. Both work by creating a moisture barrier that helps soften and flatten raised tissue over time. Silicone sheets have been used for scar treatment since the early 1980s, and they remain one of the most well-supported options available without a prescription.
Sheets can be tricky to keep in place, especially over joints or areas where you sweat, and prolonged wear sometimes causes skin irritation or odor underneath. Fluid silicone gels avoid most of these issues since they dry into a thin, invisible layer. Either way, consistent daily use over several months is necessary to see meaningful results. If your scars are flat and white rather than raised, silicone products are less likely to make a noticeable difference.
Sun protection is one of the simplest things you can do. Scar tissue is more vulnerable to UV damage than normal skin. Sun exposure triggers excess melanin production in healing or scarred skin, which can leave dark spots that persist for years. This is especially common in darker skin tones. Use a broad-spectrum sunscreen with at least SPF 30 on any exposed scars. Keeping scars covered with clothing works just as well.
Laser Treatments for Color and Texture
For scars that are still pink or red, pulsed dye laser (PDL) and intense pulsed light (IPL) treatments target the blood vessels causing that discoloration. These are quick, in-office procedures with limited downtime. You can expect temporary redness for several hours afterward. Multiple sessions are typically needed, and the exact number depends on how inflamed the scars are and your skin tone.
For scars with uneven texture, fractional lasers work by creating microscopic columns of damage in the scar tissue, prompting your skin to rebuild with new collagen. This gradually smooths the surface over a series of treatments. Fractional lasers tend to require more recovery time than PDL or IPL, with redness and peeling lasting several days after each session.
Microneedling for Scar Remodeling
Microneedling uses a device covered in thin needles to create tiny punctures in the top layer of skin. This controlled damage triggers your body’s healing response, stimulating production of collagen and elastin, the proteins that keep skin firm and smooth. Over multiple sessions, this process can improve the texture of both raised and indented scars.
Needle lengths range from 0.5 millimeters to 2 millimeters. Shorter needles treat surface-level irregularities, while longer needles reach deeper tissue and are better suited for more pronounced scarring. Sessions are spaced 3 to 8 weeks apart, and most people need a series of treatments before results become noticeable. Professional microneedling in a clinical setting is significantly more effective than at-home dermarollers, which use shorter needles and produce less collagen stimulation.
Chemical Peels for Surface Scars
Chemical peels remove the outer layers of skin in a controlled way, encouraging new skin growth underneath. For indented or shallow scars, a technique called the CROSS method uses high-concentration trichloroacetic acid (TCA) applied directly to individual scars rather than the entire skin surface. In one study of 65 patients, 94% of those treated with 100% TCA using this method achieved 50 to 70 percent improvement. Patients who completed 5 to 6 sessions saw improvement greater than 70 percent.
Medium-depth peels applied broadly across the skin tend to produce less predictable results for scarring, with one study showing only 1 out of 15 patients achieving significant improvement. The precision of the CROSS method, targeting individual scars, is what makes it more effective for this purpose.
Surgical Scar Revision
For deeper scars, surgical excision may be an option. A plastic surgeon removes the old scar tissue and closes the wound with fine sutures, replacing a wide or irregular scar with a thinner, less noticeable line. The new scar still needs time to mature, so the full result takes months to appear.
Indented or concave scars can be treated with dermal fillers, which are injected beneath the scar to raise the surface level to match surrounding skin. Results are temporary, lasting anywhere from three months to several years depending on the filler used. Treatment needs to be repeated to maintain the effect.
In cases where scarring covers a larger area, tissue expansion is sometimes used. A small balloon is placed under healthy skin near the scarred area and gradually inflated over weeks, stretching the surrounding skin. Once enough new skin has grown, the scar tissue is removed and the stretched skin is repositioned to cover the area.
Scar Camouflage Tattooing
Paramedical tattooing is a specialized form of cosmetic tattooing where skin-toned pigments are implanted into scar tissue to match the surrounding skin color. Unlike traditional tattoos, this technique uses extremely gentle application and custom-blended pigments. There is no universal “skin tone” ink. Each client’s pigment is mixed individually to match their specific coloring.
The process typically involves around 3 sessions and costs between $1,200 and $4,600 depending on the size of the area, scar texture, and color matching complexity. Camouflage tattooing works best on mature, stable scars that are relatively flat and lighter than surrounding skin. It is less effective on scars that are still red, raised, or actively changing.
What Insurance Covers
Most scar revision procedures are classified as cosmetic, which means insurance typically does not cover them. Medicare, for example, usually only covers procedures tied to accidental injury or restoring function to a malformed body part. Private insurance policies vary, but the same general rule applies: treatments aimed at changing appearance rather than treating a medical condition are your out-of-pocket responsibility.
Some exceptions exist. If scarring restricts movement (for example, tight scar tissue over a joint), the revision may be considered medically necessary. Steroid injections for raised scars that cause itching or pain may also qualify. It’s worth checking with your insurance provider before assuming a procedure won’t be covered, since the distinction between cosmetic and functional can sometimes be argued on your behalf by a referring physician.
Choosing the Right Approach
The best treatment depends on what your scars look like now. Raised, thick scars respond well to silicone products, steroid injections, or surgical excision. Flat, white scars are better candidates for camouflage tattooing, microneedling, or laser resurfacing. Red or pink scars benefit most from pulsed dye laser or IPL treatments. Indented scars can be improved with fillers, microneedling, or the CROSS chemical peel technique.
Most people end up using a combination of treatments rather than relying on a single approach. A dermatologist or plastic surgeon can assess your scars and build a plan based on their depth, color, texture, and location. Starting with less invasive options like silicone and sun protection, then moving to professional treatments if needed, is a reasonable path for most people.