The most effective thing you can put on a scar is silicone gel or silicone sheets, which have the strongest clinical evidence for flattening, softening, and reducing redness in scars. But timing, sun protection, and choosing the right product for your scar type all matter. Here’s what actually works, what doesn’t, and when to start.
Why Timing Matters
Scars go through distinct healing phases, and the remodeling phase, where your body reorganizes collagen and the scar gradually fades, lasts from about three weeks to a full year after injury. That entire window is your opportunity to influence how a scar turns out. Starting too early with the wrong product can irritate a wound that hasn’t closed. Starting too late means you’ve missed the period when the scar is most responsive to treatment.
For fresh surgical wounds, simple petroleum jelly or antibiotic ointment can be applied immediately after closure to keep the wound moist. This is the single most important thing during the first one to three weeks. Silicone products can also be started right away on closed wounds. Scar massage, sunscreen, and more active treatments typically begin around two to three weeks after surgery, once the skin has fully sealed over. Well-approximated surgical incisions re-epithelialize within one to two days, so gentle washing can start 48 hours after surgery.
Silicone Gel and Sheets
Silicone is the gold standard for scar treatment, recommended by dermatologists and plastic surgeons worldwide. It works through a surprisingly indirect mechanism: silicone is not absorbed into the skin at all. Instead, it creates an occlusive barrier over the scar that prevents water loss from the skin’s surface. When immature scar tissue loses too much water, sodium concentrations in the surrounding fluid rise, triggering a cascade of inflammatory signals that tell your body to produce excess collagen. That excess collagen is what makes scars raised, thick, and stiff. By trapping moisture, silicone keeps sodium levels stable and dials down that inflammatory signaling, resulting in softer, flatter scars.
Silicone comes in two main forms. Gel sheets are adhesive strips you place directly over the scar for 12 or more hours per day. They work best on flat body areas where they can stay in place. Silicone gel is a liquid that dries into a thin film, making it better for joints, the face, or areas where a sheet would peel off. Both forms are available over the counter. For best results, plan to use silicone consistently for at least two to three months.
Sunscreen on New Scars
UV exposure is one of the fastest ways to permanently darken a scar. New scar tissue lacks the mature protective barrier of normal skin, making it especially vulnerable. When UV light hits inflamed or healing skin, melanocytes (the cells that produce pigment) can go into overdrive, creating dark spots that persist for months or years. This post-inflammatory hyperpigmentation is particularly pronounced in medium to dark skin tones, but it affects all skin types.
Apply SPF 30 or higher to any healing scar whenever it will be exposed to sunlight, starting around three weeks post-injury. If you have fair skin, SPF 50 with strong UVA protection is the better choice. This is one of the simplest and most impactful things you can do for scar appearance, and it’s often overlooked.
Petroleum Jelly: Simple but Effective
Plain petroleum jelly is more effective than many people expect. In clinical studies comparing silicone gel to petroleum jelly (Vaseline) on surgical scars, the outcomes were statistically similar. Both products work through the same basic principle: occlusion. By sealing in moisture, they reduce the inflammatory signals that drive excess collagen production.
Petroleum jelly is inexpensive, widely available, and safe to apply immediately after wound closure. Applied three times daily for the first one to three weeks, it keeps the wound bed moist during the critical early healing phase. For people who don’t want to invest in specialty scar products, petroleum jelly is a solid alternative, especially for minor scars.
What About Vitamin E?
Vitamin E cream is one of the most popular home remedies for scars, but the clinical evidence doesn’t support it. Studies have found no meaningful improvement in scar appearance from topical vitamin E. In some cases, it actually worsened the cosmetic outcome. Nearly a third of patients in one study developed local skin reactions, mostly contact dermatitis. Vitamin E can cause redness, itching, and irritation on already-sensitive scar tissue. Despite its reputation, dermatologists generally discourage its use on scars.
Onion Extract Products
Onion extract gels (sold under brand names like Mederma) are widely marketed for scar treatment. The evidence is mixed. In a controlled trial where patients applied onion extract gel three times daily for 12 weeks on surgical scars, the treated side showed some reduction in scar height compared to the untreated side. However, there were no statistically significant differences in redness, softness, or overall cosmetic appearance. Earlier studies on Caucasian patients were described as “disappointing.” Onion extract may offer a modest benefit for scar thickness, but it’s not a dramatic improvement over simpler options like petroleum jelly or silicone.
Retinoids for Pitted Acne Scars
If your scars are atrophic (indented or pitted, the kind left by acne), the treatment approach is different. Raised scars have too much collagen. Pitted scars have too little. Retinoids, which are vitamin A derivatives available in both prescription and over-the-counter strengths, stimulate your skin’s fibroblasts to produce new collagen, gradually filling in depressed areas.
In a clinical study using a prescription-strength retinoid gel applied daily for 24 weeks, 50% of subjects showed improvement in skin texture and atrophic scarring based on investigator assessment, and over 80% reported improvement themselves. Results aren’t instant. Expect to use a retinoid consistently for at least four to six months before evaluating whether it’s working. Retinoids also make skin more sun-sensitive, so pairing them with daily sunscreen is essential.
Over-the-counter retinol products are weaker than prescription retinoids but can still help with mild textural scarring over time. If your acne scars are deep or widespread, a prescription-strength product will be more effective.
Scar Massage
Once a wound is fully closed (typically around two to three weeks after surgery or injury), gentle massage can help break up collagen bundles and soften the scar. The recommended approach is twice-daily sessions of about 10 minutes each, using firm circular pressure along the scar line. Continue for at least six weeks. You can combine massage with any topical product you’re already applying. Massage is free, has no side effects, and is especially useful for scars that feel tight or restrict movement.
Prescription Options for Stubborn Scars
For hypertrophic (raised) scars or keloids that don’t respond to over-the-counter products, prescription-strength steroid creams or steroid-impregnated tapes can help. These work by suppressing the overactive inflammatory response that causes excessive collagen buildup. Topical steroid creams are typically applied multiple times daily for up to six months. Steroid tapes are worn continuously and changed daily for three to twelve months, making them practical for scars that are actively growing or covering a large area.
For keloids or very thick hypertrophic scars, steroid injections directly into the scar tissue are often the most effective approach. These are given every one to four weeks over several sessions and can dramatically flatten resistant scars.
A Practical Scar Care Routine
For a fresh scar in the first one to three weeks, keep it clean and moist with petroleum jelly or a silicone-based product. After the wound fully closes around two to three weeks, add sunscreen (SPF 30 or higher) before any sun exposure, begin gentle scar massage twice daily, and switch to or continue with silicone gel or sheets. Use these consistently for at least two to three months before judging results.
Scars continue remodeling for up to a year, so patience is genuinely part of the process. A scar that looks angry and red at six weeks may fade significantly by six months with consistent care. The products that work best are the ones you’ll actually use every day, and for most people, that means keeping the routine simple: silicone or petroleum jelly, sunscreen, and massage.