How Scars Work

a three inch long incision with 8 stitches in it.
Scars often leave visible marks, but there are ways to treat them and lessen their appearance. See more pictures of skin problems.
© Walters

In scary movies, scars often clue us in to who the bad guys are: Characters like Freddy Krueger of "Nightmare on Elm Street" wear them like a badge of evil. The truth, however, is that scars are simply thick patches of skin that form over healing wounds, and anyone can get them -- even the good guys. In fact, it's rare to meet an adult who doesn't have a scar somewhere.

Scars are usually pinker in color and shinier than the surrounding skin, and they form a permanent protection after burns, sores, cuts and scrapes, almost like a natural bandage. As the body heals from an injury, it uses collagen as a framework to repair damaged tissue. This is an important and necessary step for healing -- think of it as a scaffolding that lets builders repair a wall. But collagen has a different color and texture than the surrounding skin. As a result, there's often a visible mark left after the injury heals. After severe injuries that involve missing tissue, scars can be pitted or craggy.


There are many different types of scars. Keloid scars, for example, extend beyond the original wound site, while contracture, or burn, scars, tighten the skin and limit your range of motion. And acne scars are a category unto themselves. Because there are so many kinds of scars and ways in which they can develop, it's almost impossible to go through life without acquiring at least a few [source: MedicineNet].

The good news -- especially if you have a lot of scarring -- is that dermatologists offer a number of different options, including creams and outpatient treatments, to get rid of these blemishes. Only in rare cases, in which the scarring is very deep, do doctors typically recommend surgery [source: American Academy of Dermatology]. If you don't want to visit the doctor's office just yet, there are some home remedies that you can safely try, too.

Read on to learn more about some of the treatment options for scars.


Scar Treatments

The simplest treatments for raised scars involve topical prescriptions, such as silicone-containing gels and creams. When used regularly, they can help reduce the thickness of raised scars. Another way to decrease raised scars is by cortisone injection, which doctors can administer during an office visit [source: American Academy of Dermatology].

For indented soft scars, you can get an injection of some soft tissue filler, such as collagen, hyaluronic acid or fat to smooth out its appearance. Although the results are immediate, you have to redo soft tissue filler treatments periodically to maintain an even complexion [source: American Academy of Dermatology: Tissue].


Dermabrasion is essentially the "sanding" of skin to remove layers and make it more even. Although it doesn't remove scars completely, this treatment can be very effective in reducing their appearance [source: American Academy of Dermatology:Dermabrasion]. The results of chemical peels, a procedure in which doctors use chemicals to strip away the top layers of your skin, are similar to those of dermabrasion [source: American Academy of Dermatology: Peels]. In both cases, treatments must be repeated every so often because, while they are effective, neither is permanent.

Depending on the severity of your scarring, a dermatologist might recommend laser scar revision, which works by directing high-energy light at the skin to reduce redness or flatten raised scars. Another form of laser scar revision, known as laser surfacing, targets indented (atrophic) scars to smooth out the skin. Punch grafts -- in which a scar is removed via a method similar to a hole-puncher and then skin is grafted onto the new wound -- is another method. For serious large, deep or irregular scars, you might consider surgery. But keep in mind that surgery cannot completely remove scars or scar tissue, though it can reduce their size and appearance [source: American Academy of Dermatology].

In addition to these professional treatments, there are a lot of home remedies that might reduce the appearance of scars. To find out which ones are most effective, read on.


Home Remedies for Scars

Among the many home remedies for reducing scars, aloe vera is probably one of the most popular. Because aloe vera has moisturizing properties, proponents theorize that it increases the elasticity of scar tissue and helps to reduce inflammation. Studies have actually shown that applying aloe vera gel to scar tissue can reduce the size and appearance of scars [source: Mayo Clinic].

Other popular home remedies include vitamin E and cocoa butter. Both of these substances theoretically work for the same reasons that aloe vera does, although there is no consistent evidence to suggest that either of these methods is truly effective. However, because they are topical and natural, unless you have an allergy to one of them, there is no harm in trying [source: Cleft Palate Foundation].


Another home treatment some people try is tea tree oil. Although there is little evidence to support the claim that tea tree oil reduces or repairs scars, it can actually help to prevent acne scarring. Tea tree oil kills bacteria, which is a common cause of acne flare-ups. You can often find tea tree oil in gels and creams that are used for treating acne [source: WebMD].

These remedies are popular for treating acne scarring at home, because people believe them to be less abrasive than chemical treatments. But not all acne scarring is the same. Read on to find out more about acne scars and how to treat them.


Acne Scars

Almost 80 percent of people between the ages of 11 and 30 have acne, which puts this skin condition among the most common causes of scarring [source: American Academy of Dermatology: Acne]. Acne scars are essentially one of two types: raised scars that are caused by increased tissue formation, and depressed or pitted scars that are caused by a loss of tissue.

Scars caused by increased tissue formation are either keloid or hypertrophic. Keloids are large, raised scars. They tend to be hereditary and are particularly prevalent in Africans and people of African descent. Like keloids, hypertrophic scars are large and raised. Both types are produced by an excessive amount of collagen, which is what gives them their raised, shiny look [source: American Academy of Dermatology: Scarring].


Some scars are caused by a loss of tissue. One type is an ice-pick scar, which is a depression with jagged edges. If an ice-pick scar gets larger, experts might categorize it as a depressed fibrotic scar. Both types are usually hard to the touch, although the ice-pick variety may be softer early on. Atrophic macules are acne scars that have a wrinkled, bluish appearance. Another kind of scar is a follicular macular atrophy, which is a lesion that looks like a small white-head pimple [source: American Academy of Dermatology: Scarring].

The good news for people with acne scars is that in most cases, scarring can be significantly reduced [source: American Academy of Dermatology: Acne]. For keloid and hypertrophic scars, many of the same treatments -- cortisone injections, surgery and laser scar revisions -- are applicable [source: Keloid]. Doctors may use a combination of dermabrasion and punch grafts to treat pitted scars, such as ice-pick scars, while dermabrasion and chemical peels might work to smooth out skin for people who have other tissue-loss scars [source: American Academy of Dermatology: Acne].

Once you decide you want to do something about your scars, contact a dermatologist for treatment options. For more information on caring for your skin, follow the links on the next page.


Lots More Information

Related HowStuffWorks Articles

  • American Academy of Dermatology. "Acne Scarring." AcneNet. (Accessed 8/18/09)
  • American Academy of Dermatology. "Acne Scars: Types and Treatments." AgingSkinNet. (Accessed 8/19/09)
  • American Academy of Dermatology. "Chemical Peeling." AgingSkinNet. (Accessed 8/19/09)
  • American Academy of Dermatology. "Dermabrasion." AgingSkinNet. (Accessed 8/18/09)
  • American Academy of Dermatology. "Soft-Tissue Fillers." (Accessed 8/19/09)
  • American Academy of Dermatology. "What Is a Scar?" (Accessed 8/19/09)
  • Cleft Palate Foundation. "Answers to Common Questions about Scars." (Accessed 8/19/09)
  • Guynup, Sharon. "Scarification: Ancient Body Art Leaving New Marks." National Geographic. July 28, 2004. (Accessed 8/19/09)
  • Mayo Clinic. "Aloe Vera." (Accessed 8/19/09)
  • MedicineNet.Com. "Scars." (Accessed 8/18/09)
  • Reese, Vail. M.D. "Expert Column: Dermatology in the Cinema: Teaching Through Movies." Medscape Dermatology. 2002;3(1). (Accessed 8/19/09)
  • WebMD. "Acne Vulgaris - Home Treatment." (Accessed 8/18/09)
  • WebMD. "Keloid." (Accessed 8/18/09)