Scar treatment: Best ways to heal, lighten or make them vanish altogether

Fifty-six billion dollars.

That’s what the global scar treatment market is expected to grow to by 2030 (up from $25 billion in 2022), according to Precedence Research.

A chunk of that is parked on the overcrowded shelf of over-the-counter lotions, ointments, creams and oils, all of which claim to make scars heal, lighten or vanish altogether, despite threadbare evidence to back up such lofty claims.

Experts suggest the nature of a scar determines the best course of treatment, which is why it’s important to work with qualified healthcare professionals to arrive at a plan. Medical history, skin type and the potential risks and benefits of every available treatment must all be considered.

Why do scars form?

“Scars are typically the result of the body's natural healing process after an external injury, surgery or skin conditions such as acne or chickenpox,” explains Dr Jaishree Sharad, celebrity cosmetic dermatologist and author of The Skincare Answer Book. “The body produces collagen fibres when we suffer from skin trauma such as burns, cuts or any other damage. These fibres form scars over the injured area as the skin repairs itself.

“Severe scars can be painful or even limit movement due to damaged tissue and might require extensive medical treatment to prevent complications and infections.”

Depending on the physiological appearance, dermatologists classify scars as atrophic, hypertrophic or keloidal. Dr Vimi Ponnamparambath, a specialist in dermatology and cosmetology at Aster Beauty Clinic in Dubai, says: “Atrophic scars mostly merge with your skin surface or are depressed below the skin surface. Scars that are above the skin surface are hypertrophic and keloidal scars are hypertrophic in appearance, but with the tendency to grow to the surrounding areas instead of staying contained to the site of the wound or infection.”

Home remedies for scars

As for the army of lotions and potions readily available in pharmacies made for use at home, Dr Ponnamparambath flatly says “they don’t work”.

“There is also no scientific evidence that home remedies such as honey, aloe vera or apple cider vinegar work on scars. Your skin might get better, which might make you think your scars are getting better. But apart from silicone gels and sheets, no other topical treatment available over the counter works. That’s the science.”

Sharad is more charitable. “They might reduce the appearance marginally, but cannot completely eliminate or make them vanish.”

Dr Kiran Sethi, medical director at Isya Aesthetics, adds: “Only if the scars are marks, and very light marks at that, but even marks often need prescription-strength creams.”

Sharad offers a checklist for at-home scar treatments: “Know your ingredients; look out for silicone, allantoin, allium cepa extract, heparin sodium and vitamin E in your products – they can aid in minimising thickened scars.

“Do your research, by looking up proof and results of clinical testing, reading contraindications, and following instructions carefully to avoid side effects.

“Finally, be realistic. The effectiveness of products will depend on the size, severity and location of the scar, as well as the individual's skin type,” Sharad says.

Expert-recommended scar treatments

All three doctors agree that, ultimately, scar treatment boils down to stimulating, regulating or rebalancing collagen levels, since collagen makes up 70 to 80 per cent of the skin and is responsible for its mechanical and structural integrity.

Here are some popular and effective treatments for scars.

Silicone sheets or gels: Regular application and use over a period of months will help to soften and compress scars by increasing the moisture of the scarred skin and regulating collagen production. This reduces discolouration, bumpiness and redness, and improves overall skin texture.

Laser therapy: It can be used to treat both atrophic and hypertrophic scars by targeting the scar tissue with concentrated light energy. This can help to break up the scar tissue and stimulate the regeneration of healthy skin cells. Pulsed dye lasers and fractionated CO2 laser resurfacing are two of the most popular treatments currently. However, Sethi warns: “Don’t pick a laser treatment if you have significant sun exposure.”

Microneedling: This involves using tiny needles to puncture the skin to trick the brain into producing collagen and, consequently, new skin cells to reduce the appearance of scars and improve overall skin texture.

Platelet-rich plasma therapy: PRP treatment involves processing the patient’s own blood to get a concentrate of platelets, which are them injected in the area of the scar. It helps with the healing process by stimulating collagen and providing the skin with important growth factors to repair wounds, improving the appearance of the scar. PRP is also often used as secondary therapy after the primary treatment in skin grafts and burns.

Dermal fillers: This cosmetic treatment involves injectables to improve the appearance of depressed scars caused by acne or injury by adding volume and smoothness to the skin so scars become less noticeable. Derma fillers might give instant results, but are not permanent and last only for a few months.

Surgery: The most invasive form of scar treatment is surgical scar revision, which entails tissue removal and skin repositioning. Sethi says: “Surgery can sometimes be worse than better because grafting is hard to do perfectly such that it looks natural. Also avoid anything invasive if you have a history of keloids or autoimmune conditions, and always undertake extensive testing before making a decision.”

Dr Ponnamparambath also adds a caveat for keloidal scars: “These are the most difficult to treat. As keloidal scars grow, they tend to compress the nerves and the patient often tends to suffer from intractable pain or itching. So treatment protocol such as lasers or microneedling won’t work. In keloids, there is an excessive growth of collagen, so we need to inject medications with steroids or methotrexate in the tissue to reduce the size of the lesion and the symptoms. Stay away from anyone recommending the same treatment for keloidal scars as hypertrophic or atrophic scars.”

Social media traps and cues

The reason the scar treatment industry is poised to grow is because most of us shudder at the mere mention of scars. New York-based beauty influencer Megha Singh, who shot to fame with her viral Normalizing Insecurities series of social media videos, says: “I made the one on scars because I have acne-prone skin and have struggled with scars in the past.

“All we see in the media is glowing, clear, poreless, ‘flawless’ skin. This has become the beauty standard worldwide for normal women to the point that scars can destroy self-image, particularly younger women, even though acne and acne scars are ridiculously common,” she says.

Perhaps we should take our cues from those who look at the scars on their body as an album of theatrical moments from a life well-lived. Over the years, the body may well paint a mosaic of our most daring and dodgy life decisions in the form of cloudy scar tissue peppered across its canvas.

The inch-long gnarly scar on the knee from a boating accident during a nervous date. The lifelong grin on the belly from the complicated C-section that brought a breech baby into the world. The faint scar tissue on the forehead from crashing into a glass table while playing catch indoors.

If Keanu Reeves, Kylie Jenner, Jason Momoa and Princess Eugenie all have stories to tell about accidents, childhood capers, bar brawls and life-saving surgeries behind their scars, why can’t you?

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