How to Get Rid of Scars for Good
Time may heal all wounds, but it's not so good at erasing them. Scars occur when an injury slices through the top layer of skin and penetrates the dermis, says Neal Schultz, M.D., a dermatologist in New York City. What happens next depends on your body's collagen response. If it generates just the right amount of this skin-repairing protein, you'll be left with a flat, faint scar. If your body *can't* drum up enough collagen, you'll wind up with a sunken scar. FYI: It's never too early to start protecting the collagen in your skin. You can even fill up on the protein via collagen powders.
But if your body churns out too much collagen? You're stuck with a raised scar. That's not to say you'll develop the same type of scar every time you're injured, "but people tend to be predisposed to scarring a certain way," says Diane Madfes, M.D., an assistant clinical professor in the department of dermatology at Mount Sinai Medical Center in New York City. In other words, if you have one raised scar, you're more likely to have another in the future.
Injury location factors in as well. Scars on the chest and neck tend to be especially obvious because the skin there is so thin, and skin trauma below the waist can scar badly because cell turnover is slower and there is less blood flow to the lower body.
As for your still-burning question of how to get rid of scars if you're sick of them? Fortunately, no matter what kind of scar you have, there are new and effective ways to get rid of scars and prevent being left with a permanent mark.
How to Get Rid of Most Scars
When the initial insult happens, the most important step (after cleansing, of course) is to keep the skin well-lubricated, says Mona Gohara, M.D., an associate clinical professor of dermatology at the Yale School of Medicine. A moist environment promotes growth needed for the repair process. Contrary to popular belief, scabs delay the healing process, she says.
Oil-based lubricants work, too—and no need to glop on topical antibiotics either. According to research, there is no difference in the infection rate between wounds treated with Vaseline and wounds treated with over-the-counter antibacterial cream, says Dr. Gohara. "If there are stitches in or if the skin is open: lube, lube, lube."
To get rid of scars, try to minimize strain, too, she notes. Especially in the case of sutures, less strain means less scarring. Take your back for example: When doctors remove skin cancers there, they recommend patients keep their arms down as much as possible so that the back muscles are not in motion. "When the muscles move, the scar can stretch and widen (a term called "fish mouthing")," she says. "Daily activities like reaching into the cupboard, driving, and brushing your teeth produce enough tension, so any additional activity should be minimized. It's important to identify points of strain and avoid them as much as possible."
And while scars can heal to a tone lighter, darker, or redder than the skin, there isn't *much* you can do in the case of hypopigmentation (lightening). To avoid hyperpigmentation (darkening), apply a good physical broad-spectrum SPF 30 or higher daily, and reapply it every two hours, she suggests. (It's also worth noting that sunscreen may not *always* be enough to protect your skin from the sun.) Fading creams with hydroquinone, vitamin C, kojic acid, retinol, soy, licorice root, and berry extract can also fade down darkened marks, she says.
Otherwise, how to get rid of a scar might depend on what kind of a scar you're looking to get rid of in the first place. Here, four common kinds of scars, plus the best ways to (hopefully) clear up each.
How to Get Rid of Sunken (Atrophic) Scars
Atrophic scars occur when you lose skin tissue and your body can't regenerate it, so you're left with a depression. They often stem from a bad case of acne or chicken pox-or from having an abnormal mole removed. Getting rid of these scars depends on the type of atrophic mark you have.
Ice pick scars: They are small, deep, and narrow, and are typically treated by cutting them out. "There are vertical bands of scar tissue anchored to the bottom of the scar, connecting it to deeper parts of the skin," says Dennis Gross, M.D., a dermatologist in New York City. Your doctor will numb the area, cut around and remove the scar, and close the incision with a single stitch. But here's the catch: This procedure will leave a scar. "You're trading an ice pick scar for a nice flat scar," says Dr. Gross.
You can also inject the scar with a filler, such as Juvéderm or Belotero Balance. "This will help fill the 'pit,'" says plastic surgeon Sachin M. Shridharani, M.D., founder of Luxurgery in New York City. "But the filler will last for only six to 12 months."
Boxcar scars: They have steep, defined borders and a flat bottom. One way to get rid of the scar is subcision, which involves popping the scarred skin back up with a needle so the area is no longer depressed. You could have some bruising for about a week.
Another option: ablative lasers (meaning that they cause damage to the surface of skin) called CO2 or erbium, "which can give you great results," says Dr. Gross. They both work by making holes in the scar tissue to induce new collagen formation. Most people need three treatments. Lasers can hurt, but a numbing cream takes the edge off. "And you'll have some redness and crusting for up to 10 days if you had a CO2 treatment or up to seven in the case of erbium," says Dr. Madfes.
Rolling scars: The last atrophic scar, a rolling scar, is broad and craterlike with rolling edges. "CO2 or erbium lasers are often used when the scarring is severe, but if scarring is more superficial, Fraxel or picosecond lasers can be effective," says Dr. Shridharani. These nonablative lasers get rid of scars by tightening skin and stimulating collagen growth. Since they don't perforate the skin, you'll just have some temporary redness.
How to Get Rid of Keloid Scars
Keloids are not only raised but also take up extra real estate that's often significantly wider and longer than the original wound. Keloids can be tough scars to get rid of, so sometimes people throw everything at them," says Dr. Schultz. "It can't hurt to try a topical scar cream," says Dr. Gross. Once a day, massage a thin layer over the scar (try Mederma Scar Cream Plus SPF30: Buy It, $10, amazon.com). In eight weeks you may see some improvement.
Silicone sheets and lasers can be effective too, says Dr. Gross, but cortisone shots tend to work better. You can also inject keloids with both cortisone and 5-fluorouracil (5-FU), a cancer drug that prevents the proliferation of cells called fibroblasts, which produce collagen, says Dr. Madfes.
Last option for getting rid of the scars: Cut them out. Since you're usually removing such a big area, you will be left with another, hopefully, smaller, scar.
How to Get Rid of Raised (Hypertrophic) Scars
Raised scars are hypertrophic scars. Your body should switch off collagen production once an injury heals, but sometimes it doesn't get the memo and keeps pumping out collagen until you're left with a raised mark. The good news is that hypertrophic scars know their boundaries—they don't extend beyond the original footprint of the wound. They can either be pink (meaning the scar is fresher and newer) or match your skin color.
OTC silicone patches like ScarAway Silicone Scar Sheets ($22, walgreens.com) can help flatten the scar "by applying pressure to the area and infusing it with hydration," says Dr. Schultz. To get rid of the scar, you'll need to leave the adhesive sheet on the scar overnight, every night, for about three months.
You can also have your derm inject cortisone directly into the scar. "Cortisone seems to slow down collagen production and melt away excess collagen," says Dr. Schultz. CO2 and erbium lasers can be handy as well because although they increase collagen, they also remodel it, which decreases puffiness. "It's like rebooting a computer-it starts proper healing," says Dr. Schultz.
How to Get Rid of Acne Scars
Pimples are annoying enough when they happen. But then to suffer from the gift that keeps on giving in the form of a scar? No thank you. Thankfully there are ways to get rid of acne scars, too. Bellafill is a dermal filler approved for the correction of moderate to severe, atrophic, distensible facial acne scars on the cheek in patients over the age of 21, says Dr. Gohara. "It can be used alone or in combination with lasers such as the Fraxel which help to resurface the skin."
Microneedling—tiny little needles make small punctures in the skin so that collagen can form and even out the complexion—is another plausible option for getting rid of acne scars, she says.
Want to keep it simple? Microdermabrasion or even topical retinol products (here are the best ones for every skin type) can minimize divots and depressions from previous blemishes, notes Dr. Gohara. (Related: These 7 Products Will Fade Your Acne Scars in Record Time)