Before looking into scar removal treatments, we believe a good understanding of the skin is required because this can tell us how scars form. With this basic understanding, you’ll understand how the skin works and the basic terminology that’ll be used later in the guide. With this in mind, you will know how to remove scars froms face and body. Better that we teach you the terms now than have you confused later, right?

STRUCTURE OF YOUR SKIN

The 3 layers of skin

Epidermis – Upper Layer

The layer of skin we touch and see on the outside, this is called the epidermis. Otherwise known as the ‘stratum corneum’, the layer contains corneocytes (flat dead cells) and this is effectively a barrier that keeps all deeper layers from dangerous chemicals, infection, mechanical stress, and even dehydration. The epidermis is also home to a number of special cells from the immune system; it therefore protects the body from fungi, viruses, and bacteria.

If you’ve ever wondered what gives the skin its color, this is the epidermis. The epidermis contains melanocyte cells that help to produce melanin (a pigment). Depending on our DNA, as well as our exposure to UV radiation, the levels of melanin will differ from one person to the next. There are also different types of melanin.

Finally, we should also note that the epidermis helps to make new skin cells. Right towards the bottom of the epidermis, the skin cells begin a journey to the top and flake off around a month layer; this is a continual process.

The 3 skin layers

Dermis – Middle Layer

Under the epidermis, we have the dermis which boasts numerous different cells, glands, and connective tissue all with an important job to do.

For example, some blood vessels remove waste and keep the dermal and epidermal cells well nourished. After suffering an injury, the body wants the wound to receive nutrients and immune cells and it does this by dilating the blood vessels. The result of this is inflammation, redness, warmth, and swelling; these are signs that your body is healing correctly.

Additionally, there are hair follicles, sebaceous glands, sweat glands, and nerves within the dermis. If you didn’t know, the root of every single hair on the body leads to a follicle. These then attach to a muscle which can tighten (this is where goose bumps originate). Of course, sweat glands allow the sweat to reach the surface of the skin after passing through tubes. Not only does sweat regulate body temperature, it also removes toxins from the body.

As for sebaceous glands, these keep the skin soft and waterproof. How? By secreting oil (sebum). To make sure we can feel things by touch, nerve endings play an important role within the dermis. There are two main types of nerve; thermoreceptors (for heat) and mechanoreceptors (for touch).

Before moving onto the last layer, the dermis also has a matrix full of elastin fibers and collagen. With this in place, the skin has elasticity and strength.

Hypodermis – Lower Layer

As the third layer of skin, this is known as the hypodermis but can also be called the ‘subcutaneous tissue’. This time, the layer is made up mostly of connective tissue and fat which includes fibrous bands (a special connecting tissue connecting this layer to the bones and muscles). The layer is also connected to the dermis through elastin fibers and collagen.

Importantly, the hypodermis stores fat which may seem frustrating for those who are trying to lose all fat through diet and exercise but is important to essentially act as padding and a reserve of energy. Through insulation, fat held within the bottom layer of skin can also provide thermoregulation.

Furthermore, various nerve cells and blood vessels extend from the dermis to the hypodermis. They’re generally larger in the hypodermis before then expanding and reaching the rest of the body.

Three Layers of Equal Importance

While simple scratch wounds will heal and disappear, those deep enough to tear the dermis will form scars. When this happens, the body springs into action by stopping the blood flow (hemostasis) before then going through a process of inflammation, proliferation, and tissue remodeling. As the tissues go through a rebuilding process, scar tissue forms from collagen fibers. If a scar is discolored or raised, this generally means that too much collagen was produced for the wound (more on this later!).

HOW DOES SKIN HEAL AND SCAR?

how does our skin scar

When the skin is burned, cut, or even after surgery, scars are a natural bodily reaction as it attempts to heal the wound as quickly and efficiently as possible.

While they can be frustrating visually, they’re actually a positive sign that the body is working as it should. Once an injury takes place, there are various steps the body must take and we’ve created a guide to this below!

WOUND HEALING IN FOUR STAGES

As mentioned previously, the wound healing process involves four different stages but they can overlap for maximum efficiency. Known as hemostasis, inflammation, proliferation, and tissue remodeling, the process is highly complex.

  • Stage 1 – First things first, the body will attempt to stop the flow of blood because this is integral for survival. After a small cut on our finger, the blood normally stops on its own and this is hemostasis.

first stage of scar formation

  • Stage 2 – From here, the blood vessels dilate and this allows the wound to receive white blood cells, macrophages, important nutrients, and antibodies. By doing this, the body clears all damaged cells, prevents infection, and starts the process of tissue remodeling. As this stage begins, you’ll start to see inflammation, redness, and heat around the wound.

second phase of scar formation

  • Stage 3 – Although the word ‘proliferation’ generally means a large increase in numbers, it’s used here to describe the rapid production of cells. Starting with the outer edges, the new cells eventually grow in the center of the wound and this forms a brand-new layer of skin.

third stage of scar formation

  • Stage 4 – Once these three stages have been completed, the tissue remodeling or maturation process can begin and this takes the longest (potentially a number of years). The new tissue requires support and this comes from collagen produced by cells called ‘fibroblasts’. Some will call this process ‘scar maturation’.

fourth stage of scar formation

HOW DO SCARS FORM?

Where does the scar form during these four stages? It actually takes place in the last stagebecause the new tissue cannot perform as effectively as the existing epidermis. Not only will the new tissue be less durable, it will lack the elasticity and strength of unwounded skin. The reason scars look different to normal skin comes in the way it forms; while natural skin uses a basket weave pattern, the collagen will cross-link in one direction alone.

  • If a scar is discolored or raised, this can be either due to an abnormal extracellular matrix (ECM) or it means too much collagen was produced during the healing process. Both keloids and hypertrophic have this appearance.
  • On the other hand, atrophic scars are sunken areas of the skin and this is caused by a lack of collagen.

Although scars are inevitable when wounds are deep enough, their appearance will ultimately depend on a number of factors such as collagen production. When too much or too little collagen is produced, this is likely to lead to an abnormal scar. For more detailed information, let’s take a look at the different types of scar one can experience!

THE DIFFERENT TYPES OF SKIN SCARS

the different types of scars

If only our body could heal a wound and leave a tiny scar, right? Unfortunately, this isn’t the case and there are a number of ways your wound could go.

Atrophic (Sunken) Scars – These are commonly caused by pockmarks and acne, and will typically drop deeper than the skin surrounding the area. Using acne as an example, there’s either not enough collagen being produced after the initial wound or there’s a distinct lack of connective tissue under the skin.

example of atrophic scars

Keloid and Hypertrophic (Raised) Scars – At the other end of the scale, we have too much collagen being produced and this leads to a raised, and even discolored, scar. Not all raised scars are the same and they can be further split into two main categories:

  • Hypertrophic – With a red appearance, hypertrophic scars will never expand beyond the original wound site. Often, they cause the owner some discomfort because they can itch and cause some pain. The most common example of hypertrophic scars occur after burns; this being said, hypertrophic scarring is more common in children as well as those with a fair complexion or with rosacea.

example of hypertrophic scars

  • Keloid – Alternatively, keloid scars will go beyond the original wound site and affect the surrounding area. They’re very similar to hypertrophic scars in that they can be red in appearance, they can itch, and they can cause some pain. Common examples of keloid scars can be found in the ears after an ear piercing, the sternum (acne), deltoid (vaccination), and other body parts after cases of chickenpox or even after surgery. This time, it’s those with darker pigmentation that are more likely to experience the scar. Somewhat unfairly, keloid scars will continue to grow and can reduce movement and thicken over time.

example of keloid scars

Stretched Scars – As the third major type of scar, stretched scars occur when the dermis (middle layer of skin) is stretched while it tries to heal. Sometimes known as striae distensae, there are two types of this scar depending on the stage at which the marks appear. During the acute stage of stretch marks, these are called “striae rubrae” and they can be red marks aligned with skin tension. In contrast, they are called “striae albae”, these are more faded, hypopigmented and wrinkled in appearance and show during the chronic stage of stretch marks. Although this may sound a little confusing, don’t panic just yet because the difference in appearance is the most important detail.

example of stretch scars

As we all know, stretch marks are common during pregnancy and it normally occurs during the final trimester. Most women see stretch marks on the abdomen, but they can also appear on the thighs, breasts, lower back, hips, and even buttocks. Ultimately, they occur as a result of the skin stretching quickly in a short period of time. For this reason, they can also occur after a dramatic change in weight, during bodybuilding, and after hormone changes such as puberty.

Contracture scars – The contracture scar is usually what you get if your skin has been burned. It is the result of the tightening of the skin after a 2nd or 3rd degree burn. During the healing process, the skin around the burn pulls together and leads to a contracture. This kind of scars can limit your movement around the injured zone.

example of contracture scars

THE SCAR REMOVAL TECHNIQUES: 9 TREATMENTS

Let’s explore the 9 different scar removal treatments that can be used to help you fade and minimize your scars. Note that they are often used in combination to get the best results.

TECHNIQUE #1: SCAR REMOVAL LASER

scar removal lasers

For those looking for a non-invasive procedure, technology has allowed the laser niche to expand in recent years and it’s particularly useful for surgical scars. How does it work? Well, an intense beam of light will impact the shape, size, and color of the scar.

One of the benefits of laser treatment is that the results can be seen within a short period of time. According to one study, three treatments alone will allow some people to remove raised one-year old scars. If the scar has been in place for more than a year, this can increase to five treatments and beyond.

WHAT IS IT?

Using a laser, the goal is to replace the scarred skin with a new, remodeled patch of skin. Thanks to the investment of numerous scientists and medical companies, the industry is now home to several different kinds of laser treatment and they tend to be effective in different areas.

HOW DOES IT WORK?

In a nutshell, there are 3 main types of skin laser treatments you can use for scar removal :

  • Laser resurfacing, sometimes called “ablative” laser resurfacing
  • Fractionated laser resurfacing
  • Non-ablative laser resurfacing

Ablative Laser Resurfacing

ablative laser resurfacing for scars

In this treatment, a high-powered laser is used to remove the top skin layer of the scar. It also penetrates the middle layers too, leading to a more tightened and smoother skin.

As perhaps the most extensive service of the three, ablative laser resurfacing requires up to two hours, protective goggles, and local anesthetic. However, it can still be done on an outpatient basis.

Returning to the point of anesthetic, you won’t be fully ‘out’ during the treatment but you will be sufficiently sedated for the dermatologist to use the laser (shaped like a small wand). To deal with the damaged skin cells, the wand will pass over the scar several times with each sweep working more efficiently than the last.

Ablative laser resurfacing itself has two different types with each boasting both benefits and drawbacks.

  • CO2 Laser : they are most effective at reaching deeper scars. Therefore, it takes patients up to two weeks to recover and you’ll need a higher tolerance to pain to complete the treatment (don’t take this suggestion lightly!). EX: Fraxel (re:pair ).
  • Erbium YAG laser : for those who don’t want to go through a higher level of discomfort, you may want to choose Erbium YAG lasers since less anesthetic is required and the recovery time is faster. Often, the scar will tell the specialist which laser is required and this second option is better for shallow scars.

For this full laser resurfacing solution, prices can go above $2,500 for just a portion of the face so this is something that needs to be considered. Of course, your medical professional will discuss these finer details with you while suggesting the most efficient solutions for your scar.

Fractionated Laser Resurfacing

Fractionated Laser Resurfacing for scars

Example of this service would be Fraxel re:store laser.

Rather than removing a continuous top layer of skin as with the ablative laser, this fractionated laser treatment penetrates deeply the skin with only tiny beams instead of one larger beam. This creates microscopic holes (where hundreds of old skin cells are removed ) which are surrounded by healthy skin.

In the deep layer of skin, collagen production is encouraged. Thanks to the surrounding healthy skin, the damage caused by laser therapy can be replaced rather quickly with new fresh skin cells.

In order to prevent pain during the process, patients will be given topical anesthetic. This treatment is definitely less invasive and requires little to no recovery time — the downside to this solution is that the level of skin improvement can never compete with full laser resurfacing. Once the treatment has been completed, the minor swelling and redness should fade within days.

In terms of a treatment plan, your specialist is likely to recommend between three and five treatments with each coming at least a week after the other. Note that you will need to be patient and wait a number of months before the full effect makes itself known. While full face treatments can cost up to $1,500, treating specific areas can be more affordable.

Non-Ablative Laser Resurfacing

non ablative laser resurfacing for scars

Ex of lasers:  Laser Genesis

The treatment uses IR infrared lasers to heat the inner skin layers but will leave the top layers untouched. That is why they are called non ablative. Once again, the aim is to promote the production of collagen and create new skin cells in the deeper skin layers that will push and replace the old scarred skin cells.  This means almost no recovery time because we do not touch the surface, we only work on the deeper skin layers. Compared to full laser resurfacing, another benefit comes with the reduced procedure time; most people can be in and out of the doctor’s office within 30 minutes.

On the other hand, patients tend to report a little more pain; this is prevented a little due to a cooling spray that passes over the skin after the laser. Once again, we should note that the results may take some time to show because the healing occurs deep within the skin. Finally, treatment plans generally last somewhere between four and six treatments with each costing up to $600.

WHAT RESULTS WITH PROS AND CONS ?

To finish this section on lasers, we should offer a quick warning to those using acne medications containing Accutane (isotretinoin). If laser resurfacing is used in these cases, healing tends to be poor and can lead to scarring. This is also true for over-the-counter aspirin and other pain-relief products. With the latter, they make the blood thinner which could cause excessive bleeding after the procedure.

On the whole, laser treatment can be a fantastic solution for scar removal because it avoids the invasiveness of surgery. However, not all cases will be suited to it; this is especially true for patients suffering with dermatitis, psoriasis, or cystic acne. Laser treatment also has effectiveness issues with darker skin types.

  • Benefits – Not every scar would suit an invasive procedure, so laser treatment is ideal in these cases. Additionally, it keeps recovery time to a minimum and can offer seriously good results.
  • Drawbacks – As well as the potential drawbacks we’ve already mentioned, laser treatment can also bring some side-effects for patients. This includes making skin both lighter and darker (hypopigmentation and hyperpigmentation respectively). Hyperpigmentation is a common problem in people with darker skin which is why a doctor may avoid recommending this solution. Aside from this, laser resurfacing has also been known to cause new scars and blistering.

TECHNIQUE #2: SCAR REMOVAL SURGERY

scar removal surgery

Unfortunately, in some cases, surgery may be the only option and this is true for the more difficult scars. Don’t worry, you won’t just be thrown into this solution, you’ll visit a surgeon so they can assess the scar and suggest a treatment plan.

WHAT IS IT ?

Before anything else, we should address a common myth that surgery aims to remove all scars permanently. While surgery cannot achieve this, it can replace your current scar with a less visible scar that has thinner stitches. Depending on the severity of the scar and wound, there are four main surgery solutions available that we will discuss below.

HOW DOES IT WORK

There are several techniques that the doctor can use depending on your type of scars, location and severity.

Simple Scar Removal

simple scar removal surgery

As the name suggests, scar removal will cut the affected area of skin before using stitches to leave a thinner scar that’s less noticeable. Sometimes called ‘punch excision’, all excess scar tissue is removed and a layer (multiple, if necessary) of stitches close the wound with the long-term goal of improving the appearance.

If you’re worried about taking too much time from work (although we would all love a long break from the pressure!), you’ll be an outpatient under local anesthesia and most people can return to work within a couple of days. After a few days, the stitches will be removed.

This simple scar removal method is often used for acne scars and for hypertrophic scars / keloid scars.

Subcision

subcision technique for scars

Specializing in sunken scars, subcision surgery is used for breaking down scars that are somewhat tethered within the layer of skin. The doctor will try to loosen the fibers with needles and this should improve the sunken appearance. Rather than the skin being anchored down lower than normal, the skin should return to a normal position. Collagen growth is actually promoted in the healing phase after subcision and this should prevent the area of skin from sinking once more.

subcision with needle for sunken scars

Z-Plasty

z-plasty technique for scars

Finally, there could also be an opportunity to reposition a scar so it blends in better with the natural lines and creases already on the skin; therefore, it won’t be as noticeable.

When contracture causes tension, Z-Plasty can provide relief and this is especially true when the scar is located across creases such as those found on the underside of the hand. With the right surgeon, the scar can be repositioned to fit with the existing ‘lines of relaxation’ so it isn’t quite as noticeable.

scar treatment Z plasty
credits : cosmeticsurgeon.org.nz

How does it work? Just as we’ve seen before, the old scar is removed before incisions create triangular flaps in the skin. Utilizing a ‘Z’ pattern, the flaps can be rearranged and the wound can be covered at a different angle to the one before. Using fine stitches, the wound is then closed (these stitches can be removed within days).

z plasty
credits: slideshare.net

If all goes well, the scar will eventually look less obvious to the naked eye. Normally, you’ll be an outpatient and only local anesthesia will be required.

Skin Grafting

skin grafting for scars

If the scar is serious and there are no other solutions, you’re likely to be recommended a skin graft or flap and this is done in a hospital under general anesthesia. Normally withheld for wide scar zones, healing can take several months and many are required to wear a bandage or some form of support for around a year.

  • Skin grafting: If you’re unaware, ‘grafting’ describes the process of moving skin from one part of the body to another. If successful, the skin ‘takes’ new blood vessels and scar tissue starts to form. With the skin coming from a healthy part of the body, most cases are successful but there’s a small risk of failure where the graft doesn’t take. Also, you should know that some scarring will occur on the donor and recipient sites.
  • Flap surgery: Alternatively, your doctor may recommend flap surgery and this is where more is taken than the skin; namely blood vessels, underlying fat, and even the muscle (in some cases). Each case of flap surgery is different; some will see the blood supply remain attached from one end to the donor site, and others will require microvascular surgery to attach the vessels at the site to vessels in the flap.

When it comes to improving function, both flap surgery and skin grafting are superb solutions. However, the negative comes with appearance and there can be issues with texture and color. Between the two, the better results from a cosmetic point of view can be seen with flap surgery as the color and texture are more similar because we used the skin near the scar area.

As we hinted at previously, these techniques are normally reserved for severe burns and other serious injuries where large patches skin are affected. As the scar pulls the edges of skin together, this is called ‘contracture’ which can be corrected by removing the scarred area and then replacing it with a flap or skin graft.

WHAT IS THE COST?

What’s the cost of scar removal surgery? Ultimately, the answer to this question will depend on the complexity of the scar and the technique required to correct it. While more simple cases can cost around $1,000, this can increase to $4,000 for the more complex scenarios.

WHAT RESULTS WITH PROS AND CONS ?

How about results? If less invasive techniques haven’t been successful so far, the specialist might recommend this level of treatment. If you can find the right surgeon, someone who is both skilled and experienced, surgery can be a fantastic step forward. In the past, we’ve been lucky enough to see how this technique can change lives.

We should note that there are certain warnings that come with surgery, including a 50-80{1e35c1693fa46bfa299623e1cddb4fa765bbcba505a6bf5a8d9ff9d2e14d7ebb} recurrence risk with keloid scars after surgical excision. Unfortunately, keloids are stubborn and they can return bigger than previously seen (we know this can be frustrating!). In these cases, it might be a case of repeat procedures to keep on top of the problem.
  • Benefits – Above all else, the biggest benefit of scar removal surgical treatments is that they can have a fantastic impact on many scars. For both comfort and appearance, this can be a great advantage.
  • Drawbacks – Compared to laser techniques, surgery is very invasive and many cases will require local/general anesthesia. Considering the scars are being physically cut from their location, there’s also a risk of excessive bleeding, infection, new scars, recurring raised scars, and even a reaction to the anesthetic. With skin grafts, a small percentage of people will experience a keloid at the donor site. Finally, this solution will be more expensive and it will require a highly skilled surgeon.

TECHNIQUE #3: MICRO NEEDLING

microneedling treatment

WHAT IS IT ?

As the third scar removal technique, we’re going to be talking about micro needling and we’re back to a treatment that’s only minimally invasive. The aim here is to encourage the body to regenerate cells and activate the healing process, and this is achieved through an small device and a controlled skin injury.

HOW DOES IT WORK?

Using a motorized pen or a simple dermaroller, the skin will be punctured to create what are called ‘micro-wounds’. As these wounds are made, the body should react, produce elastin and collagen, and form new capillaries in the outer layer of skin.

woman having microneedling session

Depending on the task at hand, the needles themselves can be anywhere from 0.25 to 3mm in length and 0.1 to 0.25mm in diameter. As you would expect, all needles are only used once by dermatologists so there’s no danger of contamination from one person to the next. With this in mind, you can be confident that the needle being used for your treatment has only and will only be used for you.

Often, people tend to over-complicate this solution but it’s a simple roller (or another similar device) that creates holes in your skin with small needles. After the holes are made, the production of elastin and collagen are both encouraged and this should help scars and it has even been known to help wrinkles and other fine lines. After the procedure, the specialist is likely to recommend vitamin C serums so they can travel down the tunnels produced by the needles. Of course, this step won’t be compulsory but it should aid the process and help stimulate skin renewal.

Over the years, this particular technique has been used mostly for wrinkles, acne scars, pigmentation and stretch marks. Although treatment will ultimately depend on the size of the treated area, and on the individual, it generally lasts for between 15 and 30 minutes. After the treatment occurs, many see visible changes immediately and results will continue in the coming months. Acne scars tend to be more serious than others, and treatment plans can last for up to eight sessions (with six weeks in between each).

HOW MUCH DOES IT COST?

With each session between $200 and $700, a complete micro needling treatment plan, lasting between six and eight sessions, can cost anywhere between $1,200 and $5,600.

The good news : For those who like DIY solutions, there are great home micro needle sets that you can use to help with your scars. Of course the needles for home use  are not as long as those found with medical devices ( for safety purpose) but they can still do a very good job and may be worth a test. Check this one we like from amazon HERE)

WHAT ABOUT RESULTS WITH PROS AND CONS ?

Thanks to a recent study, we know that micro needling can be incredibly effective. Out of 37 patients, 34 experienced a ‘noticeable reduction’ to their scar. Just as some background to this, all patients had atrophic scars on their face and were treated with a number of micro needling sessions. Therefore, this shows how useful the technique can be when treated with the right scars (the ‘right’ scars are those that aren’t too deep, and this is important to remember). When a scar is too deep, micro needling may not be effective and your doctor may recommend surgery as an alternative.

  • Benefits – As a minimally invasive treatment, micro needling won’t cost as much as lasers or surgery so it’s beneficial for those who want to save some money. Also, as we discovered earlier, laser treatment isn’t suited for those prone to hyperpigmentation so this is a great way to reduce the risk.
  • Drawbacks – If you like to be thorough with your research, the drawbacks come from the potential of complications. If not properly done, micro needling can cause excessive bleeding, bruising, and infection.

TECHNIQUE #4: DERMAL FILLERS FOR SCARS

dermal fillers for scars

WHAT IS IT ?

As the name suggests, fillers are the ideal solution for sunken scars. By injecting fillers in order to raise the sunken skin, the depressed area should soon raise to match the surrounding skin.

HOW DOES IT WORK? 

In truth, this is one of the simpler procedures and your doctor will attempt to add volume to your skin by injecting a filler to sunken areas. We should note straight away that this is NOT a permanent solution. If your doctor has recommended this treatment, it normally means they want to lift the sunken area for long enough to treat it properly. With the skin lifted, the professional can work their magic on a longer-lasting solution.

You must keep in mind 2 main criteria:

  • the filler plumps the skin well enough to correct the scar
  • it lasts long enough for prolonged correction.

With this in mind, the natural question that follows is how long the filler lasts. Ultimately, this will depend on the type of filler chosen since some can last a few months while others aim to keep the skin lifted for up to five years.

WHAT ARE THE AVAILABLE FILLERS ?

  • 6-9 Months – For the shortest period of time, fillers like Restylane and Juvederm will be ideal as these are Hyaluronic acid products.
  • 9-16 Months – With an immediate correction, Radiesse will last for up to 16 months and it’s based around calcium hydroxyapatite.
  • Up to 2 Years – As we reach the longer solutions, we find Sculptra which encourages the production of new collagen for those with acne scarring.
  • Up to 5 Years – There’s only one dermal filler that has been approved by the FDA for acne scars and this is Bellafill. Not only does it have approval, it is the most durable solution lasting for around five years. Combining PMMA particles (polymethylmethacrylate ) and bovine collagen, the aim is to boost the production of collagen; all patients require a skin test because some may be allergic. As the only FDA-approved dermal filler, all other products are considered ‘off-label’ and are mostly used privately for cosmetic work.
  • Up to 10 Years? – We said that Bellafill is the most durable option so is there really something that can last up to a decade? Well, scars can also be filled with fat but this procedure requires a careful diet. If weight is lost, the retention rate will reduce and you won’t see the full benefit. For those who exercise and tend to fluctuate in weight, this won’t be recommended.

Is Bellafill the Best?

Of all the options, Bellafill lasts the longest but let’s dig a little deeper to find the benefits and drawbacks because the decision won’t be straight forward.

  • Benefits – Firstly, it has been approved by the FDA and has been through extensive clinical studies. Furthermore, the permanent microbeads stay once injected which means they won’t be going anywhere.
  • Drawbacks – On the other hand, Bellafill contains bovine collagen which will trigger allergy problems for some individuals. While the ‘permanent’ aspect can be a good thing, it can also cause problems when bad injectors are in control. If done incorrectly, they can’t be dissolved or removed. While the bovine collagen will be gone after 5 years, the PPMA microbeads will still be in your skin, that is why most prefer the hyaluronic acid fillers.

What About Hyaluronic Gel Fillers?

  • Benefits – Compared to Bellafill, hyaluronic gel fillers can be removed and they don’t require a test before treatment begins. Also, depending on the scar, there are a number of different filler densities available.
  • Drawbacks – This solution isn’t permanent so will require further treatment down the line.

Despite popular belief, Bellafill isn’t the ‘magical’ solution in all cases. Where allergies are a problem and in some other cases, the temporary hyaluronic filler option can be the way to go.

HOW MUCH DOES IT COST?

As we’ve seen, there are several fillers available so we can’t necessarily give you one figure that will end all your problems. Also, different treatment plans will have varying numbers of syringes and vials used. Below, we’ve given a basic outline (per vial);

  • Juvederm/Restylane – $570-$650
  • Radiesse – $750-$850
  • Bellafill – $1,000

EXPECTED RESULTS WITH PROS AND CONS

For acne scars and the right patient, fillers can do marvellous work with shallow scars; deeper scars will normally require another solution. As mentioned previously, fillers will rarely be used alone since they work better alongside other treatments.

For example, a common plan would include subcision, fillers, and then laser resurfacing. As the subcision lifts the scar and brings it level with the surrounding area, the empty space beneath this area can be filled to keep it in place. Once this is done, laser resurfacing can make the area smoother and this combination leads to some magnificent results.

  • Pros: very easy to fill up the sunken scars, effective and no downtime
  • Cons: temporary and might require touch ups so can be costly in the long run.

TECHNIQUE #5: STEROID INJECTIONS

steroid injections for scars

WHAT IS IT ?

From a technique that deals with sunken scars to one that works with raised scars, steroid is actually a shortened form of corticosteroid.

What is this? Produced by the body, this is a class of hormones and they contribute to a number of physiologic process such as the regulation of inflammation, stress response, immune response, and more.

With steroid injections, they’re most commonly recommended in cases with hypertrophic or keloid scars. As we saw earlier, these scars are generally raised and discolored.

HOW DOES IT WORK?

With the treatment itself, the idea is to reduce inflammation as well as collagen synthesis during the healing process.

If you remember from earlier in the guide, collagen is needed in the healing process because it provides durability and strength. When too much collagen is produced, the resulting scar is raised and discolored.

With steroid injections, as collagen synthesis is inhibited, the raised area should reduce somewhat. In the majority of cases, the corticosteroid used will be an insoluble triamcinolone acetonide.

In summary, a steroid medication can be injected into the affected hypertrophic and keloid scar to reduce the common side effects including burning, redness, and itching. In a certain percentage of cases, the scar also shrinks.

HOW MUCH DOES IT COST?

Aside from the cost of your visits to the office, you’ll normally pay between $100 and $200 for cortisone injections.

WHAT ABOUT RESULTS WITH PROS AND CONS ?

With all this mind, will steroid injections actually bring positive results? Is it worth your time? On the whole, doctors will tell you that it’s a popular option and the results can be positive. However, you do need to be aware of the variable response rate.

In one journal, Dermatologic Surgery, they published a study which showed response rates varying from 50{1e35c1693fa46bfa299623e1cddb4fa765bbcba505a6bf5a8d9ff9d2e14d7ebb} right up to 100{1e35c1693fa46bfa299623e1cddb4fa765bbcba505a6bf5a8d9ff9d2e14d7ebb}. Sadly, there was a recurrence rate of between 9{1e35c1693fa46bfa299623e1cddb4fa765bbcba505a6bf5a8d9ff9d2e14d7ebb} and 50{1e35c1693fa46bfa299623e1cddb4fa765bbcba505a6bf5a8d9ff9d2e14d7ebb} which means it could be a flip of a coin as to whether the treatment works in the long-term.

We should also note that two or three injections will be required with one month’s space in between. Just as we saw with fillers, steroid injections are commonly used in conjunction with other solutions such as scar removal surgery. With many programs, a combination of treatments will be used in intervals over a period of up to two years. If treatment stops too early, the risk of raised scars reforming will increase.

In addition to this, there’s also a risk (higher than with others) of side effects and complications have been known to occur with intralesional steroid injections. As well as general responses from patients, we also know this because of a report in The International Journal of Lower Extremity Wounds. In the report, it showed ‘significant injection pain’ with intralesional corticosteroid injections (even where standard doses of 40 mg/ml of triamcinolone were used). For those who used this treatment for raised scars, a little over six in ten experienced side effects which can include rebound effects, skin and subcutaneous fat atrophy, hypopigmentation, ineffectiveness, and even spider veins (telangiectasias).

With the risk of failure and side effects, doctors won’t issue steroid injections lightly.

  • Benefits – Steroid injections can be effective for both hypertrophic and keloid scars. Compared to other solutions in this guide, they are also extremely simple to provide.
  • Drawbacks – Mainly, the negatives come in the shape of side effects and problems with efficiency.

TECHNIQUE #6: PRESSURE THERAPY

pressure therapy

WHAT IS IT ?

As you can see, there are a number of different treatment types and we still have four more to come. Firstly, we have pressure therapy and you might be able to guess what this entails. On the scarred area, pressure will be applied and this is normally achieved through flat-knitted compression garments. this treatment can benefit older scars and is suited towards scars away from the face.

HOW DOES IT WORK?

During this treatment, a pressure garment is placed over the scar area and is said to be effective when appropriate pressure is applied to the scar surface.

As long as the right level of compression is applied, it’s believed these types of garments can speed up the tissue remodeling process during the last phase of healing.( tissue remodeling as we saw previously

Another theory is that pressure kinda controls collagen synthesis because it limits the supply of blood, nutrients and oxygen to the scar tissue so collagen production cannot go overboard and lead to the raised scars.

This treatment is flexible since garments now include headbands, gloves, face masks, finger sleeves, arm sleeves, vests, and many more.

While perfect for some areas of the body, pressure therapy previously struggled in other areas. The therapy relies on compression, and not enough pressure will limit the overall effect. Unfortunately, it was once hard to generate enough pressure to affect the chest and mid-sternum. Now, thanks to investment in the niche, companies can provide inflatable pressure garment devices for help in these areas.

HOW MUCH DOES IT COST?

Some garments can be picked up for under $40, but the larger garments (using high-quality materials) could reach $250.

WHAT ABOUT RESULTS WITH PROS AND CONS ?

Before the introduction of many other treatments, pressure therapy was incredibly popular for scar removal. These days, it doesn’t get the same attention and Clinics, a well-known journal, once reported on their effectiveness (or lack of) in reducing scarring. Further to this, some studies have found the difference between no pressure, light pressure, and heavy pressure to be minimal (if anything at all!).

Additionally, many people have problems with the lack of efficiency with garments over time because they lose their pressure. This, combined with the fact they can be awkward to wear on a daily basis, has left many people dealing with hypertrophic scars disappointed.

  • Benefits – Compression garments can be affordable which makes it an easy option to try before seeking more expensive treatment.
  • Drawbacks – Unfortunately, the effectiveness of pressure therapy is still hotly debated and they can also be uncomfortable to wear (especially in warm weather).

TECHNIQUE #7: SCAR MICRODERMABRASION

scar microdermabrasion

WHAT IS IT ?

As another non-invasive procedure, the idea with microdermabrasion is to remove dead skin cells in the outermost layer by using fine diamond crystals. For the most part, this can be used for the face and this is where best results are seen; specialists may also recommend microdermabrasion for the shoulders, arms, chest, back, and backs of hands.

HOW DOES IT WORK?

Using a wand-type device, this is embedded with fine diamond crystals which will effectively ‘sand’ the skin. If done correctly, all dead skin cells from the stratum corneum (outer layer) will be removed and this makes way for a new layer of healthy skin. Within even the deepest of the dermis’s layers, new skin cells are encouraged to replace the previous dead (and rough) ones.

Not only does this technique lead to new skin cells, it can also stimulate collagen production which allows for an overall improvement in texture and color.

With this in mind, this really help to fade old scars, wrinkles and dark spots.

In recent years, this treatment has expanded somewhat which means that spas and health facilities will offer it as well as dermatologists. Working in sessions, those with difficult scars will require a longer treatment plan (as expected now you’re nearly an expert in this field, right?).

woman having skin microdermabrasion

Home use machines :

In addition to this, we should also mention the DIY options you’ll find on the market. These can be incredibly effective and these microdermabrasion devices allow you to save some money. Rather than paying to visit an expert within a professional facility, you can treat your scar from the comfort of your own home. You can check our complete guide to the Best Home Microdermabrasion Machines HERE.

Quick Warning – As noted previously, microdermabrasion can help to reduce the visibility of scars and make them look more youthful. Interestingly, the new skin cells will be sensitive to UV rays so this is something you need to consider. After treatment, you’ll need to apply a strong sunscreen every day. If you’re planning a day outside, your specialist is also likely to recommend a wide-brimmed hat.

HOW MUCH DOES IT COST? 

There are a number of factors that impact the cost of microdermabrasion treatment and it’s important to note that experts vary in quality. You’ll pay more for those with higher qualifications and more experience; prices can range between $200 and $550 for a single session.

What about home devices?

These can be as little as $100 and up to $300 for the very best. At the extremes of each scale, $450 can be saved with a home device and this is why it’s quickly becoming the more popular option. If you’re worried about the investment, the devices can also be used for wrinkles and fine lines so they aren’t completely useless after treating a scar. We reviewed the best microdermabrasions devices here.

Why go for a professional? You might be wondering why you should go for a professional at all if home kits are cheaper. Ultimately, it comes down to the scar because dermatologists can go deeper and stronger; this means more downtime but it also means fewer sessions.

WHAT ABOUT RESULTS WITH PROS AND CONS ?

On the whole, microdermabrasion can sometimes be the best option for acne scars since it definitely improves their appearance. Although dermatologists would like to help everyone, not all scars will become invisible and the result depends on scar depth, size, and darkness. Therefore, treatment can continue in sessions for however long the doctor recommends (perhaps even over a year).

  • Benefits – Considering the procedure is non-invasive, it shouldn’t cause pain and it’s a safe option. With home equipment especially, you can be done in around five minutes so it doesn’t have to disrupt your day like other procedures.
  • Drawbacks – Often, microdermabrasion is compared with lasers so a drawback to this solution would be the number of required sessions. When all is said and done, the bill can be a little heavy.

TECHNIQUE #8: CHEMICAL PEELINGS

chemical peelings

WHAT IS IT ?

As we come to the penultimate treatment option for scar removal treatments, we reach a process that uses chemicals and exfoliation. Also known as ‘chemical peels’, it’s a skin resurfacing technique that first applies a chemical to the area before then peeling it off to remove superficial layers of skin.

HOW DOES IT WORK?

Normally designed for acne scars, blemishes, and pimples on the face, it allows new skin cells to generate and replace old ones. As a new layer of skin grows, it should improve the overall appearance while dealing with previous problems. Today, there are varying strengths of chemical peel: light, mild/medium, and deep.

Different acids can be used for each and the one chosen for you will depend on the extent of your scar.

  • Light – Most commonly contains BHA (beta hydroxy acid) such as salicylic acid OR AHA(alpha hydroxy acid) such as lactic acid, glycolic acid, or citric acid.
  • Mild/Medium – Perhaps the most popular suggestion, trichloroacetic acid (TCA) is a safer form of peel.
  • Deep – As the strongest available, deep peels normally use phenol so it isn’t a solution recommended often. With acne scars, it has been known to cause bleaching and it can be damaging for the kidneys. TCA is a more popular peel in that case.

Ultimately, the type of peel used in your case will depend on your scar (there’s no use recommending a deep peel if a light one will work just as well!).

For acne scars, medium will typically work but deeper solutions may be required for the more severe cases. These peels often contain concentrations of up to 70{1e35c1693fa46bfa299623e1cddb4fa765bbcba505a6bf5a8d9ff9d2e14d7ebb} so, when this acidic, a professional should always be carrying out the care with some form of anesthesia.

Once the initial treatment takes place, you’ll need to partake in a cleaning regimen, extra sun protection, and maybe even antibiotics if there’s a threat of infection. As skin is peeled away, this removes a layer of protection and bacteria will find it easier to attack your body.

HOW MUCH DOES IT COST?

At a professional dermatologist office, a full-face treatment can range from anywhere between $2,000 and $5,000.

At home alternative:

We should note that home kits are available. For the cases that aren’t too severe, chemical peels can be done at home but you should always start with lower concentrations. From here, you can slowly build up if it isn’t effective. You can check the peeling we really like on Amazon HERE. It is really well formulated and cost effective. It can really help reduce scars on face and body.

Thankfully, you’ll find a vast array of strengths for home kits and it can be effective as long as you take the right precautions; be sure to follow the instructions and always keep the product away from children.

WHAT ABOUT RESULTS WITH PROS AND CONS ?

On the whole, chemical peels can be very effective as a scar removal treatment(assuming you don’t go too strong too early). If you choose a medical professional, you can let them decide the treatment plan and feel confident in their ability to help.

  • Benefits – This is a great solution for light scars and it has the added benefit of aiding wrinkles while making the whole face glow.
  • Drawbacks – If a strong peel is required, the recovery period required can be significant. For those who choose weaker home kits, the treatment will be longer (but it does mean you won’t have to walk around with a red face in public!).

TECHNIQUE #9: SCAR CREAMS AND GELS

scar creams and gels

Finally, acne scars can become less visible with many topical treatments while raised, discolored scars can be treated with over-the-counter options. The product chosen will normally depend on the age of the scar.

  • If your scar is old (more than 2 years), we can use more “aggressive” treatments such as home use chemical peels (we discussed it above), vitamin C serums etc… to fade the scars

Vitamin C – By slowing the production of melanin, a skin pigment, vitamin C can be very useful in treating skin issues; it should make the natural pigmentation look much better. How? If we look at the technical process, the production of tyrosinase (an enzyme used for pigment production) is reduced. With the knock-on effect this has on melanin, dark spots of pigmentation will gradually lighten. With regular treatment, hyperpigmentation can be reduced and prevented (in the future). You can check our guide to the best Vit C serums HERE.

  • If you have a new scar (less than 2 years), you cannot use anything too aggressive or it would affect the healing process. The topical treatment to use is silicone gel or silicone sheets. This is what plastic surgeons recommend the most after surgery or for new scars. It is a no brainer.

When treating hypertrophic scars and keloids, silicone treatments are actually recommended by the American Academy of Family Physicians.

For both scar removal treatment and prevention, products using silicone were actually voted the ‘gold standard’ non-invasive treatment by 24 experts (from around the world and from varying disciplines).

WHAT IS IT ?

Made of silicon and oxygen, silicone is entirely man-made and is a polymer that offers a safe and non-toxic treatment for our skin. Found in makeup, cosmetic products, and many other products, it’s a safe option for sensitive skin too.

HOW DOES IT WORK ?

After the silicone gel or sheet is applied, the silicone will fully adhere to the skin; it can be spread evenly over a scar site. Acting as a new protective layer, moisture can’t escape and all nasty toxins can be kept out. However, let’s dispel a common myth because oxygen CAN get inside which allows the skin to breathe. Silicone is ‘selectively permeable’ so the barrier will keep the scar breathing without having to worry about potentially harmful bacteria and dirt.

As we all know by now, collagen is required for strength, structure, and repairing tissue. Yet, too much collagen can lead to a raised scar. In the early stages of scar formation, a common problem is that too much moisture evaporates and this leads the body to thinking it needs more collagen (this is where raised scars form).

Since silicone keeps the moisture inside, the body won’t need to produce so much collagen and the forming scar can remain flat. Essentially, the silicone acts as a layer of healthy skin to provide the perfect environment for the scar to form.

You can check our reviews of the best scar removal creams and gels HERE.

Gel and sheets? In fact, there are 2 types of topical scar removal products you can use:

  • Gels – Sometimes, people find the sheets a little too frustrating so prefer a gel which tends to be more practical. Furthermore, gel can be applied across uneven skin and it dries quickly. Despite common belief, there’s no odor with silicone gel and you also won’t have to contend with residue. For visible areas of skin, or for an area that tends to stay in motion for large portions of the day, silicone gel can be used (you can even apply makeup on top!).
  • Sheets – What’s the difference between this and gel? Firstly, sheets can be applied to larger surface areas and they can also be shaped depending on the scar site. If the sheets you purchase are too large, simply cut one down to the shape you need and the rest can be stored for a later date. Sheets can often be preferred for those who want to avoid their clothes rubbing the area.

HOW MUCH DOES IT COST?

Compared to some of the other solutions we’ve provided in this guide, this is a more affordable option and can be purchased for between $20 and $60. You can check our guide to the best scar removal creams and gels HERE.

WHAT ABOUT RESULTS WITH PROS AND CONS ?

Fortunately, the Journal of Cutaneous and Aesthetic Surgery conducted a study of 30 people to see just how effective silicone gel was when attempting to treat keloids and hypertrophic scars. In case you’ve forgotten, both of these are red and raised but keloids can spread beyond the initial scar site whereas hypertrophic scars remain in the same position.

The 30 patients were asked to treat their varying scars with a thin film of silicone gel twice each day before reporting back six months later. The results were overwhelmingly positive as seen below:

  • Texture – 86{1e35c1693fa46bfa299623e1cddb4fa765bbcba505a6bf5a8d9ff9d2e14d7ebb} reduction
  • Height – 68{1e35c1693fa46bfa299623e1cddb4fa765bbcba505a6bf5a8d9ff9d2e14d7ebb} reduction
  • Color – 84{1e35c1693fa46bfa299623e1cddb4fa765bbcba505a6bf5a8d9ff9d2e14d7ebb} reduction

It’s starting to become obvious why many surgeons will recommend silicone products, right? It’s also becoming clear why a number of cosmetic brands have tried their hand at producing silicone-based scar creams and gels. Ultimately, silicone is superb at mimicking heathy skin and allows for the right environment for scars to form.

  • Benefits – Not only are silicone products effective, they are extremely safe and can be used on sensitive skin. Numerous studies have confirmed the efficacy of silicone gel, and this is made all the better by the fact the products are affordable.
  • Drawbacks – For some, it can eventually become frustrating to apply the product every single day for months on end. In an ideal scenario, the scar will be covered 24/7 for between two and four months. Not everyone has the patience for this!

BEST SCAR REMOVAL TREATMENTS FOR EACH SCAR

what treatments for each scar type

We’ve thrown a significant amount of information your way in this guide, but what does it all mean? To finish, we want to provide a list of the best solutions for each type of scar and this should allow you to make the right decision with your dermatologist!

Keloid scars and hypertrophic scars:

  • Old scars: Treatments include surgery to remove the scar, laser resurfacing, pressure garments, intralesional steroid injections, or silicone sheets to flatten the scar.
  • New scars: silicone gel or sheets

Hyperpigmented Scars (often from acne) : Microdermabrasion, chemical peels, resurfacing lasers, and vitamin C serums.

Contracture Scars : Typically, skin grafting and surgical excision will be recommended for a burn contracture.

Sunken (Acne) Scars : A dermatologist will deal with sunken scars through chemical peels, micro needling, surgical excisions, fillers, laser treatments, or dermabrasion procedures (or a combination of these techniques).

Stretch Marks : Finally, micro needling and topical treatments can be used for stretch marks.

General Rule :

When you answer the question about how to remove scars from face and body, you know there is not only one answer. There are several scar removal solutions and treatments that are possible.

Keep in mind that when dealing with skin scars, it’s always wise to be cautious because this will always be better than rushing in and causing damage that can’t be reversed. Before heading into the heavier treatment methods, we always recommend starting light and safe. Before taking any action, we also advise talking to a medical professional because they’ll be able to assess your scar and provide tailored advice.

With this in mind, it brings our complete guide about the best scar removal treatments to a close. We hope it will really help you reduce scars on face and body.

We wish you all the best in dealing with your scar in the coming weeks, months, and years !