Treatment
Some treatments – such as laser therapy – are not widely available on the NHS, so you will need to pay for them privately.
Corticosteroid injections
Corticosteroid injections are used to treat some keloid and hypertrophic scars.
Multiple small injections are made into the scar to reduce any swelling (inflammation) and to flatten the scar. Depending on the type of scar, these may need to be repeated. Injections are usually given on three occasions, at four- to six-week intervals, to assess your body’s response. Treatment may sometimes continue for several months if the scar is improving.
This treatment cannot remove scars, but it can improve their appearance.
Silicone gels or sheets
Silicone gels or sheets are available from some pharmacies. They are used on healing skin (not open wounds) to reduce redness and to try to minimise hypertrophic or keloid scars.
To be effective, silicone gels or sheets should be placed over the scar for 12 hours a day, for at least three months.
Surgery for scars
Surgery can sometimes improve the appearance of scars, as it can be used to:
- change the positioning of the scar
- change the width or shape of the scar
- release a tight scar that is close to a joint, to improve movement
Surgery alone is not advised for keloids, as they tend to grow back larger. Surgery for keloids is often combined with corticosteroid injections at the site of the removed scar immediately after surgery. Some plastic surgeons also add other treatments, such as X-ray therapy and oral antibiotics, to try to minimize the recurrence of a keloid that has been surgically treated. You can talk to your surgeon about this treatment.
Pressure dressings for scars
The aim of pressure dressings is to flatten and soften scars. They are most often used for large burn scars or after skin grafts.
Pressure dressings are usually made from a stretchy, elastic material. They are worn over the scar 24 hours a day, for around 6 to 12 months. They can also be used in combination with silicone gel sheeting, to improve the appearance of scars over a long period of time.
Laser therapy
Laser or light therapy (pulses of light) can reduce the redness in a scar by targeting the blood vessels in the excess scar tissue. For some pitted scars, laser surgery (laser re-surfacing) is used to try to make the scar flatter. This involves using a laser to remove the top layers of skin, which stimulates collagen production in the deeper layers.
Dermal fillers
Dermal fillers are injections (often of a man-made acid) used to “plump up” pitted scars. Treatments can be costly and the results are usually temporary. Repeat treatments are needed to maintain the effect.
Skin needling
Skin needling, which involves rolling a small device covered in hundreds of tiny needles across the skin, is also reported to be helpful, but repeat treatments are often needed to achieve an effect, and results vary considerably.
Scars and skin creams
Although Vitamin E cream is sometimes recommended for the self-management of scars, there is no medical evidence to suggest that it has an effect.
However, the massaging of a moisturiser such as E45 into the scar will keep it from becoming dry and help make it supple.
Scars may be sensitive to the sun. Sunscreen can be used to protect them.