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Pigmented scar in brown and red tones that can be treated for pigment issues

7 Myths about scars and how scars can actually be treated

Editorial note: an earlier version of this article was first published on April 9, 2009. It was updated on October 15, 2020.

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Many people who form scars want to get rid of them. It’s common to seek answers for a problem that seems impossible to treat. Everything from false, overnight ‘miracles’ to legitimate, medical treatments may be sought to remove scars.

However, even among the medical community, there may be misconceptions about scars. In this article, we’ll cover myths about scars that you may have heard. We’ll also explain how scars can actually be treated.

If you want to remove a scar and you live in the Vancouver area, we’d encourage you to visit our Surrey skin clinic for a consultation. We can take a closer look, and make recommendations on how to treat your particular scar (different types require different treatments).

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Scar myth #1: you must wait a year after injury to start scar reduction treatments

If you call your average physician and tell them that you have a recent scar, they may tell you there is nothing that can be done for about a year after the injury. Unfortunately, this is misinformation.

There is evidence that by treating a scar early, the outcome of the result can be improved. Some studies have shown that when a scar is treated within 8 weeks of the injury or surgery, it can heal much better than waiting an extended time. We have adopted this method of treating traumatic and surgical scars of the head and neck right away. It has worked well for our patients.

In fact, we have found that early scar treatment works with various modalities including steroid injections, silicone sheeting and pressure. We can take these measures immediately after a surgery, when they are expected to otherwise form.

When the scar reaches its point of primary healing, it can also be treated with lasers, such as a CO2 laser or Fraxel® Dual laser.

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Scar myth #2: scars can be completely removed

Unfortunately, scars can’t be totally removed. Many of them lighten and fade over time (especially if they are actually post-inflammatory hyperpigmentation or macular scars, which are leftover blood pigments). Medical interventions can also make scars appear much less noticeable than before treatment.

However, scars are simply a fact of life; we all get them. In fact, some people like having them. In other cases, some people are more prone to forming unwelcome scars (such as those with darker skin types).

The idea that a scar can be removed to a 100% degree is just not true, however. Once it forms, it can only be treated, not cured.

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Scar myth #3: scars must, can, and should be removed surgically

This is false. In fact, often the opposite is true. For example, if someone is prone to forming keloids or hypertrophic (raised) scars, surgical removal can cause a recurrence. This is because the patient is genetically predisposed to forming these types of scars. More injury will lead to more scars.

Many surgical procedures exist to make scars less noticeable. For example, plastic surgeons may change the direction of the scar, make its lines appear more random (since straight line scars stand out more) or balance its margins. In more serious cases, skin grafting can replace the skin with skin from another part of the body.

While surgery is sometimes called for to achieve scar reduction, other times, non-surgical injections can do the trick. For example, with keloids noted above, a cortisone solution called triamcinolone acetonide can help to reduce skin cells causing the raised bump.

When it comes to indented scars, such as boxcar acne scars or chicken pox scars, dermal fillers can plump them up. This way they look more in line with the rest of the surrounding skin. A popular choice for this procedure is the 5-year-filler known as Bellafill®.

Other times, scars can be reduced using lasers or radio-frequency microneedling.

A laser performs multiple functions to improve a scar. These include:

  • Allowing uneven tissue margins to be blended together, or ‘smoothed down.’
  • Producing collagen to fill in the skin’s irregularities.
  • Blending the colouration with surrounding tissues.

After a laser treatment, the area will be raw for the first 5-6 days and then be a smooth pink. This pinkness will fade over the ensuing weeks. Though, it may last several months in some cases. Lasers designed to break apart red pigments in the skin can be used to reduce this effect. For example, a pulsed-dye laser (PDL), or the one we use at our clinic, the excel® V.

Sometimes a scar needs to be lasered multiple times to see gradual improvement with each treatment. While lasering alone may work great for simple scars, more complex scars may need surgical intervention first.

Cutting procedures for scars can also be small, in-office events that are hardly ‘surgeries’ in the ‘traditional’ sense.

For example, a technique called subcision uses a special needle to break up scar tissue at the base of a depressed scar. These types of scars contain ‘spider web’ like bands called adhesions. These bans, in part, are what keep a depressed scar tethered down. By inserting a cutting needle under the scar, and swiping it back and forth, these adhesions can be separated. Once this occurs, the base of the depressed scar rises up and fills in. Subcision can be performed multiple times to improve a depressed scar.

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Scar myth #4: scar creams and ointments can fade a scar at home

This is only partially true. Remember, scars can’t be removed completely. But their appearance can be reduced, especially if they are treated early in their formation. If a product is claiming absolute scar elimination, it is probably a scam.

The thing with over-the-counter scar treatments is that they may, or may not work. It depends on the severity of your scar, how deep it is, how old it is, and so on. It also depends on how diligently you use these treatments, and how well they are made to begin with.

Scar ointments are also not the ‘first step’ to scar reduction, when you initially get a wound. At the first sign of skin trauma, you should be disinfecting the affected area. Thereafter, it’s important to keep it moist, so it can heal properly, thus avoiding a scar. The time to use a scar gel is when the skin is completely healed over, yet still red.

Popular over-the-counter scar remedies and preventers include silicone sheets and gels, onion extract, lavender oil, retinol, aloe vera and green tea-based products. Interestingly, vitamin E has been shown to make no difference in scar reduction, though it is often sold as a wound healer. The same was found to be true of topical steroid creams.

Please remember that scar creams do not replace skin disinfectants such as Polysporin®, alcohol or hydrogen peroxide. Though, some argue that using these repeatedly is bad for skin, and that soap and water should be used instead. We would say to always follow a doctor’s recommendations.

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Scar myth #5: tanning can help to reduce the signs of a scar

Please don’t ever tan to get rid of a scar. In fact, tanning in general is very damaging to skin. It should not be pursued on purpose, for any reason. It not only has potential to create skin cancer, it is the main cause of wrinkles, sagging, brown spots and other types of hyperpigmentation (like melasma). It can make all skin issues worse.

UV rays – including from tanning beds – degrade collagen in the skin. They do this through free radical damage. Once free radicals start damaging cells, they produce a chain reaction, which damages even more cells. That is, until antioxidants come in to ‘save the day.’ You can learn more about this process at the following articles on our blog:

Perhaps the thought behind the idea of tanning a scar is to darken the colour of whiteness, so that it is less visible. However, scar tissue is already damaged skin. It is photosensitive, and should not be exposed to even more damaging ultraviolet radiation.

You should always wear a high-SPF, broad-spectrum sunscreen, even on cloudy days, and when indoors. Avoid the sun during peak hours, and wear sun protective clothing.

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Scar myth #6: scars are a purely cosmetic issue

No! Scars of all kinds can cause psychological stress and even physical discomfort.

Scars – especially noticeable ones – can be embarrassing. For example, facial scars or acne scars can cause insecurities and depression. Smooth skin is highly desired in our society. No one wants to be the ‘different’ or ‘deformed’ one. So, it is very valid to treat scarring if it is creating a quality of life issue.

Scars can also be itchy, tender and tight. They can reduce mobility in some cases, too. When scars cause medical problems, insurance coverage may apply for their treatment. However, different insurance policies vary, so it’s best to ask your provider, to be sure.

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Scar myth #7: scars only form when the skin is cut deeply

While deep cuts certainly form scars, such as from surgery or injury, this is not the only way people get abnormal tissue growth.

Simple acts such as popping a pimple, getting a piercing or even a tattoo can cause a small or big scar. Let’s not forget burns, whether from fire, a hot iron or an improperly administered laser treatment. Sometimes, burn marks fade. Other times, they are hard to get rid of.

In other cases, the skin stretches too quickly, which leads to stretch marks. Stretch marks are considered a type of scar, too.

Many factors can affect whether or not you develop a scar from life events that would otherwise seem harmless. These can include your genetic predispositions, and your current state of health.

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To conclude: scars can be treated, but they require professional assessment

As we’ve seen above, scars are treatable, even if they can’t be removed completely. However, in order to get the best results possible from a scar revision treatment, it’s important to see a doctor. Even better: see a doctor with experience in scar reduction treatments.

Different scars can require different treatment paths. Whether at-home silicone sheets or ointments will work for you, or if you need more serious surgeries, a doctor should be leading your pathway to healing. Doing the wrong treatments on a scar can make it worse, in some cases.

If you are looking to have a scar removed in Vancouver, we encourage you to visit our Surrey skin clinic. We have been performing scar reduction for several years. We would be happy to take a look at your case. Book a consultation to get started!

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