Different Types of Scars and How They Are Treated
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Scarring is the body’s natural response to any wound that breaches the deeper layers of the skin. the injury comes from surgery, an accident, acne, a burn, or a piercing, the body produces to repair the damage — and the resulting tissue is what we see and feel as a scar. What’s less widely understood is that not all scars are the same. There are types, each with its own appearance, biology, and best treatment . the right starts with identifying which type of scar you actually have.
This guide covers the main scar categories, what causes each one, what treatment options exist, and where each fits within the wider at Centre for Surgery’s CQC-regulated Baker Street .
The biology of a scar
Skin is made up of three layers: the surface epidermis, the dermis it (containing collagen, and blood vessels), and the fat layer below. Minor injuries that only affect the epidermis heal producing a scar — the cells identically to what was there before. Any injury that reaches the dermis a repair process, one in which the body lays down replacement . This is structurally different from the skin: more disorganised, less elastic, and often a different colour and texture. That is what we recognise as a scar.
Scar formation moves through three phases:
A scar continues to mature for 12 to 18 months after the injury. This is why scar revision is usually for at least a year — the appearance during the first few months is not the final .
Fine-line scars
The most common scar type, and the one most scars become. A fine-line scar is pink or red and slightly raised, then gradually fades over 12 to 18 months to a pale, flat line. The final depends on the anatomical location, the patient’s skin type, the technique used to close the wound, and how the scar is cared for during healing.
Most placed by an experienced surgeon along natural skin tension lines mature into fine-line scars that are difficult to see without close inspection. Most won’t disappear entirely, but they become a minor cosmetic rather than a one. For full discussion of how surgical scars mature, see .
Hypertrophic scars
A hypertrophic scar is a raised, firm, often red scar that stays within the boundaries of the wound. It forms when the body more than was needed for repair, leaving the scar thicker and more than a typical fine-line scar. scars are most common on the chest, shoulders, upper back, and over joints — anywhere there is high skin tension. They are also more common in with darker skin types and in those with a personal or family history of poor scarring.
The good news: hypertrophic scars typically improve spontaneously over 12 to 24 months, gradually softening, flattening, and fading. The improvement can be with:
For full of history and treatment, see
Keloid scars
A keloid looks similar to a hypertrophic scar but behaves differently. The feature: a keloid beyond the boundary of the original wound, growing into previously healthy skin. Where a hypertrophic scar stays within the lines of the incision, a keloid spreads sideways into normal tissue.
are also typically firmer, darker, often itchy or tender, and — unlike scars — they rarely spontaneously. Without treatment, many or continue for years. They are most common in patients with darker skin types (Fitzpatrick IV–VI), in with a family history of keloid formation, and at certain anatomical sites the earlobes, deltoid, chest, and jawline.
Keloids need active treatment rather than watchful waiting:
on piercings are a particularly common presentation. For the approach, see
Atrophic scars
The opposite of hypertrophic scarring. Atrophic scars sit below the level of the skin — they appear as depressions or indentations rather than raised marks. They form when the body produces less collagen than was needed during healing, or when fat or tissue is lost during the injury.
Acne scarring is the most common cause of . Other causes include chickenpox, surgical complications, and injuries that deeper tissue. Three sub-types of atrophic acne scars are recognised:
Different respond to different treatments. For full detail on acne scarring specifically, see , and for treatment-specific guides see , , and .
Contracture scars
Contracture scars develop most commonly after burns. As the burn heals, the contracting wound pulls skin and tissue inward, a tight, often shiny, sometimes thickened scar that can movement. Contractures crossing joints — the elbow, knee, neck, — can produce genuine functional limitation as well as .
Severe need specialist surgical management. Techniques include (a of the scar to it), W-plasty, tissue expansion, skin grafting, or local flap reconstruction. treatments — laser resurfacing, garments, scar massage and — can help with milder contractures or as adjuncts to surgery.
Pitted and sunken scars
A that overlaps with atrophic but is sometimes considered . Pitted scars develop where the deeper structure of the skin has been lost — most often from severe acne, chickenpox, or some types of . They can also develop secondary to fat loss in the area, leaving a depression even where the skin surface looks otherwise normal.
options for pitted scars include:
Most with substantial pitted scarring benefit from several — for example Morpheus8 across the affected area, TCA CROSS for individual ice-pick scars, and targeted filler for deeper depressions. See for a detailed guide.
White (hypopigmented) scars
Sometimes a healed scar ends up paler than the surrounding skin. The pigment-producing cells (melanocytes) in the area have been damaged or lost, leaving the scar without the melanin that gives skin its colour. White scars are most common after burns, deep surgical excisions, and some inflammatory skin conditions.
These are among the harder scars to treat because complete pigment restoration is difficult to achieve. include fractional laser resurfacing, Morpheus8 microneedling, controlled peels, and — in selected cases — medical micropigmentation ( into the scar to match skin). For full discussion, see
Stretch marks (striae)
Strictly speaking, marks are a form of dermal — they form when the skin is faster than the dermis can adapt, tearing in the deeper collagen network. Initially red or purple (striae rubrae), they fade to pale silvery-white (striae albae) over months to years. They are most common after pregnancy, significant weight change, growth spurts in adolescence, and steroid use.
is because the underlying damage is deep and structural rather than . The best evidence-based options include fractional laser resurfacing, Morpheus8 microneedling, and targeted topical use on early red striae. Complete elimination is uncommon — expectations are improvement in colour and texture rather than full erasure.
Surgical scars by location
scars heal differently depending on where on the body they sit. The cluster of guides covering specific scar includes:
Treatment overview — surgical and non-surgical options
For cost information, see
Why timing matters in scar treatment
Scar treatment falls into two distinct phases:
Active scar management — starts as soon as the wound has closed (usually 2 weeks after the injury or operation) and continues for 6–12 months while the scar is maturing. The interventions are non-surgical: silicone, sun protection, massage, and steroid for problem scars. This phase is the most cost-effective window for the final scar .
Mature scar revision — at 12+ months once the scar has fully matured. The interventions can be surgical (excision and re-closure) or non-surgical (laser, Morpheus8). The mature scar is less likely to to than the maturing scar — which is why earlier intervention is preferred where possible.
The single most important thing patients can do for their final scar appearance is to start active scar early, not wait for the scar to mature and then try to fix it.
Factors that affect how your scar heals
When to seek scar assessment
Most scars settle without intervention if the wound was managed appropriately. Some warrant earlier professional review:
Earlier — particularly for hypertrophic and keloid scars — produces better outcomes than waiting for the scar to mature.
What we don’t recommend
Frequently asked questions
No. Scars are permanent changes in the skin’s structure and cannot be erased entirely. What can achieve is a significant in visibility, making the scar much harder to see. For some with carefully and treated scars, the final result is barely detectable without close inspection.
The skin closes within 1–2 weeks, but scar continues for 12–18 months. The appearance during the first few months — red, raised, firm — is not the final . Most scars become significantly less noticeable between 6 and 18 months.
A hypertrophic scar stays within the of the wound. A keloid extends beyond it into previously healthy skin. Hypertrophic scars often improve over time; rarely do without active treatment.
For most scars, yes — gel or sheeting, diligent sun protection, gentle massage once the wound has closed, and good general all help. More problematic scars (keloids, severe hypertrophic scars, mature scars not to basic care) need professional input.
It depends on the scar type, location, size, and chosen. Non-surgical treatments start from around £350 per session; scar is £1,500–4,000+ on . is available. For full pricing detail, see
NHS for scar is restricted. problems ( movement, recurrent ulceration) may qualify; cosmetic improvement usually doesn’t. Most seeking scar treatment do so privately.
For active scar management (silicone, sun protection, massage), as soon as the wound has fully closed — typically 2 weeks after the operation. For surgical scar revision, usually 12+ months after the original injury, once the scar has fully matured.
Often yes, though typically less dramatically than started during the window. Laser resurfacing, Morpheus8 microneedling, and surgical can all improve mature scars; the outcome is improvement rather than complete .
Yes — patients with darker skin types (Fitzpatrick IV–VI) have a higher rate of hypertrophic and keloid scarring, and a higher rate of post-inflammatory hyperpigmentation. Specialist and post-operative scar matter more for these .
Centre for Surgery is a CQC-regulated clinic at 95–97 Baker Street, Marylebone. All are performed by GMC-registered consultant plastic . We offer the full range of surgical and non-surgical scar treatments — laser resurfacing, Morpheus8 microneedling, intralesional injection, surgical scar revision, and combined approaches to your scar type and skin. No GP referral is .
For related guides, see , , , , , and
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