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Scars Cicatrices


What is a scar?


How can a scar be minimized?

Specific dermatological procedures to minimize scars will be determined by your health care provider based on:

  • Your age, overall health, and medical history

  • Severity of the scar

  • Type and location of the scar

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the condition

  • Your opinion or preference

Scars usually fade over time. Makeup can help cover the scar while it is healing. Some scars can be minimized by certain dermatological techniques. However, treatment can only improve the appearance of a scar; it cannot completely erase it.

The following are some of the more common scar-minimizing procedures:




  • Cortisone injections. These types of injections can help soften and then shrink hard scars. Keloids and hypertrophic scars often soften after intralesional steroid injections. 

  • Cryosurgery. Cryosurgery can help reduce the size of scars by freezing the top skin layers. The freezing causes the skin to blister.


  • Punch grafts. Punch grafts are small skin grafts to replace scarred skin. A hole is punched in the skin to remove the scar, which is then replaced with unscarred skin (often from the back of the earlobe). Punch grafts can help treat deep acne scars.

  • Surgical scar revision. Surgical scar revision involves removing the entire scar surgically and rejoining the skin. Although a new scar will form, the goal of the surgical technique is to create a less obvious scar. Surgical scar revision is usually reserved for wide or long scars, scars that healed in an unusual way, or scars in very visible places.

What are the different types of scars and treatment?


  • Keloid scars. These are thick, rounded, irregular clusters of scar tissue that grow at the site of a wound on the skin, but beyond the edges of the borders of the wound. They often appear red or darker in color, as compared to the surrounding normal skin. Keloids are formed from collagen that the body produces after a wound has healed. These scars may appear anywhere on the body. They occur more often in darker-skinned people. Keloid scars may occur up to 1 year after the original trauma to the skin.


    • Steroid injections. Steroids are injected directly into the scar tissue to help decrease the itching, redness, and burning sensations that these scars may produce. Sometimes, the injections help to decrease the size of the scar and soften the scar tissue.

    • Cryotherapy. Cryotherapy involves the scar being frozen off.


    • Silicone dioxide. Applied in the form of a gel or pad, this can help soften and decrease the redness of keloids. 

    • Surgery. If the keloid scar is not responsive to nonsurgical management options, surgery may be performed. One type of surgery directly removes the scar formation with an incision, and stitches are placed to help close the wound. Sometimes, skin grafts are used to help close the wound. This involves replacing or attaching skin to an area that is missing skin. Skin grafts are performed by taking a piece of healthy skin from another area of the body (called the donor site) and attaching it to the needed area. Surgery is not performed often on hypertrophic scars and keloids due to the high rate of recurrence. 


    • Radiation. This can be used for scars that do not respond to other treatments.


      In treating hypertrophic scars, steroids may be the first line of therapy, although there is not 1 simple cure. Steroids may be given as an injection or by direct application. These scars may also be removed surgically. Often, steroid injections are used along with the surgery and may continue up to 2 years after the surgery to help maximize healing and decrease the chance of the scar returning. Like keloids, hypertrophic scars may respond to topical silicone dioxide application.

    • Contractures. Contractures are an abnormal occurrence that happens when a large area of skin is damaged and lost, resulting in a scar. The scar formation pulls the edges of the skin together, causing a tight area of skin. The decrease in the size of the skin can then affect the muscles, joints, and tendons, causing a decrease in movement.

      There are many different surgical treatment options for contractures, including the following:


      • Z-plasty. A Z-plasty is a type of procedure that is used to revise a scar by using a Z-shaped incision to help decrease the amount of contractures of the surrounding skin. It also may attempt to relocate the scar so that its edges look more like the normal lines and creases of the skin. Small stitches may be used to help hold the skin in place.

      • Tissue expansion. Tissue expansion is a newer technique being used. It involves a process that increases the amount of existing tissue available for reconstructive purposes. This procedure is often used in addition to the flap surgery.

    • Adhesions. Another type of scarring, called adhesions, may form between unconnected internal organs. Adhesions may cause complications during certain surgeries.

    Recovery from scar revision surgery

    As with all surgeries, it is important to follow all instructions to help maximize recovery and healing. Your physician will advise you on all activity restrictions, depending on the type of surgery that was performed. Scars cannot be removed completely. Many factors will be involved in the degree of healing of your particular scar. Some scars take more than a year to show improvement in appearance following surgery.