Laser and Skin

Scar treatment: improve, not erase

A scar never disappears completely, but it can become flatter, paler and softer, and most of that change happens within the first 12 months after the skin heals. Hypertrophic scars usually appear within weeks and often fade on their own, while a keloid can appear years later, keeps growing beyond the original wound, and shows up in around 16% of some population groups. Silicone worn 12 to 24 hours a day for at least 8 to 12 weeks remains the best studied first step, alongside daily sun protection.

How a scar forms and matures

When skin is cut deeper than its outer layer, the body replaces the damaged tissue with collagen fibres rather than regenerating the original skin. This replacement tissue has no hair follicles and no sebaceous glands, and it stays less elastic than the skin around it. For the first few months a scar is usually red, firm and slightly raised, and it keeps changing for 6 to 12 months, sometimes for up to 2 years, before it settles into its final colour and texture. Location on the body changes the pace too: a scar on the chest or a shoulder tends to stay active longer than one on the face, where blood supply is richer and healing runs faster.

Two patterns break from that normal course. A hypertrophic scar usually appears within weeks of the injury and stays raised but inside the original wound margin, and it often flattens on its own within a year or two. A keloid can appear years after the original injury, grows beyond the wound edge, and keeps expanding; reported rates reach around 16% in some population groups and are highest in Fitzpatrick skin types III to VI. Both need a different plan from an ordinary scar, and both tend to return after treatment. A family history of either pattern raises the odds further, and a keloid that formed after one procedure often signals a similar reaction to the next.

What actually helps a scar

Silicone sheets and silicone gel are the most studied option for a new scar. A 2021 review of 13 randomised trials in 468 people found only low or very low certainty evidence that silicone performs better than no treatment at all, though it may edge out onion extract gel and may ease pain compared with a pressure garment. The usual instruction is 12 to 24 hours of wear a day for at least 8 to 12 weeks, longer for a larger scar; stopping after a week or two wastes the effort already put in.

For a scar that keeps growing, a clinician may add a steroid injection, a pressure garment or cryotherapy. Fractional and ablative lasers can smooth and soften mature tissue once it has stopped changing, and microneedling works by triggering new collagen rather than removing tissue. A sun exposure timer is a simple way to track daily UV exposure over a healing area while any of these treatments run their course. A typical course of fractional laser on a mature scar runs 3 to 5 sessions spaced 4 to 6 weeks apart, with the smoothing effect building session by session rather than appearing after the first visit. Anyone who has taken isotretinoin in the past 12 months should mention it before booking laser treatment, since the drug slows healing and raises the risk of a worse scar, and a blood thinner such as aspirin or warfarin is worth flagging before a steroid injection, since both raise the chance of bruising and bleeding at the site.

Sun protection is not optional

Ultraviolet light striking a scar during its first 12 months, while it is still remodelling, causes darkening that will not fade back on its own. This applies to any skin tone, though it shows most clearly on scars that are already prone to extra pigment. A broad spectrum sunscreen of SPF 30 or higher, applied daily and reapplied after swimming or heavy sweating, is the cheapest and best evidenced step on this whole list. Reapplying roughly every 2 hours outdoors, and again straight after a swim, keeps that layer working; a handful of unprotected afternoons in the first year is enough to leave a scar permanently darker than the skin around it.

Covering the area with clothing works just as well when that is practical, and it removes the need to reapply. Either way, treat the first year as the window that decides whether the final scar colour matches the skin around it or stands out against it.

Massage and movement once healed

Once a wound is fully closed, dry and free of any crust, gentle massage helps keep the scar tissue mobile. Small circular movements with light pressure, plus a careful gliding motion of the scar against the tissue underneath, for up to 10 minutes a few times a day, is a routine most people can manage at home. Starting earlier, while the wound is still open, does more harm than good. Most people notice softer, more pliable tissue within 4 to 6 weeks of daily massage, though a deep or wide scar can take longer to respond.

A scar that crosses a joint deserves extra attention, because collagen tightens as it matures. Protecting the joint too much, rather than keeping it moving within the range a clinician recommends, tends to leave a stiffness that outlasts the scar itself.

When a clinic visit makes sense

Silicone, gentle skincare and mechanical exfoliation sit well within what a beauty salon or cosmetic institute can offer. Ablative laser treatment on a scar is different: in most countries this sits with licensed medical practitioners rather than beauty professionals, because the depth of tissue removed carries a real risk of burns or further scarring in untrained hands. Pregnancy is a further reason to wait, since most clinics postpone laser treatment on a scar until after birth. If a provider offers both services under one roof, it is fair to ask which qualification covers the laser part. A single ablative session commonly costs somewhere between 150 and 600 EUR or USD depending on the area treated, on top of any consultation fee, so a full course is worth budgeting for in advance.

A scar that keeps growing, itches persistently or restricts movement is worth raising with a dermatologist within the first few months rather than waiting the full 12 to 24 months out. Early treatment of a hypertrophic scar or keloid tends to give a better result than treatment started after it has fully matured, particularly since keloids tend to recur after any single intervention.

The first 12 months

Frequently asked

Can a scar disappear completely?

No. A scar can become flatter, paler and softer, but the tissue that replaces the original skin never regains its hair follicles or full elasticity. Most of the improvement happens within the first 12 months.

When is the best time to start treatment?

For a fresh scar, the first 6 to 12 months matter most, since silicone and sun protection work with the tissue while it is still remodelling. Laser or microneedling on a mature scar usually waits until after 12 months.

Why does sun exposure on a new scar matter so much?

UV light striking a scar in its first 12 months can cause permanent darkening that will not fade later. Daily SPF 30 or higher for that first year is the cheapest safeguard available.

What separates a hypertrophic scar from a keloid?

A hypertrophic scar appears within weeks, stays inside the original wound and usually fades within a year or two. A keloid can appear years later, grows beyond the wound edge and keeps expanding, with reported rates around 16% in some population groups.

How long do you actually need to wear silicone?

Plan on 12 to 24 hours a day for at least 8 to 12 weeks, longer for a larger scar. A 2021 review of 13 trials covering 468 people rated the supporting evidence as low certainty, but the practice remains standard advice.

Can a beauty salon treat a scar with a laser?

Not with an ablative laser in most countries, since that procedure is restricted to licensed medical professionals due to the depth of tissue it removes. A salon can still offer silicone care and gentle mechanical treatments.

Sources

• Scars · maturation timeline, sun protection window, massage technique
• Hypertrophic scars and keloids: an overview · keloid versus hypertrophic features, silicone wear time, Fitzpatrick skin types
• Silicone gel sheeting for treating hypertrophic scars · 2021 review of 13 trials, 468 participants, certainty of evidence

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This guide is for general information. It does not replace medical or professional cosmetic advice or an examination.