Skin camouflage (make-up)
You can buy make-up that's specially designed for covering scars from pharmacies. It can be particularly useful for facial scars.
If you have a large area of skin to cover and you live in England or Scotland, the skin camouflage service run by the Changing Faces charity may be able to help. Your GP can refer you to the service or, in some areas, you can refer yourself.
Fully trained skin camouflage practitioners will be able to find a good colour match for your skin tone and teach you how to apply the make-up. It's waterproof and can stay in place for two or three days.
The skin camouflage service isn't available in Wales and Northern Ireland. Find out about the further support services available in these countries.
In some cases – for example, if you have a scar after having an operation or you have a disfiguring skin condition – you may be able to get camouflage make-up on the NHS. You should discuss this with your GP.
Silicone gels or sheets
Silicone gels or sheets can be used on healing skin (not open wounds) to help soften and flatten a scar. They can also relieve itching and discomfort.
To be effective, silicone gels or sheets should be placed over the scar for 12 hours a day for at least three months. They can be washed and reused.
Ask your GP, dermatologist or pharmacist if they can recommend a suitable silicone-based scar treatment for you.
Steroids can't remove scars completely, but they can improve their appearance.
Corticosteroid injections can be used to treat some keloid and hypertrophic scars.
The scar is injected a number of times to reduce any swelling and flatten it. Depending on the type of scar, the injections may need to be repeated.
Injections are usually given on three occasions, four to six weeks apart, to assess your body's response. Treatment may continue for several months if the scar is improving.
Steroid-impregnated tape can also be used to try to flatten keloid scars. It can be prescribed by a GP or dermatologist and is applied for 12 hours a day.
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 resurfacing) 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.
But there aren't many long-term studies to prove the effectiveness and safety of laser therapy. If you have laser therapy, make sure the person doing it is a fully trained medical practitioner with experience in improving scars.
Liquid nitrogen can be used to freeze keloid scars. If cryotherapy is used in the early stages, it may flatten keloid scars and stop them growing. A side effect of treatment is that it can lighten the colour of the skin in the area being treated.
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, which involves rolling a small device covered in hundreds of tiny needles across the skin, can also help improve the appearance of scars. But repeat treatments are often needed to achieve an effect, and results vary considerably.
Surgery can sometimes be used to improve a scar by:
- making it appear more natural
- making it less noticeable (by using a skin graft)
- releasing a tight scar that's close to a joint to improve movement
Scar reduction surgery is an invasive treatment that may not be suitable for everyone.
You should carefully consider the pros and cons before deciding to have surgery. As well as the normal risks of surgery, there's also a chance of making the scar worse.
If you're considering scar reduction surgery, make sure the plastic surgeon is fully trained and experienced in this type of surgery. You should fully discuss the procedure with your surgeon so you're aware of the risks and expected results.
If surgery is used to treat a keloid scar, you may also need other treatments immediately after surgery, such as steroid injections or radiotherapy, to stop the scar growing back larger.
Pressure dressings are usually used under specialist supervision for treating large burn scars or after skin grafts. The aim is to flatten and soften the scars.
Pressure dressings are usually made from a stretchy, elastic material. They're worn over the scar 24 hours a day for around 6 to 12 months. They can also be used with silicone gel sheeting to improve the appearance of scars over a long period of time.
Scars and skin creams
Vitamin E cream is sometimes recommended for managing scars, but there's no medical evidence to suggest it has an effect.
But massaging a moisturiser like E45 into the scar will stop it becoming dry and help make it supple.
You should also apply sunscreen to your scar as it may be particularly sensitive to the sun.