Scars come in all sorts of shapes and sizes. And as much as they have a bad reputation, they’re part of the body’s healing process. Scarring is normal, necessary, and the consequence of “inflammatory cells coming in to stop bleeding, prevent infection, and lay down new collagen to ‘close’ the wound,” explains Cybele Fishman, a board-certified dermatologist and assistant clinical professor of dermatology at Mount Sinai Hospital. Unfortunately, scars do sometimes end up being a cosmetic concern, according to Dr. Jody A. Levine, the director of dermatology at Plastic Surgery & Dermatology of NYC.
We tend to pay particular attention to scarring on our faces, like the average acne scar or hyperpigmentation. But here, we’re focusing on helping you treat scars that form after a surgery or significant injury, typically on the body. Surgery scars tend to be linear because they form from wounds that are created in a controlled setting. “This maximizes the chance for a less noticeable scar,” Levine says, while scars from injuries tend to be less predictable.
Experts agree that in-office laser treatments are the most effective way to improve the appearance of scars. “Lasers can target pigment in the scar or help remodel the collagen to heal the scar texture,” board-certified dermatologist Dr. Anna Karp told us. More recently, microneedling has been a popular in-office treatment for scarring, especially ones caused by acne, according to Fishman. The process uses “fine needles to mechanically disrupt the skin and cause a controlled wound, which then sets about repair mechanisms in your skin to build more collagen and elastic tissue.” That doesn’t mean there aren’t ways to help heal scars at home.“The goal is to treat wounds early and well to prevent the formation of a hypertrophic scar, which is a raised scar that stays within the confines of the wound,” explains dermatologist Anita Cela, who specializes in cosmetic dermatology. To help, we talked to dermatologists about the most effective over-the-counter products for getting rid of scars, plus what to use to prevent a scar from forming in the first place. Because there is no all-in-one, holy-grail scar treatment, we’ve instead organized their recommendations into an easy to follow step-by-step guide to treating scars.
Keep wounds clean and hydrated
The first line of defense is to keep the wound clean, moist, and covered in the early hours, days, and weeks — before you even start using a scar treatment. “Don’t let the wound get infected,” cautions Dr. Kenneth Howe of Wexler Dermatology. “This may necessitate the use of a topical antibiotic like bacitracin ointment, which is especially important if the wound occurred with concomitant contamination” — for example, a road-rash injury from skateboarding. (Polysporin contains bacitracin zinc in addition to a second antibiotic, polymyxin B, though you can get ointments that contain just bacitracin.) After you’ve treated the wound with antibiotics, Dr. Jennifer Chwalek, who practices with Union Square Laser Dermatology, says that “you want to keep the wound hydrated with something like Aquaphor, as this promotes faster healing.” It’s a myth that you want to air out the wound and let it dry, because that will form a scab, which can cause more scarring and take longer to heal. “Avoid wound breakdown,” adds Howe. “Proper wound dressing can help in this regard.” Aquaphor is also a favorite of Dr. Rachel Nazarian, a dermatologist at Schweiger Dermatology Group, for its infection prevention and protection that stimulates the healing of wounds.
“Honey has been used for centuries for wound healing because of its antibacterial and hydrating properties, especially in burn wounds,” says dermatologist Adeline Kikam, founder of @brownskinderm, a platform dedicated to skin care and dermatology information in skin of color. While there haven’t been many studies on how honey heals wounds, Kikam says that new research suggests it can help with scar reduction, so she says it’s worth trying on mild wounds and burns. Fishman seconded this sentiment, saying that honey features antimicrobial compounds and an acidic pH, which helps with wound-healing.
It’s critical to clean a wound when it first happens, and any foreign materials — think bits of gravel or dirt — can cause even worse scarring and long-term discoloration, according to Dr. Melissa Doft of Doft Plastic Surgery. Once a wound is clean, Doft suggests maintaining a moist (but not wet) environment around it. She’s a fan of Neosporin for its antibiotic qualities. This particular formula is designed to minimize the look of scars along with providing itch relief.