Quick answer
No, scars do not always turn white. The final color of a scar depends on various factors like skin tone, location of the scar, type of injury, age, genetics, and how the wound heals. Scars can end up red, pink, purple, brown or remain close to the natural skin tone.
What determines the color of a scar?
There are several factors that influence the final color of a scar:
Skin tone
People with darker skin tones are more likely to develop scars that are purple or brown in color. Their skin contains more melanin which influences the pigmentation of the scar tissue. Lighter skinned people tend to form pink or white scars.
Location
Areas exposed to the sun, like the face and arms, often produce darker scars due to sun exposure during the healing process. Scars in covered areas like the trunk tend to retain a lighter color.
Type of injury
The depth and severity of the original wound impacts scar pigmentation. Superficial wounds like scrapes leave scars close to the natural skin tone. Deeper cuts or burns more often cause hypopigmented (white) or hyperpigmented (dark) scars.
Age
Scars in children and younger adults tend to be pink or red at first, often becoming whiter over time. Scars in older adults usually retain some redness because their skin is thinner.
Genetics
Genetics play a role in wound healing and scar formation. Some people are prone to overproduction of collagen, leading to thick, raised scars called keloids which are often darker than the surrounding skin.
Healing process
How well and how quickly the wound heals impacts the look of the scar. Scars from injuries that fully heal within a few weeks tend to better match the normal skin tone. Disrupted healing raises the risk of hypopigmented and hyperpigmented scarring.
Do new scars start out red or pink?
In the initial weeks after an injury, a fresh scar will usually appear pink or red. This is because new scar tissue lacks melanin, so the blood vessels underneath show through giving the scar a reddish hue.
With time, some of the redness will fade. However, it takes a minimum of 6-12 months for a scar to mature and reach its final pigmentation.
What makes a new scar look red?
When the skin is damaged, the body triggers an intricate healing process aiming to repair the wound as quickly as possible. This involves:
- Clotting – Blood vessels constrict and platelets rush to the area to form a clot that stops bleeding.
- Inflammation – The injured area becomes swollen, painful, and appears red or pink as white blood cells fight bacteria.
- Tissue growth – Fibroblasts produce collagen to mend the wound. New blood vessels develop to nourish the scar tissue.
- Remodeling – Collagen fibers realign and crosslink for strength. The scar matures and takes on its final appearance.
The influx of blood vessels and lack of melanin cells in the new scar tissue cause the bright red or pink color. It takes time for collagen remodeling to be completed and for the scar to fade.
What color will my scar be?
It is difficult to predict the exact final color of a scar. However, below are some general guidelines based on skin tone:
For lighter skin:
- Initially the scar will be pink or red.
- Over time, it often fades to a pale white color.
- In some cases, the scar remains pinkish or achieves a color close to the surrounding skin.
For darker skin:
- Early on the scar will look pink or reddish.
- Eventually, it tends to transition to a brown or purple color.
- With deeper skin tones, the scar is more likely to retain a darker pigment long-term.
Of course, individual factors like genetics and location of the scar also affect the end result. Discuss your situation with your doctor to get a better idea of what to expect.
Can you make a scar less visible?
While it’s difficult to make a scar disappear entirely, there are things you can do to reduce the appearance of a scar and help it blend with your natural skin tone:
Silicone scar sheets
Applying silicone gel sheets or strips to new scars helps hydrate and flatten the tissue to make scars less noticeable. Silicone may also reduce redness.
Gels and creams
Over-the-counter topical creams containing ingredients like vitamin E, onion extract, and hydroquinone can help fade discoloration and improve scar texture over time.
Sun protection
Limiting UV exposure with clothing and broad spectrum sunscreen prevents the darkening of scars.
Steroid injections
For raised or thickened scars, steroid injections can flatten the scar by reducing excess collagen production.
Surgery
For large or problematic scars, surgical scar revision techniques can minimize the scar’s appearance by rearranging or removing tissue.
Microneedling
Using tiny needles to create controlled injury to the skin triggers renewed collagen production that helps smooth and soften the scar.
Laser treatments
Vascular and ablative lasers resurface the outer layers of the scar to reduce pigmentation irregularities and improve texture.
What is a hypertrophic scar?
A hypertrophic scar is an enlarged, raised scar that remains within the boundaries of the original injury site on the skin. It is more common after:
- Deep burns
- Large wounds
- Injuries with increased tension across the wound
- Traumatic tissue damage like piercings or cuts
Hypertrophic scars tend to be red, thick, and itchy. They form due to overproduction of collagen during the healing process.
Differences from keloid scarring:
| Hypertrophic scars | Keloids |
|---|---|
| Remain within wound borders | Grow beyond original wound |
| Often improve and regress over time | Do not regress, require treatment |
| Less likely to reoccur after removal | Can reoccur after surgical removal |
Hypertrophic scars tend to improve on their own over a period of 6 months up to 2 years. Keloids are more severe and require treatment to prevent progression.
What is the best treatment for hypertrophic scars?
Hypertrophic scars respond best to conservative treatments focused on flattening and smoothing the scar tissue:
Silicone sheets
Silicone sheets help hydrate and compress the tissue to reduce scar thickness. Continuous use for 12 hours a day provides the best results.
Onion extract gel
Onion extract contains anti-inflammatory quercetin which helps soften and flatten raised scars. It also reduces redness.
Compression therapy
Using tape, bandages or compression garments creates pressure on the scar to minimize collagen production and prevent additional thickening.
Intralesional steroid injections
Injecting triamcinolone or similar steroids directly into the scar reduces inflammation and excess collagen. It also flattens and softens the scar.
Laser treatments
Vascular lasers target blood vessels to reduce redness. Ablative lasers resurface the top layers of the scar and improve its appearance.
Minor surgical scar revision may be considered if conservative treatments fail to improve the scar over time. Avoiding sun exposure and massage of the scar also helps optimize results.
Can you completely get rid of a scar?
It is very difficult to get rid of a scar completely. A scar forms because the skin’s structural proteins, especially collagen, are deposited to quickly seal and close a wound. The composition of a scar is different from normal, healthy skin.
Even with advanced scar treatment techniques, some evidence of the injury will usually remain. However, there are ways to minimize scars:
- Using silicone sheets and gels can flatten and smooth scars.
- Steroid injections reduce inflammation and excess collagen.
- Laser resurfacing improves scar texture and coloration.
- Surgical excision helps eliminate large, thick scars.
- Microneedling and chemical peels create controlled injury to renew skin.
Complete scar removal requires replacing the scar tissue with new, unblemished skin – such as with skin grafting. But even skin grafts leave fine line scars at the graft site.
With early intervention and proper long-term care, scars can often be greatly minimized. But expecting complete and permanent disappearance of a scar is unrealistic in most cases.
Can you get rid of old scars?
It becomes more difficult to treat older, fully matured scars compared to fresh scars. But treatments are still available to help minimize old scars:
Over-the-counter topicals
Creams with vitamin E, hydroquinone, retinoids, or alpha hydroxy acids can help soften and slowly smooth out tough, uneven scars.
Laser resurfacing
Ablative laser treatments remove outer layers of the skin to improve scar appearance. It works on scars up to 10 years old. Repeated treatments provide gradual improvement over time.
Dermabrasion
Using a rotating wire brush or diamond wheel, dermabrasion sands away the top skin layers. This refreshes the surface and stimulates remodeling of old scar tissue.
Chemical peels
Applying acids like trichloroacetic acid or phenol removes damaged skin cells. Mild scarring can look better as new skin regenerates.
Surgical revision
For severely disfiguring scars, surgeons can surgically excise or reposition the scar. This is effective on older scars, but does leave new surgical scars.
Microneedling
Microneedling punctures the skin to generate minor injury and therefore kickstarts wound healing processes that remodel the scar.
With patience and diligent care, even years-old scars can be smoothed and faded to some degree. But the older the scar, the harder it is to eliminate.
Do certain vitamins help with scar healing?
Yes, ensuring adequate intake of certain vitamins and nutrients supports the complex process of wound healing and scar formation. Key micronutrients include:
Vitamin A
This fat soluble vitamin maintains skin integrity. It enhances epidermal growth and promotes regeneration of damaged tissue.
Vitamin C
Vitamin C aids collagen production needed for skin repair. It also has antioxidant properties that combat inflammation and cell damage.
Zinc
Zinc assists with skin cell multiplication and growth. It accelerates wound closure and stimulates immune function.
Protein
Dietary protein provides amino acids that form the building blocks for regenerating skin cells and collagen fibers during healing.
Bioflavonoids
Plant pigments like citrus bioflavonoids improve blood vessel strength and circulation for better scar healing.
A balanced diet or a multivitamin containing the above nutrients ensures the best wound repair and minimal scarring. Supplements are available, but should be unnecessary if eating a healthy variety of foods.
Conclusion
In summary, scars can form a variety of colors including white, pink, red, purple and brown. The final scar color depends on multiple factors like skin type, location, age and genetics. While scars cannot be removed completely, early intervention and proper long-term care can minimize their appearance. Treatments like silicone sheets, steroid injections, laser therapy and surgical techniques are helpful. Ensuring adequate intake of vitamins and minerals supports the body’s wound healing process, leading to optimal scar formation.
