Deep scars can be difficult to treat and soften. There are a variety of methods that may help reduce the appearance of deep scars over time. These include topical treatments like silicone scar sheets and gels, injections, laser therapy, skin needling, and even surgery in some cases. The type of treatment will depend on the location, size, and nature of the scar. With consistent care, deep scars can be softened and become less noticeable.
What Causes Deep Scars?
Deep scars form when an injury damages the deeper layers of the skin. This causes abnormalities in collagen production during the healing process. Common causes of deep scars include:
- Cuts from sharp objects like knives or glass that penetrate deep into the skin
- Serious burns
- Deep wounds from accidents, surgery, or trauma
- Severe acne including cystic acne
- Chickenpox scars
The depth of the initial wound impacts how raised or sunken a scar will be. Deep wounds that damage fat or muscle result in more pronounced scarring. Genetics also play a role in how prone someone is to scarring.
Types of Deep Scars
There are several classifications of deep scars:
Hypertrophic Scars
These scars are raised above the surface and occur when too much collagen is produced at the site of injury. Hypertrophic scars remain within the boundaries of the original injury. They often improve and flatten out over time.
Keloid Scars
Keloids expand beyond the original wound site. They are a type of excessive scar tissue that grows progressively larger over time. Keloids can be challenging to treat.
Contracture Scars
Also called skin contractures, these scars tighten the skin, making it stiff and immobile. They form when the wound healing process pulls the edges of the skin together. This causes functional problems in addition to cosmetic concerns.
Depressed Scars
Depressed scars sink below skin level, creating pits or indentations in the skin. They occur when insufficient collagen is produced during healing resulting in a sunken appearance.
How to Soften and Minimize the Appearance of Deep Scars
While deep scars cannot be completely erased, there are treatment options to help minimize and soften their appearance. Here are some methods for improving deep scars:
Silicone Scar Products
Silicone is thought to work by hydrating the scar tissue and preventing excessive collagen production. Silicone sheets, gels, creams and sprays can be used to flatten and smooth hypertrophic and keloid scars. These products are easy to use at home. They are often recommended for several months after scar formation to help maturation.
Scar Massage
Gentle massage can help break up scar tissue over time. Using lotion, oils or silicone gel, massage the scar using firm circular motions. This may help soften and realign collagen fibers. Performed daily, scar massage can improve range of motion and function.
Compression Therapy
Compression with elastic wraps or tape can be used to flatten raised scars. Compression helps decrease collagen formation. It may be used alone or along with silicone and massage. Consistent compression for 12-24 hours daily gives the best results.
Corticosteroid Injections
Corticosteroid medicines like triamcinolone or Kenalog are directly injected into stubborn hypertrophic and keloid scars. The steroids work to soften scar tissue by suppressing the immune response and collagen production. Multiple treatments are often needed spaced 4-6 weeks apart for optimal improvement.
5-Fluorouracil Injections
Similar to steroids, 5-fluorouracil (5-FU) is used to minimize excessive scar tissue. It helps reduce collagen formation and renewal of skin cells within the scar. Multiple treatments 4-6 weeks apart yield better results.
Cryotherapy
Using extreme cold, cryotherapy helps diminish scar tissue. Liquid nitrogen is commonly used to freeze hypertrophic scars. It works by causing localized injury to the area prompting new collagen production. Several treatments may be required for optimal effect.
Dermabrasion
Dermabrasion is a resurfacing procedure that removes the top layers of skin using a rapidly rotating brush. Often combined with laser, it can help improve the texture and appearance of depressed and pitted scars by promoting collagen regrowth. Several treatments are usually needed.
Laser Therapy
Lasers generate targeted beams that vaporize scarred skin cells. This triggers production of healthy new tissue. Lasers can flatten and smooth the surface of hypertrophic scars. They also help improve skin texture and coloration of depressed scars. Multiple treatments are required.
Skin Needling
Skin needling, also called microneedling, creates tiny punctures with superfine needles. This controlled skin injury activates the body’s natural wound healing. New collagen and elastin fibers fill in depressed scars to improve their appearance. Several treatments may be needed.
Surgical Excision
In severe cases, surgical removal of the scar may be performed. The scar is cut out, and the edges pulled together. Revision techniques like Z-plasty can help minimize scar recurrence. Surgery provides a more permanent solution for extensive scarring.
Over-the-Counter Scar Creams
There are many non-prescription creams marketed to reduce scarring. Ingredients like onion extract, vitamin E, and centella asiatica may help improve scar texture, color, and pliability when applied consistently over time. Look for creams with silicone for best results.
Home Remedies
Some natural remedies like using aloe vera gel, coconut or vitamin E oil may also aid healing. Make sure to perform a patch test before applying anything new to your scar. Consistency is key when using home remedies.
Prevention of Deep Scars
While not all deep scarring can be prevented, prompt and proper wound care can reduce the chances of significant scarring. Here are some tips:
- Clean any wounds thoroughly with mild soap and water. Keep the area moist with ointment.
- Stitches, steri-strips or liquid bandage can help close a deep wound.
- Watch for signs of infection like increasing redness, warmth, swelling, pain or pus.
- Avoid picking scabs or reopening healing wounds.
- Use sun protection on fresh scars to prevent pigmentation changes.
- Massage fresh scars a few times a day to promote proper healing.
- Silicone scar sheets can be used soon after suture removal to minimize scarring.
- See a dermatologist early on about scar prevention options.
Prompt, proactive wound care gives you the best chance of avoiding severe scarring after any cuts, surgery or injuries.
When to Seek Medical Care
Consult a dermatologist or plastic surgeon if you have extensive scarring impacting your appearance or function. Do not try to remove scars on your own. Medical procedures should only be performed by an experienced provider. Seek medical care for:
- Very large or raised scars
- Scars that worsen over time
- Facial scarring, especially near the eyes, nose or mouth
- Scars limiting mobility or function
- Painful or itchy scars
- Keloid scars that enlarge beyond the original scar site
A doctor can help determine the best course of treatment whether topical creams, injections, laser therapy, or surgical revision. Early intervention provides the best chance of improving deep scars.
Coping Tips for Living with Scars
Though scars fade over time, learning to accept and embrace your skin can help you move forward with confidence. Some tips include:
- Remind yourself that scars show you survived and healed
- Don’t obsess over hiding scars, and allow yourself to enjoy life
- Surround yourself with people who help build confidence
- Use makeup, clothing and accessories to draw attention away from scars
- Talk to a therapist if you’re struggling with self-esteem
- Join a support community to share stories and advice
- Practice positive self-talk and be kind to yourself
Scars do not define you. Focus on your inner strengths and talents to boost your self-image. Over time, most scars fade. Consistent treatment can help improve the look of deeper scars.
Conclusion
Deep scars can be challenging to treat, but a variety of options exist to help soften and reduce their appearance. Topical silicone, steroid injections, laser therapy, and surgical excision are proven methods. Preventing scars through proper wound care is ideal. Procedures are most effective when begun early before scars fully form. With time and consistent treatment, the look of deep scars can be minimized. Though scarring may impact confidence initially, self-acceptance is important. Remember that scars do not take away your inner beauty and strength.
