Reducing Scars

Prevent, reduce, or minimize scars with these tips from the skin care pros.

It doesn't take much to acquire minor wounds and scrapes. Trip over a curb, mishandle a dull kitchen knife, and before you know it you're bleeding -- and wondering, is that going to scar?

Fortunately, it’s not difficult to prevent some scars and reduce others. WebMD went to practicing dermatologists for their quick tips on how to take care of minor cuts and scrapes. Follow their advice and you may have a tale to tell about your mishap -- but without the scar to prove it.

The Best Scar Prevention: Good Wound Care

Whether you're concerned about scarring from a cut, scrape, stitches, or even a small surgical wound or acne, the best way to prevent an unsightly scar or reduce the cosmetic appearance of it is to do a good job caring for the wound. Use these three steps:

Clean out a fresh cut or scrape . Soothe and clean the wound with cool water. Then remove any pebbles or splinters with alcohol-sterilized tweezers. Gently wash around the wound with soap and a washcloth. Irritants such as harsh soap, hydrogen peroxide, iodine, and alcohol aren't good for cleaning minor wounds. In fact, these substances can actually delay healing.

Keep it covered. Covering your cut or scrape helps it heal by barring bacteria, dirt, and other irritants. It also helps keep the wound moist for the first few days, which speeds healing. You can use an antibiotic cream or ointment to help keep your wound clean and moist. Keeping the wound covered and moist helps reduce the appearance of scars.

Don't pick at scabs. Right after you get a cut or scrape, or even pick a pimple, your body starts healing the wound. White blood cells attack infection-causing bacteria. Red blood cells, fibrin, and platelets create a clot over your wound. And in no time, a scab forms. If you pick off the scab, you may not only reopen the wound and introduce bacteria, you could also create a larger scar.
Why Could a Scar Still Form?

Even if you care for a wound perfectly, you may still end up with a scar. That's because some people are just more prone to scarring and some places on the body are just more prone to scars. A wound doesn't need to be deep or severe to leave a scar.

"Scars tend to develop more frequently in areas of skin that are under tension or pull," says Valerie D. Callender, MD, a dermatologist in Maryland. For example, your chest, shoulders and back are common places for scars to form. To prevent scars in these areas, avoid upper body exercise and lifting heavy objects while your wound heals.

When scars do form, they are usually pale and flat, although some can be raised. Called hypertrophic or keloid scars, these occur when the body produces too much collagen.

Reducing Scars: What Works and What Doesn’t

Once you have a scar, there are many strategies and products for minimizing scarring. Here’s the scoop on how they work.

Sunscreen. Sun protection is vital for minimizing a scar and preventing hyperpigmentation, says California dermatologist Sonia Badreshia-Bansal, MD. She recommends a sunscreen with zinc or titanium dioxide -- blocking agents protect against UVA and UVB rays. Look for a sun protection factor (SPF) of 30 or higher. Badreshia-Bansal also suggests massaging around a wound to help prevent the development of thick scars.
Fancy creams. Skip pricey creams, says Elizabeth Tanzi, MD,a dermatologist in Washington, D.C. You'll find many creams that claim help healing because they contain vitamin E or cocoa butter, but there's no hard evidence that they work. To keep a scab moist -- and hopefully free from itch -- dab on a little petroleum jelly instead, Tanzi says.

Silicon gel sheeting. Putting a sheet of silicon gel on a scar every day may help it fade or keep it from getting worse. The sheeting is available at pharmacies or from dermatologists. Florida dermatologist Andrea Cambio, MD, says gel sheeting should be used for at least three months for best results.
Concealer.

This can be a good temporary way to make a scar go undercover. Pick a shade that is most effective with the color of your scar. "If the scar is red or pink, try a concealer with a green undertone,” Cambio says. “If the scar is brown, try a concealer with a yellow undertone. If the scar is lighter that your normal skin, pick a concealer that matches your skin tone." Cambio also suggests using a concealer that is waterproof.

Bleaching creams. These may help fade some dark scars, also called hyperpigmentation. Some hyperpigmentation is permanent, however. Ask your dermatologist for suggestions.

Injectible fillers. Injecting substances such as collagen or fat can immediately raise sunken scars. However, this treatment doesn’t last permanently and may need to be repeated.

Steroid injections. These may help flatten raised scars, but a long-term course may be needed.

Dermabrasion. This procedure uses special equipment to remove the surface of the skin, helping to reduce the look of raised scars. Microdermabrasion, a less invasive process, can help superficial scars.

Laser resurfacing. This is done two ways: The skin surface is removed with lasers, or lasers are used to work on the collagen in the dermis without removing the upper layer of skin.

Surgery. You can’t remove a scar entirely with surgery, but you can alter its size, depth, or color. Surgery isn't suggested for hypertrophic or keloid scars because it can make them worse.
Scar Prevention: When to Call a Doctor for Wounds

In some cases, special attention is needed to heal a wound well and prevent or reduce scarring. See a doctor if a wound is:

Bleeding heavily and doesn't stop after five to 10 minutes of direct pressure

Deep or longer than 1/2 inch
Located near your eye or on your face
Dirty or was caused by a dirty or rusty object
Ragged

From an animal or human bite
Very painful or shows signs of infection, such as increased warmth or tenderness around it, yellow or green fluid, redness, swelling, fever, chills, body aches, or swollen lymph nodes at your armpit, neck, or groin.