Remove scars
and Martina Feichter, medical editor and biologistCarola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.
More about the expertsMartina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
More about the experts All content is checked by medical journalists.
Removing scars or at least letting them fade is particularly indicated if they represent a visual or psychological problem for those affected or if they restrict the mobility of the body. Read more about the topic here: What helps against scars? How can the doctor treat or remove scars? What can those affected do themselves?
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. L90L91
Goals of scar treatment
Some scars are perceived by those affected as visually disturbing or represent a psychological burden (e.g. scars on the face). A scar can also affect important functions such as joint mobility. Scar treatment may be advisable in such cases. It can serve to ...
- to make the surface of the scar more supple, elastic and soft
- To reduce adhesions
- Plumping up sunken scar tissue or leveling raised scars
- fade colored scars
- Relieve symptoms such as itching, pain, or redness
- to improve the local blood circulation (and thus, among other things, to support scar healing)
There are various options for achieving these treatment goals - from massages and special ointments to scar correction using a laser or surgical intervention with a scalpel. Some procedures can (almost) remove scars, others at least relieve symptoms or improve the appearance of the scar.
In all cases, the following applies: Scar treatment takes time - it can take several months until it is fully effective.
The therapy and care measures for scar treatment should be carried out by experts, i.e. by doctors or - as prescribed by a doctor - by physiotherapists or occupational therapists. Those affected can do some things themselves (e.g. massage the scar) - preferably always in consultation with a doctor or therapist.
Methods of scar treatment
Non-surgical measures such as massages, cupping or silicone treatment can, for example, make the scar tissue more supple or make a scar less noticeable. The latter is particularly sought after with protruding scars. To do this, you can laser or grind scars, among other things. You may also try to remove scars with an operation - at least largely. 100 percent scar removal is practically impossible. Often, however, scars can be treated in such a way that they are almost invisible.
Whether and how scars can be treated depends on the type and extent of the scar. Different methods are often combined with one another.
The most important methods of scar treatment at a glance:
Light massage
Mobilizing scars using massage is a form of scar care. It relaxes and perfuses the scar tissue, making it more elastic. In addition, the newly formed tissue can align itself better as a result. In addition, scar mobilization can also alleviate any pain in the scar area.
The massage should not begin until four weeks after the wound has been closed. Often times, a physical therapist will perform them. After a short briefing, the affected person can do the scar massage himself at home.
Old scars can also be treated with a massage. Regular creaming is also recommended here: Scar ointments, creams or gels can support the blood circulation effect, make the skin more supple or reduce redness.
cupping
In the so-called negative pressure vacuum massage (UVM), the affected person is placed on the scar with suction cups, which create negative pressure. This is supposed to stretch and massage the scar. Cupping is mainly used for small scars, for example on the face or neck.
Silicone treatment
Silicone compounds can keep a wound area moist and pliable, preventing hypertrophic scars or keloids (both types of raised scars) from forming. Such preparations are available in the form of creams, gels, pillows, pads or foils. You can read more about this in the article on scar care.
Abrasion (dermabrasion)
The edges or raised parts of scars can be removed with a special grinding device. So you can make the skin surface more even. This method is often used for acne scars on the face, for example. In many cases, it can also be used to treat thickened, bulging scars.
Injections
In the case of sunken (atrophic) scars, one often opts for collagen injections. This is an important part of the fibers in the skin, bones and tendons. Sunken scars can be "filled in" with it. However, the effect only lasts for a while.
If you want to remove or reduce pathological scars - hypertrophic scars or keloids - glucocorticoid injections are an option. Glucocorticoids are colloquially summarized under the term cortisone. You can reduce excessive scar growth. The glucocorticoid triamcinolone (TAC) is most commonly used for scar treatment. If necessary, the injections are repeated at intervals of several weeks.
Injecting glucocorticoids into scar tissue is painful.
Icing (cryosurgery)
Freezing - medically called cryosurgery - is a form of cryotherapy (cold therapy). It is suitable for treating protruding scars (keloids, hypertrophic scars). The scar tissue is frozen with liquid nitrogen. This is sometimes only done for a short time in order to make the subsequent injection of cortisone (see above) less painful.
In other cases one opts for intensive freezing. The scar tissue freezes through completely, dies and is then removed. The procedure usually has to be repeated every four to six weeks until a raised scar (keloid, hypertrophic scar) is leveled. The treatment is preferably carried out in combination with glucocorticoid injections (more precisely: TAC injections).
Pressure treatment
Pressure treatment reduces the local blood flow in the smallest vessels (capillaries), accelerates collagen maturation and can thus flatten a freshly protruding scar (keloid, hypertrophic scar).
To do this, the scar is placed under constant pressure - usually with elastic textile fabric (e.g. compression suit, stocking, bandage), sometimes with transparent plastic masks or snaps. Pressure should be maintained around the clock for six months to two years, depending on the scar.
This complex method of scar treatment is recommended, for example, for large-area hypertrophic scars (e.g. after burns). It can also be used preventively after an operation if the patient is known to have a tendency to develop hypertrophic scars or keloids.
Laser treatment
In some cases, patients have their scars "lasered away". Various laser technologies are available for this. The basic principle in all techniques: The high-energy laser light causes heat damage (thermal damage) in the tissue.
This is used in an ablative laser treatment to remove keloids or hypertrophic scars: The laser is used to remove the protruding tissue layer by layer (the term "ablative" comes from the Latin word for removal or removal).
A non-ablative laser treatment must be distinguished from this. This can be used, for example, to remove a strong red color from scars. For example, a so-called dye laser is used for this. Alternatively, the "Intensed pulsed light (IPL)" technique can be used for this purpose for laser cutting.
Microneedling
In this form of scar treatment, the scar tissue is pierced with many small needles (arranged on a roller or a punch). The tiny injuries set in motion a cascade of wound healing that can ultimately improve the appearance of the scar - among other things by stimulating the formation of collagen.
In some cases, active substances are administered through the resulting puncture channels. This is known as "needling-assisted drug delivery".
Microneedling (with or without the administration of active substances) can be used to treat hypertrophic scars, especially those caused by burns or scalds. Before the treatment, the patient is given a local anesthetic or - in the case of extensive scars - anesthesia.
surgery
An operation is not carried out on fresh scars, but can be considered after a year at the earliest - before that, a scar can recede on its own. The surgeon can completely or partially remove scars. The resulting wound is sutured or covered with a skin graft.
Surgical scar treatment can be carried out, for example, if scars disfigure the person concerned (e.g. noticeable scars on the face) or restrict mobility (e.g. scars on joints). Scars that lead to growths due to tension, as well as pathological scar formation, can also make surgical intervention necessary.
Further treatment often follows after the operation. After the keloids have been cut out, radiation (radiation therapy) can be applied to counteract new cell growth and inflammation processes.
Scar Treatment: Home Remedies
First things first: You cannot remove scars with home remedies. You can use it to make the scar tissue more supple or to counteract excessive new tissue formation. In this sense, for example, marigold ointment and onion extract are suitable home remedies for scars. You can find out more about the topic in the article Scar Care.
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