How Do Scars Form on Our Skin?

Like it or not, scars are a natural part of life, It’s hard to escape childhood without racking up at least a few cuts and bruises along the way. In order to make it easier to learn how to heal scars and how to further care for your skin, it is vital to better understand the process of skin and scarring.

More often than not, scars cannot be completely erased. Still, discoloration, surface irregularities, and other subtler flaws can be cosmetically improved upon with treatments like scar revision surgery, which offer very pleasing cosmetic results while drastically improving on any poorly healed scars.

The procedure is meant to minimize the look of a scar so that it is more consistent with surrounding skin tone and texture. A specific type of plastic surgery is performed to improve the condition or appearance of scars anywhere on the body.

Scar Formation

The skin is a sensory organ (and it has the unique distinction of being the body’s largest organ). When the epidermis is damaged, either by accident or through surgical incisions, the injury typically results in a scar. As such, scars represent the final phase of the body’s healing or repair processes. Scars are a direct result of everything from burns, surgery, skin conditions, or exposure. Even a procedure as simple as an ear piercing can sometimes cause a deforming scar or keloid.

Initial phases of the wound-healing process include control and cessation of bleeding and sealing the wound to prevent the penetration of bacteria or potential infection. The body then produces collagen to repair and close the wound. The entire healing process can be likened to human cement that is triggered by the body to fill up a hole—i.e. the wound. The resulting scar tissue has a different texture and quality than the older, surrounding tissue.

Types of Scars

There are various different varieties of scars, ranging from the more typical flat and pale-looking to more raised scars. The latter type is called a hypertrophic scar or keloid scar, and it occurs when the body produces too much collagen. Other blemishes have a more sunken or pitted appearance, occurring when underlying structures supporting the skin (like fat or muscle) are lost. Some surgical scars also have this appearance, as do some acne scars

Another classification of scars: those that occur when skin stretches rapidly, as evidenced in growth spurts or during pregnancy. This stretching phenomenon can also arise when the skin is near an overly stressed joint or experiencing increased tension during the healing process.

Best Scar Treatments

Like scars themselves, the plethora of treatment options for scars varies widely. During their early stage of formation, some scars should be vigorously massaged with a moisturizer several times a day for about one minute, as the active movement helps reorganize the not yet mature collagen bundles that are forming during the reparation of the injury. The moisturizer not only decreases friction on the tender new scar but also provides moisture to the area. Some choices such as cocoa butter and vitamin E oil are often quite effective.

One important thing to remember is to stay away from sunlight because immature scars need to be amply protected from the sun in order to prevent hyperpigmentation or becoming overly dark. 

No matter how well you care for a recent wound, scarring may be inevitable. In the case of such an eventuality, a medical procedure is required to alleviate the damage. Surgical techniques for scar revision are designed to make the scar as smooth and invisible as possible. It can involve everything from moving skin around the affected area to actually recreating the incision to make it less visible. What works best for any specific scar depends solely on where it is located and how it looks. Most of the time, surgeons will evaluate individual cases beforehand to discuss the many options for revision surgery.

Some of the most effective scar treatments available include:

  • Steroid injections: Long-term courses of steroid injections into a scar may help flatten it by helping soften the appearance of keloid or hypertrophic scars.
    • Dermabrasion: Removes the surface of the skin with special equipment and is especially useful when a scar is raised above the surrounding skin (though it is less useful for the treatment of sunken scars). Microdermabrasion, a less invasive form of dermabrasion, can also be minimally useful for very superficial scars.
    • Laser Resurfacing: Similar to dermabrasion, resurfacing removes the surface layers of the skin using different types of lasers. The advanced technology results in little downtime as opposed to traditional laser resurfacing and dermabrasion, which both require a long recovery.
    • Radiotherapy: Low-doses of superficial radiotherapy can be used to prevent the recurrence of severe keloid and hypertrophic scarring. 
    • Filler injections: Though the effects of injections are only temporary, they can be used to raise sunken scars to the level of surrounding skin. These procedures must be repeated regularly and there are many newer forms of injectable fillers now on the market that may be worth considering.
    • Surgery: Although it is not recommended in cases of hypertrophic or keloid scarring (raised scars), surgery can be used to alter a scar’s initial shape or to make it less noticeable.

The formation of scars after surgery or trauma to the skin is an inevitable fact of life that needs to be dealt with as it occurs—whether we like it or not. It is important to be proactive in regards to the treatment of scars early on in order to maximize the outcome of their final appearance.


As with any kind of surgery or scar revision, it is very important to follow the surgeon’s aftercare instructions to make sure the wound heals properly. Though some patients recover rather quickly, it’s best to err on the side of caution and take a more gradual approach when it comes to resuming your normal activities. Furthermore, depending on the surgery performed and the site of the scar, facial plastic surgeons will provide a list of activities and specific medications to avoid. It is also important to remember that scar tissue requires a year or more to fully heal and achieve maximum improved appearance.

Immediately after the procedure, expect to feel some discomfort, especially in the cases of facial scar revision surgery. Swelling, bruising, and redness are generally unavoidable, and though sutures are typically removed within days after the surgery, the skin still needs ample time to heal.

Facial plastic surgery and other forms of scar revision surgery essentially make it possible to correct any flaws in the skin that undermine self-confidence. Sometimes, even the slightest change in the appearance of a scar can help change how one feels about oneself. And like all other cosmetic procedures, teamwork between the physician and patient is always needed to help ensure an optimal result in scar revision.

Let Dr. William J. Binder, an experienced, acclaimed, and world-leading facial plastic surgeon be of help. Contact his office today to find out more about ways to address your scarring issues.