How to Prevent Scars – Cleveland Clinic

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From kitchen accidents to scraped knees to surgical incisions, we all have scars with stories behind them – but most of us would rather our wounds heal without reminders of past misfortunes.

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We spoke to a dermatologist Shilpi Khetarpal, MDto find out what causes scarring and how to prevent a cut from turning into a scar.

What is a scar?

Scars come from the tearing of the dermis, our lower level of skin, which is rich in collagen – the elastic fibers that keep our skin elastic (among other bodily benefits). Scarring can occur after any injury to the dermis.

“Think of our normal collagen as basket weave, very nice and even,” says Dr. Khetarpal. “When we have a scar or injury to the skin, it triggers a healing response that can create just enough collagen, not enough, or a little more. It will always be different from the initial skin you had in that area.

Our bodies lose collagen as we age, which means older people are more prone to scarring than children. And whether a wound is likely to heal may depend on what part of your body you injured and how much blood is circulating there.

“Your face and scalp tend to heal the fastest because we have the most circulation there,” says Dr. Khetarpal, “but a cut on your foot, where the circulation isn’t as good, could take weeks to heal.”

Types of scars

Ideal scarring is minimal and light, but scars can take a variety of forms:

  • Atrophic scars: These indented scars, like those from acne or chickenpox, occur when the skin cannot regenerate enough collagen to replace the original tissue.
  • Hypertrophic scars: These scars are thick, raised, and often reddish, appearing within the boundaries of the original injury.
  • Keloid scars: Keloid scars are thick, raised scars that extend beyond the original injury. they are created when the skin makes too much collagen while trying to repair itself. Some people are genetically predisposed to keloid scars, and they are more common in black people than in other populations.

The best way to prevent scars

You cut yourself. Now what? “We want to minimize inflammation or other trauma to the skin,” says Dr. Khetarpal. Here’s how to reduce your risk of scarring:

  • Clean the wound. As soon as you are injured, clean the affected area with soap and water to get rid of any bacteria and prevent infection.
  • Keep it moist and covered. You may have grown up learning to keep cuts dry, but the opposite is true. “Keeping it moist is best to avoid a scar,” says Dr. Khetarpal. Apply petroleum jelly to your wound and bandage it to let it heal.
  • Avoid bacitracin. Resist the temptation to apply a topical ointment, as 8% of people are allergic to it, which can further inflame the area and increase the risk of scarring.
  • Minimize travel. “Each time the scar moves, it will alter the formation of a wider or thicker scar,” says Dr. Khetarapal. Give your wound time to heal by not overworking the injured area.
  • Leave these scabs alone: Scabs are our skin’s natural dressings, so keep your fingers away from them and let them do their job. Picking will only prolong your wound and prevent it from healing. Do you think you’re picking scabs while you sleep? Buy a pair of cotton gloves to wear to bed.

In summary, Dr. Khetarapal says, “The main thing is to not crust it, keep it moist, keep it clean, keep it covered, and minimize strain.”

Do scar creams work?

Silicone scar sheets can help prevent new scarring, but only if you use them in the first few weeks after an injury. And there’s no need to apply any special creams to your scars either, says Dr. Khetarpal.

Instead, it’s massaging this cream — or any simple, bland moisturizer — into a scarred area that can have the biggest impact on healing.

“During the first year, it’s important and has proven helpful to gently massage your scar for a few minutes a day,” she says. “It helps break up any scar tissue for those that are getting thick.”

The complete scar remodeling process takes a year, during which time your scar may go through different phases of appearance: redder or darker, thicker or more textured. But once you hit the one-year mark, your scar is unlikely to change much on its own.

“After you get past the one-year phase, topical medications won’t do anything,” warns Dr. Khetarpal.

Ask for early intervention

In the past, you may have been told to let a wound heal for a year and then see a doctor if you are unhappy with the result. But Dr Khetarapal says the advice has changed; now doctors can influence scar healing by getting involved as early as possible.

“If someone is worried about a scar, say they had surgery or major trauma, the sooner we intervene the better,” she says. “We can actually influence how a scar heals rather than waiting for it to heal and then trying to improve it.”

You can explore scar minimization options as early as a week after your injury (or as soon as your stitches are removed, if you have any). In-office procedures such as laser and microneedling – which trigger a controlled wound response – can reduce the appearance of scars by 50-60%.

“We can’t erase it, but we can improve it,” says Dr Khetarpal.

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