Scars: How They Form, and How to Tream Them

Scars: How They Form and How to Treat Them

Only those who battle with scars themselves will truly know how troublesome and vexing the process really is. Many seemingly promising treatments fail or are applied too late to work. That is why, in this article, we present you effective therapy options to approach the problem smartly. Before we commence with that though, another smart thing to do first is to get to know what we are fighting against.

 Exmaples of acne scars on the face and stretch marks (striae alba) on the flanks



Simply said, a scar is a connective tissue growth which is formed as a natural healing response to injury. The process of its transformation to its final state though is more complicated - it consists of three stages: inflammation, proliferation and remodeling.


  • The inflammatory stage takes up the first 3 to 5 days of healing and includes the primary immunology pathways right after the injury takes place. It contains first vasoconstriction and blood clot forming, to minimize bleeding, then the typical inflammatory response involving edema, vasodilation and thus skin redness, increased skin temperature and immune cells migration.
  • Proliferation stage, lasting from 5 to 15 days, consists of proliferation and migration of epithelial cells from the wound edges to its center to cover and establish the wound completely. Disorganized collagen III and new blood vessels are then produced.
  • Remodeling phase lasts up to 1 year and involves replacing the disorganized collagen III with collagen I which normally constitutes the healthy skin composition.

 Scar formation stages illustrated during healing process




Microneedling (e.g. DERMAROLLER)

Dermaroller allows to get straight to the proliferation stage, enabling faster and better organized new skin formation with one subtle yet essential difference - it directly lets the desired collagen be produced alongside other beneficial dermis constituents.


The roller contains less than 200 microneedles, 0.5 - 1.5 mm in length and 0.1 mm in diameter, which mildly penetrate the outer layer of the epidermis, stratum corneum, to naturally generate growth factors in deeper skin layers. This way, the synthesis of new, proper collagen, elastin and blood vessels is induced what enables total skin resurfacing and promises stunning effects.


What is important to keep in mind when choosing this option is to regularly use high sun protection, avoid sun exposure for at least 24 hours after dermarolling, make weekly intervals in between sessions and never use it on the actively inflamed skin e.g. when struggling with active acne.


Another benefit of a dermaroller is that it increases the absorption of topical therapies so it can be even more effective in combination with the alternatives presented below.

 Microneedling sample illustrating needle micro sized distributed around cylindrical roller


Steroids, both topical and in injections, have documented efficacy especially in hypertrophic scars. They minimize and flatten the scar tissue as well as reduce swelling. They should be applied in series, each a few weeks apart. We highly recommend you to refer to a licensed dermatologist before applying topical steroids.

 Steriods Chemical Structure Illustration and How They Might Help in Scars Treatment under Medical Supervision


Concentrated vitamin C solutions are helpful with reducing the size of the scars as well as improving their coloration. Vitamin C is a substance which not only actively takes part in collagen synthesis, but it also inhibits the skin pigment production in skin cells.

 Vitamin C Structure Illustrationand How That Can Be Used in Combination with Dermaroller Microneedling for Scar Treatment


The exact mechanism of improving the appearance of the scars by silicones is yet to be discovered nevertheless these compounds visibly soften and flatten the scar. Moreover, they relieve any itching and discomfort. To be effective, they should be applied on the skin for at least 4, best if 12 hours a day.



Onion extract contains plentiful of phenolic antioxidant compounds which significantly reduce the inflammatory response in the skin tissue. They also take part in the mentioned dermis remodeling what makes them an effective scar treatment option.

 Onion and its extract role in scar treatment as cosmetic ingredient


There are various laser types used in scar therapy, like fractional CO2 and Er:YAG as ablative lasers, and Er:Glass as non-ablative (and lesser results). Such lasers are the most advanced. In general terms, their mechanism of action is somehow similar - they remove the superficial layers of the skin with very precise laser beam and stimulate the lower skin layers to produce collagen and thereby treat scarring by generating new collagen and new tissues. Before the procedure, a numbing cream is applied to lessen the pain.

 Fractional CO2 Laser and Its Role in Scar Treatment





  1. Shobhit Mohan, Lalit Mohan, Renu Sangal, Neelu Singh; Dermaroller in dermatology and cosmetology
  2. Microneedling with Dermaroller; Journal of Cutaneous and Aesthetic Surgery - Jul-Dec 2009, Volume 2, Issue 2
  3. Afshan Shirkavand, Leila Ataie Fashtami, Zahra Korouria; Applied Lasers in Acne Scar Treatment: A Brief Review
  4. P. Sidgwick, D. McGeorge, A. Bayat; A comprehensive evidence-based review on the role of topicals and dressings in the management of skin scarring
  5. Iris Westra, Hth Pham, Frank B. Niessen; Topical Silicone Sheet Application in the Treatment of Hypertrophic Scars and Keloids