After a wound has healed the scar is commonly red and in some cases raised. This is a normal phase of the skin’s recovery process and most scars will turn into a more skin-like color eventually.
Read on to find out how to reduce this scar redness how smoothen it, and how to prevent the scar from becoming raised. The advice given here is based on my experiences and on clinical trials and studies. Only proven treatments are recommended and some myths are debunked.
How To Reduce Scar Redness
The best remedy are silicone scar treatment sheets and in lesser amount (liquid) gels. These products are the golden standard in scar treatment.
Originally used by burn centers and later on cosmetic surgeons and hospitals, silicone sheeting is a clinically proven, effective over the counter treatment for red and raised scars.
Reduce Scar Redness with Silicone Patches
the best product to fade scar redness
I have used these patches myself on several types of scars. Mostly surgical and scars from cuts. These patches have to be applied daily for a minimum of 12 to 14 hours (preferably up to 24 hours) and this for several weeks at least.
For the optimal result a treatment of months may be needed. This may seem cumbersome (and to be honest, at times it is) but the sheets do actually work. My scars did improve and the redness was already reduced considerably after a few weeks.
Causes of Scar Redness
Scars can be red, itchy, elevated, indented, firm, contracting and even growing out of the original wound boundaries. Many red scars are so called hypertrophic scars. More on this type later.
Especially surgical scars can be red (erythematous) This has partially to do with the depth of a surgical incision.
How does a scar get red?
Initially, all scars are red. This is due to the healing process which involves the creation of new tissue and cells. In order to do so the body forms extra blood vessels which purpose is to support this new scar tissue. There is also an increased blood flow to aid this process which also adds to the red color.
How long will scars stay red?
This will take from about 9 months till up to 18 months. Scars in children tend to stay red for a longer period. It also depends on skin type, genetics, race, life style, and other factors.
How to reduce the red color of scars quickly?
Well, the answer is that it depends on what your definition of quick is. It can be done in a few weeks but this depends on various factors such as location on the body, skin type, general health, genetics, whether or not someone smokes tobacco, and more.
Clinical trial shows scar redness fades on average at 7 months.
Silicone Patches and Gels Reduce Scar Redness
Several studies have shown this to be the most effective product to use on red scars. (works also relatively well on other types such as keloids, burn and other raised scars)
The patches decrease the scar’s visibility by reducing the redness and thickness making it more skin color, flat and soft. They induce a decrease of redness and pain or itch almost immediately. This over the counter treatment often works whereas other conventional therapies do not.
“86% to 94% of scars treated with silicone sheets improved in appearance and elasticity within two months, compared with only 12% of untreated scars.
At two months and six months, the skin of the treated scars was significantly more extensible than the untreated scars.”
(Burns-1994 – Carney S.A. et el)
Reduce Scar Redness Tips
Here are some tips on how to reduce the redness of your scar and how to avoid it becoming even more red.
- Keep the scar out of the sun at all times. Newly formed scars are very sensitive to sunlight. Sunlight radiation will make the scar more red and is also in other ways detrimental to its appearance. Use a sunscreen of minimal SPF 30 and cover the scar as much as possible by clothing or plasters. Keep in mind that many clothes do not provide much protection against sunshine. A simple white cotton t-shirt only has a SPF of 10 or less.
- Massage the scar. Only when the wound has closed completely and always gently and carefully.
- Keep the scar warm
- Hydrate the scar. Internally by drinking enough and externally by using a petroleum based emollient (Vaseline)
- Use silicone gel patches or creams. (creams are less effective than patches)
If you have a new scar it’s understandable you are searching for a quick fix. You have to deal with an unwanted, disfiguring part of your body that wasn’t there before.
But reducing scar redness quickly isn’t possible. It will at least take a few weeks and possibly longer. So keep in mind to be patient and with the right measures the scar’s appearance will be reduced.
Redness of most scars will fade over time but not always. Treatment can be beneficiary in some cases.
Making sure a wound heals optimally is one of the most effective ways to prevent and control scarring.
Hippocrates (c 400 BC) already recognized the importance of taking active care of a wound. He adviced:
“Healing is a matter of time, but it is sometimes also a matter of opportunity.”
Prolonged or excessive wound inflammation might result in raised, thick, red scars. Studies indicate that inflammation may delay healing and result in increased scarring. (you can recognize inflammation when a the surrounding skin of a wound is red and elevated.)
there is substantial evidence that inflammation is an essential prerequisite for scarring
Inflammation can be prevented or at least kept at bay by keeping wounds in a moist and sterile environment. Research has shown this to be the most advantageous circumstances.
Scar Tissue and Sunscreen
why protect scars from direct sunlight
Fresh scars (up to 18 months) are susceptible to damage from ultraviolet radiation present in sunlight. The collagen structure can be altered and increased, elastin hardened and hyperpigmentation will occur.
In other words, not protecting your new scar from the sun might lead to a more discolored (red and eventually even purple) as well as a thicker and harder scar.
Sunscreen or sun block creams protect scar tissue from ultraviolet radiation.
Scar Massage and Redness
massage carefully and regularly
There are several scar massage techniques known to reduce scars. Important is to always apply gentle pressure and massage very carefully. When the scar tissue gets more red than before massaging it is recommended to stop the massage.
I liked to use an ointment when massaging my scars because it made it less uncomfortable. It depends on the person as well as the type of wound and scar but my scars did hurt when touched.
For some parts, especially the part of the scar on the middle of my chest, this discomfortable feeling maintained up to more than a year after surgery. By using a cream or lotion the process of massaging feels smoother, the tissue tends to get red less quickly and you also hydrate the tissue which seems to be an important factor in scar reduction.
studies show Vaseline to be an effective moisturizer
Among the few measures known to aid in reducing scar redness and improving its overall appearance is scar hydration.
Although many products are claimed to be the most effective moisturizers research has shown petrolatum based ointments (e.g. Vaseline) to be the most affordable option.
Studies show moisturizing scars helps decreasing itching, pain, and contraction.
…..as a result, it is to be expected that moisturizers may improve the signs and symptoms of scars.
several studies are reported in this review that demonstrates that moisturization is a key component to reducing the clinical signs and symptoms of scars and striae.
Scar Hydration With Manuka Honey Dressings
If there’s one natural remedy which skin care benefits can’t be overstated it’s manuka honey. Much research on its unique abilities has been done the past decades and is still ongoing.
Extremely problematic wounds such as those infected with the nearly unbeatable MRSA bacteria are cured with this honey. Treating these wounds with manuka honey has two benefits.
- it helps to kill MRSA and other superbugs,
- it can also prevent bacteria from becoming resistant to antibiotics.
Professor Liz Harry, of University of Technology Sydney, said:
‘Manuka honey should be used as a first resort for wound treatment, rather than the last resort, as it so often is.’
Apart from that it has very potent hydrating properties. It is not a proven effective scar redness remedy but it does enhance wound healing and experts suspect it may help scar healing. Since it has such potent hydrating properties it is likely to help reduce scar redness.
Manuka honey boosts wound healing and may possibly aid scar improvement as well.
Keep Scars Warm to Reduce Redness
increased temperature reduces scars
Originally this was concluded after researching pressure therapy. Directly after wound closure pressure garments are applied to the scar.
It is thought the pressure decreases blood flow in the tissue among other effects. One of these effects is the increase in scar tissue temperature due to the tight garment weave.
This increased temperature, even by 1°C, will significantly increase collagenolysis and scar maturation studies have shown. Thus the use of for example heating packs or paraffin are considered a useful treatment modality.
Pressure therapy in general shows to be effective but not as effective as the use of silicone gel dressings. Source:rehabpup
Reduce Scar Redness with Zinc Tape
A 1982 study among 41 persons reported a reduction of scar redness using adhesive zinc tape in all patients.
Keloid and hypertrophic scars from 23 of the 41 patients turned out to be “reduced to the level of the surrounding skin”. Also itch was decreased in all patients who complained about itch and had disappeared completely in half of them.
Zinc is known to stimulate the process that reduces excessive scar tissue growth. (collagenase)
I’m not sure about cream. It seems to me it has the same action as zinc tape but zinc also has a moisture repelling action. So I am not sure if this interferes with scar hydration which is known to be a beneficial scar reduction factor. Also tape has a function itself. Paper tape for instance is used to reduce tension on the fresh scar thus preventing scar widening.
The Hypertrophic Scar
red, elevated and sometimes painful
Some scars will fade eventually and become a thin white line. This is not always the case. Many people tend to develop problematic scars. Whether someone is prone to this depends on race, (dark skinned people have a higher risk on hypertrophic scarring), genetics, life style and habits, and the location on the body.
Hypertrophic scars usually start to appear 4 to 8 weeks after wound closure.They are results of overproduction of scar tissue. Hypertrophic scars are most likely to develop in case of deep wounds (such as surgery wounds) and burns. (source)
The center of the chest, where I had a hypertrophic scar a few years ago, is a very delicate part of the skin which needs extra care in order to prevent problems.
Hypertrophic scars are elevated and can take the form of a red raised lump on the skin. They do not grow beyond the boundaries of the original wound such as keloids and their appearance often improves after a few years. Hypertrophic scars can sometimes cause contracture. This can lead to limited movement and can be painful.
You could say hypertrophic scars are the opposite of atrophic scars which are indented / depressed.
The Keloid Scar
benign expanding scar tissue
Keloids are non malignant tumor type scars growing out of the original boundaries of the wound area. They are caused because the body does not stop creating scar tissue. Keloids are hard, raised and permanently red. Although they are not dangerous they are perceived as unsightly by many. Treatment can exist of silicone patches but if these don’t work (in the more extreme cases) other measures can be taken. More about this later.
Hypertrophic vs Hyperpigmented Scars
Hypertrophic scars are red, raised, bumpy, and may cause pain or itch. Hyperpigmented scars are not necessarily red but more often dark colored. E.g. brown or other tints. The latter have another cause which results in overproduction of melanin (skin pigment).
In order to define the optimal mode of treatment it is wise to make a distinction between these two types. Here’s more info on thethe best cream for scar lightening based on whether a scar is hypertrophic or hyperpigmented.
It takes about 12 to 18 months for a scar to mature. This means it is in its final state and will probably have become less noticeable.
Scar Redness will Fade in Time
two phases of natural scar healing
The natural, the body’s own, scar healing process consists of two stadia. The immature and mature phase
The immature phase starts directly after a wound has closed. At this point it is no more a wound but a scar. During this period a scar will evolve. Many scars improve naturally while others tend to worsen. They might get sensitive, itchy or painful. New scars are commonly red but can also be thickened, raised and hard.
When a scar is in its final state, which means it has stopped evolving and collagen production has ended it is considered a mature scar. It will take up to 18 months for a scar to get mature although for smaller, less severe scars this will be a shorter period.
Does Mederma Help Reduce the Redness of my Scar?
onion extract creams not effective
Conclusion of several studies have shown hydration of scars to be an important factor in reducing redness and improving overall appearance. This can be achieved with topical petrolatum-based ointment such as Vaseline.
There seems to be no need for dedicated (mostly more expensive) scar ointments. So although Mederma is a very popular cream for scar treatment its efficacy isn’t backed by substantial clinical evidence.
“no statistically significant difference between pre- and posttreatment evaluations of scar erythema and pruritus in patients using topical onion extract gel was found. A statistically significant reduction in scar erythema was found in patients using a petrolatum based ointment.” source:Wiley Interscience
One study on rabbits showed some benefits of onion extract on scars. A report of this study can be found here.
Can Vitamin E Help Reduce the Redness of your Scar?
topical vitamin E can cause allergic reactions
Of the different studies conducted on vitamin e and scar redness none have shown efficacy. In fact dermatologists and other medical personnel discourage this home remedy because the same studies did show the topical use of vitamin e capsules did in fact cause skin irritations such as a so called generalized erythema multiforme reaction. (redness, itch and rash)
The Best Cream For Scar Redness
reduce scar redness with silicone cream
I have used both silicone patches and gels. Some studies state that patches are more effective while others say that ointments are just as good. For locations on which patches are hard to keep in place such as the face I would use a cream such as Kelo-cote. For other locations I would personally choose patches, just to be sure.
Kelo-cote is probably the most well-known, very well reviewed silicone cream. After application the gel dries and forms a thin film which covers the scar tissue.
Best Cream To Fade Dark Scars
Although I haven’t used this cream myself I think InviCible Scars is the best cream to fade dark scars. Invicible scar cream is fairly new but already awarded for its efficacy and safety of use.
It contains proven effective, safe ingredients such as stable vitamin C and licorice extract. Apart from that it also contains silicones which is another proven effective scar reducing agent.
For raised, red scars I recommend silicones. For dark, red, or otherwise discolored scars I recommend Invicible.
Image skin layers: Wikimedia Commons.