Different-types-of-scars

Different Types of Scars and How They Are Treated

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Scarring is the body’s natural response to any wound that the deeper layers of the skin. Whether the injury comes from surgery, an accident, acne, a burn, or a piercing, the body produces collagen to repair the damage — and the tissue is what we see and feel as a scar. What’s less widely understood is that not all scars are the same. There are types, each with its own appearance, biology, and best treatment approach. the right intervention starts with which type of scar you have.


This guide covers the main scar categories, what causes each one, what treatment options exist, and where each fits within the wider at Centre for Surgery’s CQC-regulated Baker Street private hospital.

The biology of a scar

Skin is made up of three layers: the surface epidermis, the dermis beneath it (containing collagen, and blood vessels), and the subcutaneous fat layer below. Minor injuries that only affect the heal without a scar — the cells identically to what was there before. Any injury that reaches the dermis triggers a different repair process, one in which the body lays down replacement collagen. This collagen is structurally different from the skin: more disorganised, less elastic, and often a different colour and . That is what we recognise as a scar.


Scar formation moves through three phases:


A scar continues to mature for 12 to 18 months after the injury. This is why scar is usually deferred for at least a year — the appearance during the first few months is not the final appearance.

Fine-line scars

The most common scar type, and the one most surgical scars become. A fine-line scar is initially pink or red and slightly raised, then fades over 12 to 18 months to a pale, flat line. The final appearance depends on the anatomical location, the patient’s skin type, the used to close the wound, and how the scar is cared for during healing.


Most surgical incisions placed by an plastic along natural skin tension lines mature into scars that are to see without close inspection. Most won’t disappear entirely, but they become a minor cosmetic feature rather than a prominent one. For full of how surgical scars mature, see .

Hypertrophic scars

A hypertrophic scar is a raised, firm, often red scar that stays within the of the original wound. It forms when the body more than was needed for repair, the scar thicker and more prominent than a typical fine-line scar. scars are most common on the chest, shoulders, upper back, and over joints — anywhere there is high skin tension. They are also more common in with darker skin types and in those with a personal or family of poor scarring.


The good news: hypertrophic scars improve spontaneously over 12 to 24 months, softening, flattening, and fading. The can be with:


For full discussion of natural history and treatment, see

Keloid scars

A keloid looks similar to a scar but behaves differently. The distinguishing feature: a keloid beyond the boundary of the wound, growing into previously skin. Where a hypertrophic scar stays within the lines of the incision, a keloid sideways into normal tissue.


Keloids are also firmer, darker, often itchy or tender, and — unlike scars — they rarely . Without treatment, many keloids persist or continue growing for years. They are most common in patients with darker skin types (Fitzpatrick IV–VI), in with a family history of keloid formation, and at certain sites including the earlobes, deltoid, chest, and jawline.


need active treatment rather than waiting:


Keloids on are a particularly common presentation. For the approach, see

Atrophic scars

The opposite of scarring. scars sit below the level of the skin — they appear as or rather than raised marks. They form when the body less collagen than was needed during healing, or when underlying fat or tissue is lost during the injury.


Acne scarring is the most common cause of atrophic scarring. Other causes include chickenpox, complications, and injuries that deeper tissue. Three sub-types of atrophic acne scars are recognised:


Different to different . For full detail on acne specifically, see , and for treatment-specific guides see , , and .

Contracture scars

Contracture scars develop most commonly after burns. As the burn heals, the contracting wound pulls surrounding skin and tissue inward, producing a tight, often shiny, sometimes thickened scar that can movement. Contractures crossing joints — the elbow, knee, neck, — can produce limitation as well as cosmetic .


Severe contractures need surgical . include Z-plasty (a of the scar to lengthen it), W-plasty, tissue expansion, skin grafting, or local flap . treatments — laser resurfacing, pressure garments, scar massage and — can help with milder contractures or as adjuncts to surgery.

Pitted and sunken scars

A category that overlaps with atrophic scarring but is sometimes considered separately. Pitted scars develop where the deeper structure of the skin has been lost — most often from severe acne, chickenpox, or some types of . They can also develop secondary to fat loss in the area, leaving a depression even where the skin looks otherwise normal.


options for pitted scars include:


Most patients with substantial pitted from several modalities — for example Morpheus8 across the affected area, TCA CROSS for scars, and targeted filler for deeper depressions. See for a detailed treatment guide.

White (hypopigmented) scars

Sometimes a healed scar ends up paler than the surrounding skin. The pigment-producing cells (melanocytes) in the area have been or lost, leaving the scar without the melanin that gives surrounding skin its colour. White scars are most common after burns, deep surgical excisions, and some inflammatory skin conditions.


These are among the harder scars to treat because complete pigment is difficult to achieve. Realistic options include laser resurfacing, Morpheus8 microneedling, controlled peels, and — in selected cases — medical (tattooing pigment into the scar to match surrounding skin). For full discussion, see

Stretch marks (striae)

Strictly speaking, marks are a form of dermal scarring — they form when the skin is stretched faster than the dermis can adapt, producing tearing in the deeper . Initially red or purple (striae rubrae), they fade to pale (striae albae) over months to years. They are most common after pregnancy, significant weight change, growth spurts in adolescence, and use.


Treatment is challenging because the damage is deep and rather than . The best evidence-based include fractional laser resurfacing, Morpheus8 microneedling, and targeted topical retinoid use on early red striae. Complete is uncommon — are in colour and texture rather than full .

Surgical scars by location

Surgical scars heal differently on where on the body they sit. The cluster of guides covering scar scenarios includes:

Treatment overview — surgical and non-surgical options

For cost information, see

Why timing matters in scar treatment

Scar treatment falls into two phases:


Active scar management — starts as soon as the wound has closed (usually 2 weeks after the injury or operation) and continues for 6–12 months while the scar is maturing. The interventions are non-surgical: silicone, sun protection, massage, and selective steroid injection for problem scars. This phase is the most window for influencing the final scar .


Mature scar revision — at 12+ months once the scar has fully . The interventions can be surgical (excision and re-closure) or non-surgical (laser, Morpheus8). The mature scar is less likely to to treatment than the maturing scar — which is why earlier intervention is preferred where possible.


The single most important thing can do for their final scar appearance is to start active scar early, not wait for the scar to mature and then try to fix it.

Factors that affect how your scar heals
When to seek scar assessment

Most scars settle without intervention if the wound was . Some warrant earlier review:


Earlier — particularly for and keloid scars — better than waiting for the scar to mature.

What we don’t recommend
Frequently asked questions

No. Scars are changes in the skin’s structure and cannot be erased entirely. What treatment can is a significant in visibility, making the scar much harder to see. For some with planned and treated scars, the final result is barely detectable without close .


The skin closes within 1–2 weeks, but scar continues for 12–18 months. The appearance during the first few months — red, raised, firm — is not the final . Most scars become significantly less noticeable between 6 and 18 months.


A scar stays within the boundary of the wound. A keloid beyond it into previously healthy skin. Hypertrophic scars often over time; keloids rarely do without active .


For most scars, yes — silicone gel or sheeting, diligent sun protection, gentle massage once the wound has closed, and good general healing all help. More problematic scars (keloids, severe hypertrophic scars, mature scars not responding to basic care) need input.


It on the scar type, location, size, and treatment chosen. treatments start from around £350 per session; scar is typically £1,500–4,000+ depending on . is available. For full detail, see


NHS funding for scar treatment is . problems (restricted movement, ulceration) may qualify; usually doesn’t. Most patients seeking scar treatment do so .


For active scar management (silicone, sun protection, massage), as soon as the wound has fully closed — typically 2 weeks after the . For surgical scar revision, usually 12+ months after the injury, once the scar has fully .


Often yes, though typically less than treatment started during the maturation window. Laser resurfacing, Morpheus8 microneedling, and can all improve mature scars; the outcome is improvement rather than complete .


Yes — patients with darker skin types (Fitzpatrick IV–VI) have a higher rate of hypertrophic and keloid scarring, and a higher rate of hyperpigmentation. Specialist and scar management matter more for these patients.


Centre for Surgery is a CQC-regulated plastic clinic at 95–97 Baker Street, Marylebone. All are by GMC-registered consultant plastic surgeons. We offer the full range of surgical and scar treatments — laser resurfacing, Morpheus8 (click for more) microneedling, injection, surgical scar revision, and combined approaches calibrated to your scar type and skin. No GP referral is .


For related guides, see , , , , , and


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