Scar Revision: Improving Skin Appearance and Comfort
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: What is scar revision?
Scar revision is a medical or cosmetic treatment that improves the look and feel of scars from injuries, surgeries or skin conditions by addressing their color, texture and size. [1] Methods include silicone gels, injectable medicines, skin resurfacing and surgery. [1] Most scars need 12 to 18 months to mature before revision is considered, because new scars respond poorly. [1]
What the research says
Silicone gel improves scars after surgery. A meta-analysis of 6 randomized trials (375 patients) found that silicone gel reduced scar pigmentation, height, and stiffness compared with placebo or no treatment, and that gels and gel sheets worked about equally well (Wang et al., Int Wound J, 2020) [4].
Silicone is better supported than other over-the-counter scar products. A systematic review of 34 trials (16 on silicone gel sheets) found that silicone gel products prevented pathologic scars and improved mature scars, while only a limited number of studies supported onion extract, vitamin E, trolamine, or microporous tape (Tran et al., Dermatol Surg, 2020) [5].
Combining laser with other treatments works best for acne scars. In a network meta-analysis of 68 randomized trials (4,480 patients), laser combined with platelet-rich plasma ranked best for reducing scar severity scores, laser combined with chemical peels ranked best for patient satisfaction, and microneedling was the best tolerated for pain (Wu et al., PeerJ, 2025) [6].
What Is Scar Revision?
Scar revision refers to techniques that reduce how noticeable a scar is. A scar is the mark left on the skin after a wound has healed. [1] [3] The main goal is to help the scar more closely match the color and texture of the surrounding skin. [1] [3] It will not completely eliminate the scar, but successful revision can improve both appearance and comfort. [1] Scar revision is usually cosmetic, but severe scars can be painful or limit how the body works, and those scars need medical treatment. [1]
Who considers scar revision?
Anyone with an unwanted scar may consider scar revision. Common causes of scarring include:
Acne (see our guide to acne scars). [1]
Burns from accidents or radiation therapy (see our burns guide). [1]
Cesarean birth, cleft lip repair, and other surgeries, including cosmetic or reconstructive surgery. [1]
Piercings, skin infections, and traumatic injuries. [1]
What are the common types of scars treated with scar revision?
Scars can take several forms depending on how the body heals and what caused the injury. The type, location, and cause of the scar are important for choosing the right revision method. [1]
Scar Type | Physical Characteristics | Common Causes |
Hypertrophic | Thick, raised, and often red; stays within the original wound boundaries. | Surgery, burns, or injury. |
Keloid | Piercings, infections, injuries, or a genetic tendency. | |
Atrophic | Depressed or sunken below the skin surface; may look pitted. [1] | Acne, chickenpox, or certain infections. |
Contracture | Tight scar that pulls the skin together and can restrict movement. [3] | Large tissue loss, such as burns, or wounds that cross a joint. [3] |
Keloids can also form on the back of the neck, as in acne keloidalis nuchae.
How do you prepare for scar revision, and when should it be done?
Your healthcare team will explain how to prepare for scar revision, and timing matters because most scars need time to mature first. You may be asked to:
Eat a diet rich in minerals and vitamins, especially zinc and vitamins A, C, and E, to support wound healing. [1]
Quit smoking, because tobacco use can prevent wound healing (see our guide to nicotine replacement therapy). [1] To learn how the body repairs tissue, see our article on fibrin.
Stop taking anticoagulants (blood thinners) if your provider tells you to. [1]
People with diabetes or those taking immunosuppressants may need special instructions. [1] If you take isotretinoin or other medicines for severe acne, you may need to delay treatment. [1]
Timing matters. Most scars need 12 to 18 months to mature, and new scars do not usually respond well to revision. [1] Surgery on a scar that is still changing often does not give the best result.
What techniques are used for scar revision?
Scar revision has four main categories of treatment, ranging from simple topical products such as silicone gel to surgery.
Topical treatments
Topical treatments are applied to the skin, with no needle or cut. They work best while a wound heals or on mild, newly formed scars. [1]
Silicone gel: Flexible silicone gel sheets or gels can relieve redness, itching, and irritation and help prevent raised scars. [1] [5]
Polyurethane dressing: A self-adhesive pad can reduce a scar’s hardness and size and help it return to a normal color. [1]
Pressure therapy: A bandage or wrap applies pressure to a healing wound or new scar and may reduce raised scars. [1]
Most people need to use topical treatments 12 to 24 hours a day, sometimes for several months. [1] Vitamin E or A creams, gels, and oils are sometimes recommended, but research on them is inconclusive. [1]
Injectable treatments
Injections are most effective for raised scars and keloids, and most people need more than one. [1] They can reduce a scar’s size and ease pain, itching, and irritation. [1]
Corticosteroid injections: Reduce collagen formation, which can shrink and soften a scar. [1] [2]
5-FU or bleomycin injections: Cancer drugs that stop cell growth and may prevent the skin from making new tissue in the scar. [1]
Cryotherapy: Liquid nitrogen or argon gas freezes scar tissue so that it dies. It is usually reserved for small scars. [1]
Dermal fillers: Help scars that sit below the surface, such as acne scars and pockmarks. [1]
Skin resurfacing
Resurfacing removes the top layers of skin to reveal smoother tissue underneath, which can improve scar color and texture. [1]
Chemical peels: Best for mild scars, usually on the face. [1]
Dermabrasion and dermaplaning: Sand or shave away the upper skin layers. [1] [2]
Light or laser therapy: Uses light or heat to trigger skin cell turnover and can help scars return to a normal color. [1]
Microneedling: Creates tiny punctures that encourage the skin to remodel. [1]
Skin bleaching: Lightening products may reduce the look of scars. [1]
Surgery
Surgery may be needed for large, severe scars, especially if they cause pain or limit movement. [1] The surgeon cuts out the scar and closes the wound with stitches. [1]
Z-plasty and W-plasty: The scarred skin is cut into a “Z” or “W” shape, which gives the area more movement once it heals and can place the scar along natural skin folds. [1] [2]
Skin grafts: Used when there is not enough healthy skin to close the wound, and a common treatment for serious burn scars. [1]
Your provider may also recommend injections or topical treatment after surgery to help the new wound heal and reduce the risk of more scarring. [1]
Treatment Category | Common Methods | Best Suited For |
Topical | Silicone gel, pressure therapy, polyurethane dressings. | Redness, itching, and newly formed or mild scars. [1] |
Injectable | Corticosteroids, 5-FU or bleomycin, cryotherapy, dermal fillers. | Raised scars, keloids, and some sunken scars. [1] |
Resurfacing | Laser therapy, chemical peels, microneedling, dermabrasion. | Texture improvement and color correction. [1] |
Surgical | Z-plasty, W-plasty, skin grafting. | Large scars, restricted movement, and severe burns. [1] |
What are the risks and benefits of scar revision?
The risks depend on the type of treatment. Topical treatments carry the fewest risks, mainly mild discomfort or a skin rash. [1] Injections and resurfacing can cause redness, swelling, blistering, and sensitivity to sunlight, and they can change the scar’s color so that it looks darker than the surrounding skin. [1] Surgery carries the most risks, including infection, bleeding, the scar coming back, or a new scar forming. [1] [2] Protect healing skin from the sun (see our guide to sunburn).
Scar revision can improve a scar’s color, size, stiffness, texture, and thickness, and reduce discomfort. [1]
What is recovery like after scar revision, and what results can you expect?
Recovery depends on the treatment. Topical treatments can take several months to show results but need little downtime. Most people need several injections or resurfacing sessions to reach their goal, and recovery after surgery can take weeks or months. [1] Follow every post-treatment instruction to prevent complications. Revision is unlikely to remove a scar completely, so discuss your goals with your provider to set realistic expectations. [1] Some providers combine revision with treatments such as platelet-rich plasma. [6]
When to call your provider
Contact your healthcare provider if the scar or the skin around it is bleeding, blistered, infected, or severely swollen. [1]
Conclusion
Scar revision offers helpful options for people who want to improve how a scar looks or feels. By using the right mix of modern techniques, many people can get a more natural result. A healthcare professional can help you choose the strategy that fits your scar, your health, and your goals.
What are the next steps if you are considering scar revision?
If you are thinking about scar revision, first let your scar mature, since most treatments work best after at least a year of healing. Prepare for a consultation by noting symptoms such as pain or itching and by being ready to discuss your medical history, medicines, and chronic conditions. Good nutrition and avoiding tobacco will help your recovery.
Trusted resources: Cleveland Clinic: Scar Revision, American Society of Plastic Surgeons: Scar Revision, MedlinePlus: Scar revision.
Frequently Asked Questions
Can scar revision completely remove a scar?
No. Treatment can improve how a scar looks and feels, but it will not completely eliminate it.
How long should I wait before seeking scar revision?
Most scars need 12 to 18 months to mature, and new scars do not usually respond well to revision.
Are topical treatments effective for old scars?
Topical products tend to work best on mild, newly formed scars or while a wound heals, but silicone products have also been shown to improve mature scars.
Does scar revision surgery leave a new scar?
Yes. Any surgical cut creates a scar, but the goal is a new scar that is much less noticeable than the original.
What is a keloid scar?
A keloid is a large, lumpy, raised scar that grows beyond the edges of the original wound.
Is laser therapy painful?
Some discomfort is possible. Ask your provider how it will be managed for your treatment.
Can diet affect scar healing?
A diet rich in minerals and vitamins, especially zinc and vitamins A, C, and E, supports wound healing.
What is Z-plasty?
A surgical technique in which the scarred skin is cut into a “Z” shape. It gives the area more movement and can place the scar along natural skin folds.
Are there risks with steroid injections?
Injections can cause redness, swelling, and changes in skin color, and they can make the scar darker than the surrounding skin. Ask your provider about the risks for your treatment.
Can acne scars be treated with revision?
Yes. Microneedling, chemical peels, laser therapy, dermabrasion, dermaplaning, and dermal fillers are commonly used for acne scars.
Do I need to stop smoking before treatment?
Yes. Your provider will likely ask you to quit smoking, because tobacco use can prevent wound healing.
What is cryotherapy for scars?
Cryotherapy for scars uses liquid nitrogen or argon gas to freeze scar tissue so that it dies. It is usually reserved for small scars.
Will insurance cover scar revision?
Scar revision is usually cosmetic, but severe scars that cause pain or limit movement may need medical treatment. Check coverage with your insurer and provider.
How long is the recovery after scar revision surgery?
Recovery after surgery may take weeks or months, depending on the procedure. Your provider will give you instructions for your case.
What are atrophic scars?
Atrophic scars are sunken or pitted scars that sit below the surface of the surrounding skin, often from acne or chickenpox.
Related Reading
Breast Reduction Scars: Healing Timeline, Types and Treatment explains how breast reduction scars heal.
References
Cleveland Clinic. Scar Revision. Cleveland Clinic. January 31, 2023. https://my.clevelandclinic.org/health/treatments/24670-scar-revision
MedlinePlus. Scar revision. National Library of Medicine. May 6, 2025. https://medlineplus.gov/ency/article/002991.htm
American Society of Plastic Surgeons. Scar Revision. American Society of Plastic Surgeons. Accessed October 7, 2026. https://www.plasticsurgery.org/reconstructive-procedures/scar-revision
Wang F, Li X, Wang X, et al. Efficacy of topical silicone gel in scar management: a systematic review and meta-analysis of randomised controlled trials. Int Wound J. 2020;17(3):765-773. PMID 32119763. https://doi.org/10.1111/iwj.13337
Tran B, Wu JJ, Ratner D, et al. Topical scar treatment products for wounds: a systematic review. Dermatol Surg. 2020;46(12):1564-1571. PMID 32932267. https://doi.org/10.1097/DSS.0000000000002712
Wu B, Gao M, Zhang Y, et al. Optimal treatment options for acne scars in patients with historic acne: a systematic review and network meta-analysis. PeerJ. 2025;13:e19938. PMID 41081097. https://doi.org/10.7717/peerj.19938
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.
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