19.7 min read4981 words

Facial scar treatment | Types and the source of scars + the best treatments


Mahlagha Homayouni


July 2, 2021


What is a facial scar and how can it be prevented?

Our skin is sore from some skin diseases, surgeries, and the like due to contact with sharp things. Some of these scars are superficial and heal over time, leaving no trace, but some wounds do not, and after healing, a scar remains on our skin due to the formation of skin wounds. Here there are some tips for facial scar treatment but before that, we should know the cause and different kinds of facial scar in the first place.

Sometimes the appearance of these scars is annoying. Fortunately, in some cases, proper wound care reduces the risk of scarring. For this reason, we want to teach you tips in this short text to prevent scarring.

What exactly is a facial scar?

When your skin is damaged, your body naturally repairs the area of the injury. How this is repaired depends on the depth of the damage. If only the surface layers of your facial skin are damaged, you will probably see new skin as it heals. However, to repair the damage for deeper layers, the body creates thicker skin. This thick tissue usually turns into a scar.

The color of the new scars is reddish-pink. Over time, the scar becomes lighter or darker in color than the skin. Most scars are flat and the skin on them is wrinkled. If the body produces too much tissue, the scar will bulge. Sometimes the extra tissue that builds up in your body can lead to a scar larger than the main wound. These bulging scars are called keloids.

Sometimes you may see a sunken scar caused by a lot of skin inflammation (like acne and chickenpox). In fact, excessive inflammation destroys the skin’s collagen. This is why you often experience sunken scars when chickenpox and acne heal.


skin assessment

Chapter 1

Kind of facial scar

In order to recommend the best facial scar treatment you better know the types of scars; in general, we have three types of facial scars:

Hypertrophic scars: This type of scar is more raised than the surrounding tissues and has a raised form.

Atrophic scars: These scars are deeper than the surrounding tissue. in facial scar treatment they are called sunken scars as well.

Keloid Scars: There is a third type of facial scar that is found in some susceptible people called keloid. Keloids are actually a type of hypertrophic scar, but they go beyond the size of the wound and enlarge. It is usually more common in black people, but it is also seen in some white people.

Some areas of our body are more prone to producing hypertrophic scars. The face usually has the best skin repair and produces the least amount of scars. Conversely, the neck, front of the chest, and shoulder are very prone to hypertrophic scars. Acne scars are another type of scar that mainly occurs on the facial skin of people who have severe and purulent acne or people who manipulate their pimples.

Facial acne scar and its treatment

Acne scars are one of the most common skin problems that appear after a pimple on the skin. Acne itself is a troublesome disease and leaving it on the skin can be even more irritating. Acne is caused by fat, dead skin, and bacteria closing the pores of the skin. In the presence of acne, the pores of the skin become inflamed and eventually burst. If the filled pores burst in the deeper layers of the skin, the remaining infections will leak into the deeper tissues, causing larger lesions.

The causes of the facial scar

Scarring (scars and burns) on the skin is part of the natural healing process of the human body after damage to skin tissues. This injury can occur for a variety of reasons, including:

  • Accident injuries such as skin tears as a result of falling off a bicycle
  • Intentional damage using special tools
  • Cracks created as a result of surgery, such as cracks created during cesarean section (Caesarean delivery)
  • Bites and scratches as a result of animals or humans
  • Burns and blisters due to hot objects or liquids
  • Piercing the body; like piercing the ear or nose
  • Injections; such as tuberculosis vaccination
  • Body tattooing

Wounds and scars can also be a side effect of other skin problems. For example, if your skin gets pimples, pimples may remain on the skin after healing (this condition is most often seen when you scratch your skin at the area of the pimple).

Hypertrophic and keloid scars on the skin are often thought to have roots in our genes, some people think facial scar may run in their families and there is no treatment for it. This condition means that if a member of your family is prone to developing certain scars on their skin, you are more likely to develop these conditions. In addition, scarring may always occur in the body as a result of injury or surgery.

Does facial scar run in the family?

You may have noticed that scars (pimples) sometimes occur in family members. Although there is no specific gene to stimulate the scar on the skin, recent research has shown that genetics play a role.

Facial scar treatment

For example, genetics can determine how effective your immune system is in expelling the acne bacterium Propionibacterium (P. acnes), which is the acne-boosting bacterium. If left unchecked, P. acnes stimulates the production of fat in the follicles and causes inflammation in the skin and facial scar appears.

Hormonal conditions, such as PCOS or ovarian laziness, can also play a role in causing facial scar and acne. In fact, some hormonal disorders have been found in families due to diseases such as polycystic ovary syndrome (PCOS). Acne and facial scar is one of the most common symptoms of PCOS.

Flat facial scar and its treatment

These scars are one of the most common types of scars on facial skin that are caused by the natural healing process of the skin. Initially, the scar created in this condition can be red or dark and after the wound heals, it becomes flat and pale scars. However, over time, this scar gradually becomes flatter and more colorless. Flat facial scar treatment can take up to two years.

What can be done to reduce the scar?

There are several methods used today that are often performed in dermatological clinics under local anesthesia. General anesthesia and hospitalization are required only for the repair of severe cases such as extensive burns, but usually, facial scar treatment does not require major and complicated surgery.

New methods can change its length, width, or direction, or raise sunken scars and flatten types, but they never completely eliminate the scar, and there is no magic way to return the skin to its original condition. Surgical correction techniques can improve the appearance of the skin, but they themselves leave effects on the skin that are better than the original scar.

The most important step in facial scar treatment is consultation and an appropriate treatment plan. However, we emphasize that scars are different and each requires a specific treatment method, and often requires the patient’s patience and the doctor’s mastery of different treatment methods and adopting a suitable combination treatment program.

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Chapter 2

Facial scar treatment

Facial scar treatment takes several months and it is best to start after a few months of normal tissue repair. Facial scar treatment is not 100% and only relative recovery can be relied on. Scars heal nicely but do not disappear completely. Scar treatment is diagnosed and determined by medical examination.

Depending on the type of scar, different treatment options are considered.

Usually, before facial scar treatment starts, such parameters should be taken into account:

  • Wound condition (depth – length and width of the wound, etc)
  • Scar direction
  • Gender
  • Color of the facial scar
  • Age
  • The location of the scar

But here are some scar treatments that are useful either for facial skin or other parts of the body;


In the past, tools such as Nokor, which looked like a razor blade was used to perform subcision surgery. This was painful along with a risk of serious complications, but today we use a special device called a Subcijector and Thymycin injection, which is without pain and risk of complications.

After any injury, wound, or inflammation that takes time to heal, the tissue in the affected area may become attached to the underlying tissue, called fibrous tissue. This fibrosis pulls the skin down and gives the skin an uneven appearance.

Facial scar treatment

How and by what means is Subcision done?

In the past, ordinary needles or razor-like tools called Nokor were used, but today subcision is performed by a special tool that has a semi-sharp tip and is commonly called Subcijector.

Does Subcision have side effects?

Any method in facial scar treatment can have side effects. These include swelling and sometimes bruising, which is not a concern. The swelling usually goes away in 1 to 2 days and the bruising usually does not occur, but if it does, it goes away within a week at most.

Less common complications are damage to the arteries, nerves, and infection. If done by an experienced physician with the right technique, the risk of vascular and neurological damage is greatly reduced to zero.

The risk of infection is greatly reduced if post-surgery care is followed.


One of the new methods that has appropriate and acceptable results in treatment is microneedling. One of the benefits of microneedling treatment is a reasonable cost. It does not have a recovery period and is less complicating.

Microneedling is a method based on creating very small and microscopic holes in the skin and thus stimulating collagen production.

This method has brilliant results in facial scar treatment and skin rejuvenation. This method surprisingly stimulates collagen formation and gentle exfoliation of the skin, while also regulating the collagen and elastic fibers in damaged skin.

Microneedling is currently one of the best methods of collagen production, which has received a lot of attention due to its very low cost.

How to do Microneedling

In this method, after local anesthesia with cream (no injection is done for anesthesia) with a special device, pores and very small canals are created in the skin, forcing the skin to make high amounts of collagen, and of course if a defect such as an acne scar or burn scar is on the skin, the problem will be solved in the best possible way.

Concomitant use of Platelet-rich plasma factors (PRP) by injection or topical or mesotherapy drugs can increase the amazing results of this treatment, which is called meso needling.

Perks of microneedling

Microneedling is great for facial scar treatment and of course it has some extra benefits as follow:

  • Treatment of acne scars, surgery, and burns scars
  • Treatment of wrinkles and fine skin lines
  • Skin rejuvenation
  • Treatment of striae (Stretch marks) or skin cracks
  • Reduce the size of the open skin pores
  • Treatment of lines around the lips in smokers

What should be done after microneedling?

There may be some redness and inflammation after microneedling, which usually resolves after 24 hours, and a slight burning sensation that resolves 2 to 4 days later.

  • Preferably do not shower for 8 hours and then wash only with cold water.
  • Do not apply makeup for 48 hours and do not use colored sunscreen.
  • Avoid contact with the sun directly and in case of contact with the sun, use the appropriate volume of mineral sunscreen.
  • Use prescription creams regularly.

Injectable filler

Filler injection involves injecting a standard gel or injecting one’s own fat into the tissue, which is more commonly used in atrophic scars. The amount of gel injected depends on the size and firmness of the scar. Recovery with this method is immediate, because of that, filler injection is a proper choice for facial scar treatment for anybody.

What are the benefits of fat injection?

Fat injection – due to the presence of stem cells – can significantly reduce wrinkles and other skin imperfections and rejuvenate the skin. The injection can also create a more youthful appearance by recreating a pleasant appearance.

  • When fat is compared to other soft tissue fillers, its main advantage is that it is taken from the body and is 100% natural and there is no possibility of an allergic reaction.
  • In cases where the injection is to be performed in deep layers of more than 10 cc, the first choice is fat injection.
  • The injection may be done alone or in combination with procedures such as facelifts or brow lifts.
  • Another advantage of fat injection – in facial scar treatment – is that it is sufficient for most people to inject in the areas needed.
  • Fat is more durable than many absorbable fillers (hyaluronic acid).
  • Appropriate cost, low complication, and repeatability as often as needed.

Facial scar treatment

Fat injection steps

Fat injection for facial scar treatment is done in 3 steps:

  • Harvesting

First, the area from which the fat is to be removed is disinfected, and under sterile conditions, local anesthesia is performed, or special syringes and cannulas are used without the need for incisions and stitches (Similar to cannulas in liposuction). Then the fat is removed.

  • Refinement

The resulting fat is centrifuged, which separates the blood and other fluids from the fat, and the fat is concentrated to make it purer.

  • Transfer

The injection area is flushed with a disinfectant solution and local anesthesia is performed. Then, using an insulin syringe and special cannulas (such as Colman or Amar), fat injection is performed in different layers depending on the desired location. Eventually, the facial scar treatment ends.


Cold therapy or cryotherapy is a treatment for facial scar and acne in which very cold substances are sprayed on the skin lesion to treat the skin imperfection. Many substances are used for this purpose, the most common of which is liquid nitrogen. Cryotherapy for the treatment of many skin problems, including Actinic keratoses, viral lesions such as warts and molluscum contagiosum, and Seborrhoeic keratoses.

Facial scar treatment

Things to keep in mind when doing cryotherapy

  • For facial scar treatment – some doctors – recommend taking ibuprofen (400 mg) half an hour before the procedure to relieve minor discomfort. Some other doses of antibiotics are used before cryotherapy as a way to protect against infection. For deeper treatments, including tumors, patients should avoid taking blood thinners (Such as Aspirin) for the recommended period of time before treatment.
  • You should tell your doctor about all the medicines you are taking, including herbal supplements, and if you are allergic, especially to local anesthetics, general anesthetics or antidotes containing iodine. Your doctor may advise you to refrain from taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners for a period of time before the procedure. Women should always inform their doctor and X-ray technician if they are pregnant or not. Many imaging tests are not done during pregnancy because the fetus should not be exposed to radiation. If an X-ray is needed, precautions are taken to minimize the child being exposed to radiation.
  • Some doctors – in order to gain best result in facial scar treatment – recommend a short overnight hospital stay after the cryotherapy procedure. In the case of cryotherapy, which is performed using a large surgical incision (cryosurgery), short hospitalizations are required. Dermal cryotherapy can be done as an outpatient service, but you may need to stay overnight in the hospital.


Corticosteroid injections can be effective in facial scar treatment and some cases of colloidal, and hypertrophic scars. In this way, multiple limited injections are used into the damaged area or the wound to reduce the inflammation of the wound in order to flat it.

In this case, depending on the type of scar, the patient may need to repeat the treatment. Necessary injections in this treatment are usually done in three stages and at intervals of four to six weeks to evaluate the patient’s skin reaction to the injection.

If scar healing is observed after the necessary examinations, this treatment may be continued for several months. Note that, however, that injecting corticosteroids may not eliminate the scar or burn, but it does reduce the appearance of the remaining scar on the skin.

Using Laser for scar

Different lasers are used in facial scar treatment. Depending on the type of scar, the appropriate laser device should be utilized. Common lasers for treatment include PDL, Co2-Fractional, Erbium, etc. In some cases where the color of the scars is red and there is still an inflammatory condition, PDL laser can be used which has a wavelength of 585 nm and can be effective in fading the red color of these lesions and flattening the protruding types of scars.

Fractional method

Fractional laser technology is a leading method for treating surgical scars. In this method, laser light pulses are used to coagulate blood capillaries in wound tissue and stimulate skin collagen production to create healthy and new tissue. Recovery time is very short, the risk of infection is very low and there is little pain. It is also possible to use this method for all skin types.

Laser for atrophic scar

Atrophic scars are often caused by damage that results in the loss of a large area of tissue. With the help of non-invasive laser treatments, it is possible to heal and repair this type of scar. There are several methods, including the use of CO2 lasers to heal various types of atrophic scars, remove skin bumps, and create a smoother surface. The use of a color pulsed laser also helps to improve skin redness and reduce the thickness of scars. Q-switched lasers, on the other hand, can be used to lighten the dark skin of a wound. In some facial scar treatment the use of a combination of lasers are required.

Fillers for rough skin surfaces such as collagen and hyaluronic acid can be used to heal soft scars. In this method, there is an immediate improvement, meaning that the initial repair is visible immediately after the injection.

Laser for hypertrophic and keloid scar

Lasers are also used to improve the appearance of hypertrophic and keloid scars. Color pulsed lasers are a standard treatment for this type of facial scar and imperfection. This type of laser reduces the red appearance of the scar, smoothes the scar surface, and improves the burning and itching sensation that is usually associated with the scar.

Q-switched lasers can also help reduce the appearance of scar pigment. Although hypertrophic and keloid scars can be treated at any time, the best results are achieved when the healing process begins as soon as possible.

Skin grafting

Unfortunately, a large number of accidents, fires, and explosions cause skin damage and require transplants. A skin graft or skin transplant – as facial scar treatment – is a layer removed from a person’s skin and placed where the skin is damaged and does not heal easily. (Transplantation of healthy skin to the affected area is called grafting).

Skin grafts are used to replace damaged or peeling skin, and when the skin does not heal on its own, for example in large burns or large wounds, or in cases where the skin is lost, for example in some cancers as well as in Plastic surgery is used, but it is mostly used in the facial scar treatment.

Postoperative care in patients with skin grafts

The patient should keep the grafted area as immobile as possible and should avoid strenuous activity in the case of facial skin treatment grafts. In the case of graft on the arm, it can be immobilized with a splint. Other postoperative cares are mentioned are as followed:

  • The position should be held high when the transplant is performed on the lower limbs, as the new capillary connections are fragile and may rupture due to high venous pressure.
  • Examine the dressing daily. If there is an abnormal discharge or inflammatory reaction at the edge of the wound that indicates an infection, it should be reported to your doctor.
  • If the graft area has been recovered, the patient should take a bath while visiting the clinic and gently wash the wounds and the graft area with baby soap and water. Otherwise, the patient should not take a bath and return with the previous dressing.
  • The graft area should not be exposed to direct sunlight and if the skin graft is on the face, use sunscreen according to the doctor’s instructions.
  • Avoid any itching in the graft area and avoid being in crowded and dusty places and stay away from hot and humid places.
  • The diet should include protein such as meat, poultry, fish, and vitamins such as fresh vegetables, fruits, and plenty of fluids.
  • In order to get the best result of facial scar treatment do avoid stimulant foods such as eggplant, tomatoes, garlic, peppers, sausages and hot dogs.

Chemical Peeling

In this method, the upper layer of the skin is removed with the help of a chemical to create new skin in a place that looks smoother and more flawless and becomes uniform. This method is mostly used for facial scar treatment and is more useful for superficial scars. This method has good results in the treatment of sunken acne scars as well as chickenpox.

After that chemical peeling is applied to the skin, the skin blisters and then peels off, although chemical peels are now safer than before and are intended to remove superficial and dead skin cells, which normally lead to improves fine lines, acne, discoloration, and more benefits.

Facial scar treatment

Recent advances in chemical exfoliation methods mean that they help to deposit chemicals in the skin, such as collagen, which can reduce lines and help improve overall skin health, and beyond. The top layer of your skin is removed following chemical peeling, which increases collagen-producing cells and produces more hyaluronic acid, both of which have anti-aging effects.

Types of chemical peeling

There are many different types of chemical peeling available, some of which can only be done by dermatologists, and some can be used at home.

Light chemical peeling

Facial scar treatment is accompanied mostly by mild skin problems, but requires less recovery time. The results are usually less noticeable, especially after just one treatment, but are usually suitable for any skin color and pose a small risk of hyperpigmentation.

Medium chemical peeling

It helps to remove facial lines, facial scars, and birthmarks, but it may cause side effects that will heal. Most people will see at least some results after one treatment, but multiple treatments are usually needed for full effects. Some dermatologists now recommend soft peels, which use multiple acids instead of just one at a higher strength, as multiple acids can lead to less irritation.

Deep chemical peeling

Can be used to remove cancerous tumors, deep wounds or wrinkles, serious pimples and age spots. Deep chemical peels usually provide results with just one session; however, they can have serious side effects.

4 main and potential benefits of chemical peeling

Peeling is via a chemical that uses a solution of different chemicals. Exfoliating chemicals remove the top layer of skin and make the skin appear smoother underneath; of course, this is part of the properties and benefits of chemical peels, and other benefits include:

  • It helps exfoliate and soften the skin

One of the most common reasons people choose chemical peels is because they want softer skin with a smoother tone and texture. Peeling can not only make the skin silkier and even with more color, but it can also help the skin absorb the care products better because of the dead skin cells that are removed from the skin surface.

  • Minimizes sun damage and excessive accumulation of pigments

Light peeling can be used to treat sunspots, dark spots, freckles, facial scar treatment and pigmentation problems that age the skin.

  • Reduces the symptoms of acne and blemishes

Certain types of chemical peelings help control acne and reduce the damage caused by past symptoms. They do this by blocking pores and hitting the surface of the skin to clear blackheads, and materials that gradually give way to pimples. Light chemical peeling is considered the best one for facial scar treatment .

  • It disappears the wrinkles along with facial scar

If you are looking to fade lines and wrinkles near your forehead, eyes and mouth, then choosing a chemical peel is a good choice. Light peels may be enough to soften mild lines, while deep chemical peeling is the best option for deeper wrinkles.

Chapter 3

Facial scar treatment with surgery

This method is one of the methods for wide or deep scars. Removing and aligning the edges of the wound is a good method of treatment, which is based on the high elasticity of the skin. Deep scars can be removed and sutured again to make the scar line narrower.

Sometimes surgery can change the direction of the facial scar so that all or part of it becomes in line with the natural lines of the skin which is less visible. In the same way, they can be moved to less visible areas (such as the edge of the hairline or the junction of the nose and cheeks) so that they are not visible.

The best results in surgical correction are observed when the edges of the scar are not pressed together after removal of the scar, so the careful design of the scar removal with details of the natural lines of the skin and the direction of the muscles under the skin is necessary. The patient, the lack of skill of the surgeon, and the failure to follow the necessary instructions may make the scar worse.

New methods of injecting toxins at the suture site are used to relax the surrounding muscles and reduce pressure on the scar for better treatment results.

Facial scar treatment via tattoo!

Medical tattoos or micropigmentation (Permanent makeup) are used to remove or improve the appearance of surgeries, accidents, burns, fractures, facial scar or diseases such as segmental vitiligo and psoriasis. In medical tattoos, injecting dye under the damaged parts and scars, it makes the scars less visible and becomes more natural.

Facial scar treatment via punch excision

Punch biopsy reduces the appearance of large scars. This method changes the size, depth, and color of the scars and improves their appearance. Scars do not go away completely, but they can be minimized to reduce their visual impact.

If the scar is deep, the dermatologist may use a facial punch to improve the pores. In this method, the dermatologist removes the scars with medical cutters after local anesthesia. It then removes a skin graft from behind the ear and covers the treated area. These steps are performed separately for each scar. This method – for facial scar treatment – is very successful.

Microneedling vs. Punch biopsy

As you know microneedling is one of the best methods in facial scar treatment that is now compared with punch technique:

Microneedling is one of the classic methods of facial beauty that is less effective than new methods such as punch biopsy to treat facial scar and eliminate pimples that are deeper and have more specific conditions. On the other hand, quick treatment of facial scar and acne with face punch is more economical than this classic method. Other benefits of removing pimples, acne, and scars with a face punch include more effectiveness and better results.

The method of microneedling is that small needles create small holes all over the skin, which may further damage the epidermal layer of the skin and take longer to heal due to increased bleeding. But in the face punch method, using a large needle, the wound tissue is destroyed, therefore, less bleeding and as a result, the time required for healing is significantly reduced.

Chapter 4

Natural facial scar treatment

When the skin is damaged, the body creates a fibrous tissue known as scar tissue on the wound because it can protect the deep and inner layers and repair the skin. This process leads to the formation of excess meat. Therefore, scar tissue may form with any type of injury. Now that you have known the surgical treatment for facial scar it is time to know home-made remedy for these blemishes.

Onion juice and olive oil for facial scar treatment

The healing properties of the onion are ideal for scarring. Olive oil also has regenerating properties for skin cells. Puree a quarter of the onion, mix it with 1 tablespoon of olive oil and put it on the facial scar for 20 to 30 minutes, and then wash it off. You can use this cream twice a week.

Lavender oil to remove facial scar

Lavender oil is one of the best oils for calming the nerves, but it can be used for facial scar treatment as well. This oil speeds up the process of cell regeneration and therefore can be used for both fresh wounds and facial scars. To take advantage of the properties of lavender oil to remove facial scars, you can pour a few drops of it in water and apply it to your skin.

Use apple cider vinegar to remove facial scar

Apple cider vinegar is an antiseptic and can shrink the skin. This substance is very useful for the natural treatment of skin scars. It also gives your skin freshness.

We suggest you read:

Skin plumping | Get rid of your fine wrinkles with these solutions!

Chapter 5

Last word

In this article, we have talked about the causes of facial scar, its types, and proper facial scar treatment which is unique and medical. But keep in mind that to use any of the treatments for facial scars, you should also pay close attention to the type of your skin and the type of pimples. You can also find different methods for homemade remedies – for facial scar treatment – in this article.

Facial scar treatment


Can facial scars be removed?

Dermabrasion and laser resurfacing can make rough or elevated scars less prominent by removing part of the upper layers of skin with an abrading tool or laser light. The scar will remain, but it will be smoother and less visible.

Does Mederma really work?

Mederma Advanced Scar Gel works nicely on reducing the overall appearance of scars, eliminating redness, and improving skin texture. It doesn't work on reducing the appearance of hypopigmentation, though.

Can laser remove old scars?

Laser treatment cannot get rid of a scar. Thanks to recent advancements in medicine, lasers are becoming a dermatologist's go-to treatment for many scars. Laser treatment can: Prevent a raised scar from forming after surgery. Reduce scar pain and itch.

Is Bio oil good for scars?

Bio Oil also works as an effective scar treatment that helps improve the appearance of all scar types. It is highly effective in helping to maintain the elasticity of scar tissue on joints and other high-mobility areas.

How long is laser scar removal?

Scar removal treatments vary depending on how many areas are treated, but most treatments take no more than an hour to complete.

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