I’ve always loved the quote, “Chicks dig scars,” especially when it came from Keanu Reeves. It’s something I still say to my grandsons when they show up with their latest scrapes and bruises. It brings a sense of bravery and lightness to the marks we collect in life.
But not all scars tell fun or fearless tales. Some remind us of moments we’d rather forget—accidents, surgeries, breakouts, or deeper trauma. Wrinkles, in a way, are scars too—etchings of time and experience. Whether they’re physical or emotional, scars mark our journey.
Lately, I’ve been receiving more and more questions about scars:
Can they be improved? Can we fade them? What are the safest, most effective treatments?
The answer is yes—but not without proper evaluation. Every scar is as unique as the person wearing it. That’s why I’m launching a mini-series on aesthetic scar treatment, starting with this foundational guide to help you understand what you’re working with—before you decide how to treat it.
🛠️ Step 1: Identify the Type of Scar
Scar Type | Appearance | Best Treatments |
Atrophic (pitted) | Depressed or crater-like (e.g., acne, chickenpox) | Microneedling, PRP, Subcision, Laser Resurfacing, Fillers |
Hypertrophic | Red, raised, thick within wound borders | Silicone gel, Steroid injections, Laser, Microneedling (gentle) |
Keloid | Raised, thick, extends beyond original wound | Steroid injections, Silicone sheets, Cryotherapy, Surgery |
Contracture | Tight, shiny, may restrict movement (burn scars) | Surgery, Laser, Microneedling, Physical therapy |
Stretch Marks (Striae) | Thin, streaky, pink/red/white | Microneedling, Peels, Radiofrequency, Topicals |
Post-Inflammatory Hyperpigmentation (PIH) | Flat, dark marks from acne or trauma | Peels, Brightening topicals, Microneedling with serums |
🎯 Step 2: Assess Key Characteristics
- Age of the Scar
- New scars (<1 year): Respond well to topicals, LED, microneedling, silicone
- Mature scars: May require deeper work—laser, subcision, fillers
- Color
- Red/pink = Active inflammation → Try calming serums, LED, steroids
- Brown/dark = PIH → Brightening agents + strict SPF
- Depth & Texture
- Shallow = Peels, microneedling, topicals
- Deep = Microneedling + PRP, subcision, laser
- Location
- Face: Requires gentle, pigment-safe options (enzyme peels, microneedling, PRP)
- Body: Thicker skin tolerates deeper modalities (RF, deeper peels, fractional laser)
🌈 Step 3: Consider Skin Tone
For Fitzpatrick Skin Types IV–VI, choose melanin-safe options:
- Avoid high-heat lasers
- Use microneedling, enzymatic peels, and non-inflammatory protocols
- Always prioritize sun protection post-treatment
🧬 Step 4: Lifestyle & Healing Factors
Ask:
- Is the client consistent with homecare?
- Do they have a history of hyperpigmentation?
- Are they outdoors frequently?
- Can they manage downtime?
- Are they using topical prescriptions (e.g., tretinoin, steroids)?
These insights shape realistic, safe treatment plans.
🔧 Step 5: Match Treatment to Scar Type
Quick reference:
- Flat, red or dark marks → Brightening peels, LED, microneedling with tyrosinase inhibitors
- Indented scars → Microneedling + PRP/exosomes, subcision, fillers
- Raised scars/keloids → Silicone, steroid injections, cautious microneedling
- Stretch marks → Microneedling, glycolic/lactic peels, collagen support
📸 Step 6: Track Progress
Use consistent before/after photography, check every 4–6 weeks, and tweak the plan based on skin response. Patience and consistency win.
💡 Pro Tip:
Combination therapy is key. Most scars won’t fully resolve with one modality. Pair clinical treatments with consistent home care:
- Hydrating serums
- Growth factors
- Silicone gels (for raised scars)
- SPF every day
Final Thoughts
With over 40 years in aesthetics, spa, wellness, and plastic surgery support, I’ve seen firsthand how healing the appearance of a scar can empower someone deeply. Whether it’s a facial acne scar or a post-op reminder, we have tools to soften the edges—physically and emotionally.
Your scar doesn’t define you. But if you’re ready to change the story it tells, I’m here to help guide the way.
Disclaimer: I am a licensed aesthetician and massage therapist with over 40 years of experience. This content is for educational and inspirational purposes only. Always consult your state board, physician, or supervising medical provider before initiating advanced scar treatments.