Once there is a scar, it is forever. Generally, it will blend into the normal skin creases so that it is hardly noticeable. Most scars reach this point six months after surgery. It can take up to two years for some severe scars to fully develop.
After a scar is first formed, the body continues to touch up its work where it can - which is why scars fade slightly over the years when left alone. But scar tissue does not get replaced by this process2, which means that most scars, when left to heal naturally, will never fully disappear.
In time, some collagen breaks down at the site of the wound and the blood supply reduces. The scar gradually becomes smoother and softer. Although scars are permanent, they can fade over a period of up to 2 years. It's unlikely they'll fade any more after this time.
Most scars fade over time and don't cause long-term health problems. How a scar changes depends on its location, size and type. A scar may fade so much that you can barely see it, but it never completely goes away. Some scars cause problems months or years later.
There are four main types of scar which form differently and require different treatments. Old scars are harder to treat, but their appearance can be reduced over time.
“When we're younger, we secrete more SDF1 into the blood stream to form scars, but as we age, we lose this ability, which allows tissue to regenerate.”
The genetic material, or DNA, within any cell does not generally change, so the cells that are dividing on the bottom stairs are transmitting the same genetic characteristics from one generation of cells to the next. Unfortunately, if these characteristics are of scar tissue, that is what will be regenerated.
A skin wound that doesn't heal, heals slowly or heals but tends to recur is known as a chronic wound. Some of the many causes of chronic (ongoing) skin wounds can include trauma, burns, skin cancers, infection or underlying medical conditions such as diabetes. Wounds that take a long time to heal need special care.
Mature scars can also flatten out as they go through this aging process, but it's important to note that scars will never go away completely. Even with some scar treatments, the appearance will be improved, but they will never totally disappear because the skin composition is different from the surrounding tissues.
Hypertrophic Scars – Raised scars that remain within the boundaries of the initial injury, incision or trauma, hypertrophic scars can be red and raised enough to be readily noticeable. In some cases, hypertrophic scars will fade over time on their own. Other times, they'll require more aggressive treatment to erase.
It can take up to 12-18 months after your injury or operation for a scar to heal. A normal scar will become darker initially and after a period of time this will start to fade. Dark scars can remain for years or indefinitely in people with darker skin.
Skin also becomes thinner with age. It's less resilient and elastic, which makes it harder for wounds to heal. It also makes scar development and healing a longer process. When scars develop, they may take on a reddish or purple tone, growing dense and fibrous outside the natural borders of the original wound.
Your body is forever making more of it, knitting yourself together with a kind of sticky meat yarn. Without enough vitamin C, the collagen is made poorly and is therefore unstable: capillaries burst, wounds remain open, and, since your body is constantly replacing the collagen in scar tissue, old scars can reopen.
Scars are more likely in injuries where the skin is not just cut but also crushed or otherwise damaged. Clean cuts can heal very well if they're washed out and treated to avoid infection.”
It's a common misconception that tanning your skin will help your scar fade; this is just not true. Sun exposure on a still-healing scar will only cause further damage and make the affected area appear darker. So, protect your scar by applying sunscreen—all over, but especially on the scarred skin.
The Connection Between Old Scars and Itching
Scars from burns, contractures, may make your skin stretch tightly. Healed burn scars may often trigger an itchy sensation due to the skin tightness.
Conclusions: Scar redness fades on average at 7 months. This is influenced by the wound type and position. The authors advocate the use of the term "rubor perseverans" to describe the physiologic redness of a normal scar as it matures beyond the first month, a process that does not involve inflammation.
Scar tissue is even more vulnerable than healthy skin to factors such as poor nutrition, persistent moisture, smoking, heat and unrelieved pressure. In the end, scar tissue just isn't as resilient as healthy tissue. It stands to reason, at least from an evolutionary standpoint, that scars form the way they do.
Immediately following wound healing, a scar is usually red in appearance and is referred to as an 'immature' scar. Between 3 months and 2 years the scar should become paler, flatter and softer and can then be referred to as a 'mature' scar.
Hyperpigmentation refers to dark brown spots that form on the scar due to an overproduction of the skin pigment melanin. Once formed, this brown discoloration can be permanent. If you cannot avoid sun exposure, it's important to protect your scar from the sun by using a broad spectrum SPF 30 sunscreen.
Scars take time to settle. The lumpiness, puckering and thickening in the scar take 2-3 months to diminish, whilst the redness and pigmentation can take up to 9-12 months to fade. Most scars become flat and pale after 12 months.