A burn scar forms when the skin’s deep layer, the dermis, is damaged, causing the body to produce fibrous tissue for repair. This results in a mark with a texture and color different from the surrounding tissue. While erasing a scar completely is not possible, significant fading and improvement are achievable through consistent treatment. The goal of scar management is to make the mark less noticeable, flatter, softer, and closer to the surrounding skin tone. Achieving a less prominent scar requires patience and adherence to a long-term care strategy involving at-home techniques and professional treatments.
Accessible At-Home Methods for Fading
Early intervention with non-prescription products and manual techniques is an effective first step once the wound has fully closed. Silicone sheets and gels are widely supported as a primary topical treatment for preventing and managing raised scars. Silicone works by forming an occlusive barrier over the scar, which minimizes water loss. This retained moisture hydrates the upper skin layer, signaling cells to normalize collagen production and reduce the excessive buildup that causes a raised scar.
Silicone products should be worn for a minimum of 12 hours a day for several months to maximize their therapeutic effect. Specialized scar creams may also be used, often containing ingredients like onion bulb extract (allantoin) or vitamin E, which possess anti-inflammatory and moisturizing properties to support skin pliability.
Scar massage is another important at-home technique that should be started once the skin is healed. Gentle, firm pressure applied in circular or back-and-forth motions helps mechanically break down disorganized collagen fibers. This action improves the scar’s flexibility, reduces its thickness, and prevents the formation of adhesions.
Clinical and Professional Scar Revision Treatments
When hypertrophic or keloid burn scars do not respond adequately to at-home care, medical professionals offer in-office procedures to promote tissue remodeling. Fractional laser therapy, such as the fractional CO2 laser, creates microscopic thermal zones of injury within the scar tissue. This controlled damage stimulates the body’s natural healing response, promoting the restructuring of collagen and elastin fibers for a softer and more flexible scar surface.
Pulsed dye laser (PDL) therapy addresses scar color by targeting excess blood vessels that cause persistent redness. The laser light is absorbed by hemoglobin, causing vessels to collapse and fade, helping the scar’s color match the surrounding skin.
For scars that are significantly raised and firm, intralesional corticosteroid injections are employed. These injections, typically triamcinolone, suppress inflammation and inhibit fibroblasts, the cells responsible for excessive collagen deposition. Steroids also increase collagenase activity, an enzyme that breaks down collagen, leading to a flatter, softer scar over a series of treatments.
Microneedling and Surgery
Microneedling uses fine needles to create controlled micro-injuries, initiating a healing cascade that remodels the scar and stimulates new collagen production. For severe contractures that restrict movement, surgical scar revision may be necessary to release the tightened tissue and replace it with a skin graft or flap, restoring function.
Realistic Expectations and Timelines for Results
Fading is a gradual process that requires a commitment of time and consistency. A burn scar will never be completely erased because the repaired tissue differs from the original skin. The maturation phase, during which the scar naturally softens, flattens, and lightens, can take between 12 to 18 months, or up to two years for severe hypertrophic scars.
Initial results from at-home treatments like silicone or massage may be noticeable after a few weeks, but significant improvement requires several months of diligent application. Clinical procedures, such as laser therapy, often require multiple sessions spaced four to six weeks apart. The final outcome becomes apparent months after the last treatment.
Protecting the scar from the sun influences the long-term cosmetic outcome. New scar tissue is vulnerable to ultraviolet (UV) radiation, which can trigger hyperpigmentation and cause the scar to become permanently darker. Consistent sun protection, using a broad-spectrum sunscreen (SPF) and covering the scar for at least the first year, is crucial for optimal color fading.