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20 Nov 2017

Scars; different types & how to treat them

20 Nov 2017
Scars; different types & how to treat them

Whilst ritual and non-ritual scarring practices are popular in some cultures and subcultures around the world, the majority of us would rather be without visible scars on our skin. Below is a quick guide to help you understand and treat scars.

What is a scar?

Put very simply, it is a remnant of a wound. Scar tissue is made of the same collagen as the tissue it has replaced, but in a slightly different composition, making it look and act differently to the skin around it. As we go through life, most of us will accumulate some scars – and whilst you may not be keen on scars per say, it is far better than the alternative – an open or unhealed wound, as this can be a far more serious condition.

There are five main types of scars:

Hypertrophic scar

This is a raised scar. Hypertrophic scars are red and thick and may be itchy or painful.

They usually occur within 4 to 8 weeks following wound infection or wound closure

Keloid scar

This is also a raised scar. The main difference from a hypertrophic scar is that they can grow outside the wound area. Keloid scars can occur on anyone, but people with darker skin pigmentation are more prone to them. 

Atrophic scar

This is a sunken scar, like a recess in the skin, which has a pitted appearance.

Stretch marks

Stretch marks are also a form of scarring. These are caused when the skin is stretched rapidly, eg pregnancy or rapid weight gain. 

Umbilical scar

The one we all have; commonly referred to as to the navel. Yes – this really is a type of scar!

Treating scars:

The first step to finding a treatment for your scar is working out what sort of scar it is. Most of us can identify stretchmarks, they are usually level with the skin and will differ only in colour. If it's recessed or sunken, it's atrophic. It gets trickier when trying to distinguish between hypertrophic and keloid, and to be sure, you should consult a dermatologist. (We are leaving the umbilical scar out of it for now, because hopefully we all know what a navel looks like, and this is a text about treating other types of scars).

Create new scars to cover up old ones

Yes, you read that correctly. Because, in order to remove scarring, nearly all treatments will involve creating what the body will perceive as a new ‘wound'. The trick is to do so in a manner that is so controlled that the new scar tissue forms in a way that is not visibly different to the surrounding skin. Furthermore:

To combat raised scars, such as those caused by eg pimples, cuts, piercings, or burns, you need to break down the collagen build-up that forms the scar and replace it with flatter scar tissue.
To combat recessed scars, such as those caused by acne, chicken pox or surgery, you need to break up the collagen holding the skin down and refill with new collagen.

Depending on the nature and severity of the scar, there are several methods to achieving this. 

Combination of clinical and at-home treatments

Clinical techniques can be invasive and costly, but can provide great immediate, or quick results. Treatments you can administer or perform yourself can be just as effective in the long run, but will require more patience and dedication to a daily routine. Most experts agree that a combination of professional clinical treatments and at-home follow up will give you the best long-term results when dealing with serious scarring. Below is a list of popular (and some less popular, but effective) treatments you might consider learning more about and discussing with a skin care professional. 

Surgery: This is a treatment where a doctor cuts around and removes the scar, then closes the incision with one or more stitches. This procedure will also leave a scar, but it will be flat, and smaller than the original. Used to treat small, deep, and narrow atrophic scars and some hypertrophic scars.

Subcision: This is a method where a doctor will numb the area, use one or several needles to ‘pop' the scarred skin back up, so the area is no longer depressed. Used to treat atrophic scars. 

Dermabrasion or micro-dermabrasion: Dermabrasion is performed by a doctor and involves a controlled, deeper ‘wearing away' of the upper to mid layers of the skin with a strong abrasive device such as a wire brush, diamond wheel, sterilized sandpaper, or other mechanical means. Microdermabrasion is a lighter cosmetic procedure that typically involves an exfoliating material like crystals or diamond flakes and a machine based suction to gently lift up the skin during exfoliation. Used to treat most types of scars.

Microneedling: This is a treatment that can be performed at home or in a clinic, depending on the length of needle-length. It works in two steps; first by breaking up the tissue that is either holding the skin down (atrophic scars), or raising the skin (hypertrophic scars). It also stimulates natural collagen production. Used to treat all types of atrophic and hypertrophic scars.

Fillers: This is a treatment that will give immediate results: cosmetic fillers are injected into the scar, filling it immediately. Over time, if it is a ‘collagen inducing filler', it will help stimulate the body's own ability to produce collagen in the area. Used to treat larger, deep, atrophic scars.

Chemical peeling: Chemicals which destroy the top layers of the skin are applied in a controlled manner affected (and surrounding) area, leading to accelerated exfoliation. Used to treat atrophic pock marks, but be cautious, particularly people with darker pigmentation, and those individuals susceptible to keloid scarring. 

Laser treatments: There is such a vast array of laser therapies that we would need to write a whole new piece on it, but a general description says that they all work by ‘destroying' the skin to a certain depth. The skin then 'heals' and the renewed skin looks and feels less scarred. Suitable for most types of scars, depending on the type of laser.

Topical treatments: Creams, serums, or other topical treatments will work in different ways, depending on ingredients, to reduce the appearance of scars. Coupled with a microneedling treatment they can be a great addition to a daily at-home beauty regime. Suitable for all types of scars.

A final note

As with any treatment that is designed to change your appearance, caution is a word to be remembered; Consult experts! Ask about the cons, not just the pros! Ask for testimonials, and start slow. Increase intensity and/or frequency once you start seeing results and reactions. Adding to a treatment plan or regime is always easier than reversing adverse effects!

Do you have a question regarding a specific treatment or would like further advice on a particular scar-related concern, we are here to help. Get in touch with Customer Service!

Read more about the Swiss Clinic at-home treatments to reduce the appearance of scars here:

Facial scars 
Scars on the body