Scars are permanent by definition. What treatment changes is how noticeable they are, and that is a meaningful distinction to establish at the outset, because the gap between improvement and erasure is where most disappointment in this area comes from.
Sam Assassa, MD has performed more than 25,000 aesthetic procedures since founding Beverly Hills Aesthetics in 1995 and is a member of the American Society of Liposuction Surgery. He is board certified in Internal Medicine.
Why Scars Form the Way They Do
When skin is injured past a certain depth, the body repairs it with collagen laid down quickly rather than in the organised pattern of undamaged skin. That replacement tissue has a different fibre arrangement, so it has a different texture, a different colour, and reflects light differently.
How a scar turns out depends on the depth of the injury, where on the body it happened, how it healed, whether it became infected, your age, and genetics. Two people with identical injuries frequently end up with very different scars.
Types of Scars
They need different treatment, and two of them need opposite treatment.
Depressed or atrophic scars sit below the surrounding skin. Not enough collagen formed during healing. Common after acne, chickenpox, and some injuries.
Raised or hypertrophic scars sit above the skin but stay within the original wound boundary. Too much collagen formed.
Keloids also result from excess collagen but grow beyond the original wound, sometimes considerably. They are more common in deeper skin tones and they frequently recur after treatment, which affects how they are approached.
Contracture scars form where a large area of skin was lost, often from burns, and tighten as they heal.
Discolouration without texture change is not scarring. Post-inflammatory hyperpigmentation and the persistent redness after a healing wound both fade over months.
Timing Matters More Than People Expect
A scar continues remodelling for a year or more after the injury. Colour fades, texture changes, and raised scars often flatten on their own during that period.
That cuts both ways. Some treatment is more effective early, particularly for raised scars where intervening before the collagen fully matures produces better results. And some scars improve enough on their own that treatment is unnecessary. Which applies depends on the scar and how long ago it formed, which is assessed at consultation rather than assumed.
What Scar Improvement Looks Like
Realistically: a scar that is flatter, closer in colour to the surrounding skin, smoother in texture, and considerably less noticeable in normal light. Not a scar that is gone.
Acne scarring is a category of its own, with its own patterns and its own treatment sequence, covered on the acne and acne scars page.
How Scars Are Treated
- Fractional CO2 laser resurfacing remodels scar tissue and blends texture and colour into the surrounding skin.
- Microneedling stimulates collagen remodelling with less pigmentary risk, over a series.
- Subcision releases depressed scars tethered from beneath.
- Corticosteroid injection flattens raised and keloid scars by reducing the excess collagen, across a series of treatments.
- Fillers or fat restore volume beneath a depressed scar that has been released.
Skin type affects the plan throughout, particularly for keloid-prone patients, where aggressive treatment can provoke the response it is meant to correct.
Learn More About Scar Reduction in Beverly Hills
Dr. Assassa will assess what kind of scar you have, how mature it is, and whether treatment now or later would serve you better. Request a consultation or schedule your appointment online.