How to Prevent Scarring

A wound, whether large or small, can leave a scar as it heals. This is a natural result of the healing process: collagen from deeper layers of skin rises and pushes to the surface to close the wound, resulting in a scar forming during this time. While there is no miracle home remedy to prevent scarring, there are steps you can take to influence the healing and development of scar tissue during the recovery process.

Clean the wound. The first step in allowing the wound to begin its natural healing process is to clean the injured area. Make sure there are no foreign objects stuck in the wound as they may cause infection.

• Use soap and water. Gently clean the injured area with mild soap and warm water. Apply a clean, dry material to the wound to stop any bleeding.
• Avoid using hydrogen peroxide to clean the wound. When the body begins producing new skin cells, hydrogen peroxide destroys these cells and increases the likelihood of scarring from the early stages of healing.

Assess if medical care is needed. Certain wounds may require special treatment, including deep puncture wounds, continuous bleeding, deep cuts, fractures, visible tendons, ligaments, or bone, facial injuries, animal bites, wounds with torn or jagged skin, or those causing the current wound to open.

• Based on severity, some wounds may need to be stitched. In fact, stitching a wound can reduce the likelihood of scarring. Once it's determined that medical care and/or stitches are not required, you can take care of the wound at home.
• If the wound is on the face, you may require a cosmetic surgeon to stitch it, as plastic surgeons possess the skills and techniques to minimize scarring.

Apply petroleum jelly. Petroleum jelly helps retain moisture in the injured area, promoting healing and preventing scabbing. It doesn’t interfere with the wound’s natural healing process but actually accelerates it.

• If a scar forms, using petroleum jelly may help reduce its size as the tissue heals.
• Scabbing is a natural process the body uses to create a protective outer layer for the new wound, but scars begin to form just under that scab.
• As the body heals, collagen is brought to the surface to reconnect the damaged tissue.
• A temporary scab then forms over the collagen. As collagen works to repair the damaged tissue, scars begin to form beneath the scab.

Use hydrogel or silicone gel dressings. Some evidence shows that hydrogel or silicone gel dressings may help reduce scar formation. These materials maintain moisture in the injured tissue throughout the healing process, helping reduce scarring.

• Hydrogel and silicone gel dressings facilitate fluid exchange between healthy and damaged tissue. They are moisture-retentive bandages that help prevent scars from forming.
• Follow the instructions on the packaging if you choose one of these products. They can be purchased over-the-counter without a prescription, and manufacturers provide guidelines for their usage.
• More affordable alternatives are available. Ask your doctor or pharmacist about over-the-counter scar treatment dressings.
• Continue using moisturizing/compression dressings for several weeks or longer to minimize the formation and size of scars.
• You don’t need to use petroleum jelly if you’re using hydrogel or silicone gel dressings or other less expensive alternatives, as long as they keep the wound adequately moist.
• Check daily to assess how the wound is progressing. Consider switching materials if the tissue is no longer moist and starts to scab.

Cover the wound. Use an appropriately sized bandage to protect the wound, ensuring that it is fully covered and sealed. While exposure to air doesn’t hinder the healing process, it doesn’t help prevent scarring either. In fact, leaving the wound uncovered and unprotected increases the likelihood of scarring.

• Exposure to air dries the wound out quickly, leading to scabbing, which acts as a barrier that can contribute to scarring.
• If your skin is sensitive to adhesive, use non-stick dressings and medical tape or gauze to cover the wound.
• Use butterfly bandages. These bandages bring the edges of the wound together. Ensure the bandage is long enough to adhere to the surrounding skin when petroleum jelly is applied.
• Even with butterfly bandages, you’ll still need to use gauze or a larger dressing to fully cover the injured area to reduce the risk of infection or accidental damage.

Change the dressing daily. Clean the wound daily, check for signs of infection, keep the wound moist with petroleum jelly, and rebandage.

• If the butterfly bandage is secure and shows no signs of infection, you can leave it in place.
• Continue monitoring the wound daily to ensure it’s healing properly and watch for any signs of infection while cleaning, changing the dressing, and reapplying petroleum jelly.
• Once new skin forms and heals well, which may take between seven and ten days, you can extend the time between dressing changes to a few days, as long as the wound remains moist. Stop the treatment when the skin is fully healed.

Monitor for signs of infection. Change the dressing daily, and use mild soap and water to clean the wound each time you change the dressing. Check for any changes that could signal an infection. Even the best-cared-for wounds can become infected.

• Visit a doctor as soon as possible if you notice any signs of infection. The doctor may treat the wound with topical antibiotics or prescribe oral antibiotics for a period of time.
• Signs of infection include redness or swelling around the wound, warmth when touched, the appearance of red streaks spreading from the wound, pus or fluid pooling under the skin near the wound or oozing from the wound, foul smell, sharp pain, or softening skin, along with fever or chills.

Massage the injured area. As the wound starts to heal, massage movements help break down collagen formation that causes scar tissue. Be cautious not to reopen the wound.

• Massage helps break down collagen bonds and prevents the formation of hard collagen areas that attach to the new skin layer. This can reduce or prevent scarring.
• Massage the area several times daily with circular motions for 15 to 30 seconds each time.
• Use scar prevention lotions or creams to support the massage. Over-the-counter options are available.
• One commonly used product group, which includes onion peel extract, has been proven to have a positive effect. Another group of products with combined ingredients helps retain moisture and reduce scarring.

Apply pressure to the wound. Gently and evenly applying pressure to the wound can help prevent or reduce scarring. Focus on areas most likely to scar.

• There are bandages specifically designed to apply pressure to the wound. In addition to hydrogel and silicone dressings, there are other products designed to evenly apply pressure while protecting the wound.
• Consult your doctor about pressure bandages tailored to your needs. Options include thickening a standard dressing with additional materials and applying it directly to the scar-prone areas.
• For larger or raised scars, there are pressure devices to be used during the day for 4 to 6 months. This is an expensive method and should be evaluated and recommended by a doctor or wound care specialist.
• Animal studies on scar compression therapy have shown significant and stable results in improving scar tissue, reducing the thickness of scarred skin, and improving blood circulation in the treated area.

Use elastic bandages. Once the skin injury has healed and there's no risk of the wound reopening, you can apply specialized elastic bandages to stretch the skin, improve blood flow to the area, and prevent scar formation.

• The most familiar brand of this bandage type is Kinesio Taping.
• Wait two to four weeks after the injury to ensure the wound is fully healed.
• Different types of bandages are recommended depending on the position, depth, and length of the wound. Work with your doctor, therapist, or sports coach to find the most suitable type for your injury.
• A commonly used bandage type to prevent scars is to apply a strip of elastic bandage along the length of the wound. Stretch the bandage about 25–50% of its capacity. Gently rub the bandage over the injured skin.
• Gradually increase the tension when applying the bandage, as long as the skin can tolerate it without being stretched or torn.
• Kinesio tape is most effective in preventing scars when applied in a manner that stretches the skin, promotes circulation, and disrupts collagen formation. Consult your doctor, therapist, or coach to determine the best application for your wound.

Avoid excessive movement. Stress and motion can cause the scar to widen, so it is important to minimize activities that might stretch the skin around the wound.

• Move gently if the wound is near joints like the elbows or knees. Although you may wish to move freely as before, be cautious to prevent reopening the wound.
• Continue with your usual exercises or daily activities, as long as they don't negatively affect the wound. Exercise improves circulation, a key factor in the healing process.

Keep the wound out of direct sunlight. Apply sunscreen to protect the new skin as the wound heals and you no longer need to cover it with dressings.

• Ultraviolet rays from the sun can slow down the healing process. Ensure the wound is fully healed before you remove protective dressings to shield it from the sun's rays.
• Sunlight can also stimulate pigment production in the skin, causing the new skin to turn red or brown, which can make the scar more visible if it forms.
• Use broad-spectrum sunscreen with a minimum SPF of 30.

Follow a diet that supports healing. A healthy diet provides essential nutrients that boost the body's ability to repair damaged tissue. Key components that aid wound healing include vitamin C, protein, and zinc.

• Incorporate more vitamin C-rich foods into your daily meals. Studies suggest that increasing vitamin C intake may help prevent scar tissue formation in new wounds. Although vitamin C supplements are available, it's best to obtain it through food.
• Consult with your doctor for proper dosage. Most people can enhance their diet with vitamin C-rich foods, but in some cases, higher doses may be recommended under medical supervision.
• Since vitamin C is used up by the body, make sure to include it in every meal, or even as a snack.
• Foods high in vitamin C include bell peppers, broccoli, potatoes, tomatoes, and cabbage. Fruits like oranges, strawberries, grapefruits, cantaloupe, and mandarins also provide high levels of vitamin C.
• Recent research suggests that consuming more vitamin C in meals (or supplements), along with applying vitamin C creams, may help prevent scarring. Vitamin C creams typically come in concentrations between 5-10%.
• Boost your zinc intake by eating foods like beef, liver, and seafood such as crab. Zinc is also found in sunflower seeds, almonds, peanut butter, dairy products, and eggs.
• Protein is essential for providing the nutrients the body needs to heal damaged skin. Good sources of protein include dairy products like eggs, milk, cheese, as well as fish, shellfish, tuna, chicken, turkey, and red meat.

Increase curcumin intake. Curcumin, a spice extracted from turmeric root, is a primary compound found in Indian dishes.

• Animal studies have shown a positive correlation between curcumin and reduced inflammation, which helps improve wound healing. Researchers concluded that curcumin plays a significant role in promoting tissue healing and preventing scarring.
• There is evidence supporting the use of curcumin beyond animal studies, though research is still limited.

Apply honey to the wound. While there is ongoing debate regarding the use of honey for promoting wound healing, there is substantial evidence supporting the use of medicinal honey to accelerate the healing of certain wounds. Scarring is less likely when a wound heals faster.

• The most recommended medicinal honey for wound care is Manuka honey. It was approved by the FDA in 2007 as a recommended treatment for wounds.
• This honey is relatively rare because it is primarily produced in specific regions of the world where the Manuka tree naturally grows.
• The high demand for Manuka honey has led to some counterfeit products, so it's important to be cautious when purchasing this honey.
• Create a dressing for the wound by applying a small amount of Manuka honey onto a sterile material, such as a sterile dressing. Place it on the wound and seal it with medical bandages to prevent leakage.
• Clean the wound and change the dressing multiple times a day. Always check for signs of infection.

Use aloe vera. Although scientific research on aloe vera is still limited, manufacturers continue to promote its benefits for wound care, and traditional medicine in China and other cultures still use aloe vera for both topical application and internal consumption.

• A recent publication did not provide enough evidence on aloe vera's effect on wound healing. However, the authors suggested further controlled trials to study and report on aloe vera's healing properties.
• Topical aloe vera gel products are often formulated with vitamins A, B, C, and E, as well as enzymes, amino acids, sugars, and minerals.
• Consuming aloe vera is not recommended due to a lack of evidence supporting its effectiveness and the potential toxicity of ingesting aloe vera.

Avoid using vitamin E. Although vitamin E has long been touted as a remedy for wound healing and preventing scars, recent studies have shown that vitamin E does not help prevent scar tissue formation.

• One study found that applying vitamin E actually interfered with the natural healing process.
• Another study found that using vitamin E could trigger new allergic reactions, affecting up to 30% of people using it in this way.

Avoid using antibiotic creams or ointments. Unless there are signs of infection or a doctor specifically recommends it, you should refrain from using over-the-counter antibiotic creams or ointments.

• Increasing numbers of people are becoming antibiotic-resistant due to unnecessary use, overuse, or prolonged use.
• This also includes over-the-counter antibiotic products intended for topical application without a prescription.