What is a scar?

A scar is a visible defect that occurs during recovery from damage in the skin, such as after inflammation, acne, surgery or burns. During the healing process, connective tissue repairs the skin in that area, resulting in scar tissue that is often less flexible than normal skin. As a result, the scar may feel or look different. It will often be redder, thicker, thinner and tighter than the skin around it. Generally, scars heal well; however, in some cases a scar does not heal as nicely and may feel unpleasant. This can be a hypertrophic, keloid or atrophic scar.

In brief

• Cause: healing after trauma (surgery, accident), inflammation (acne), burn or skin condition.
• Forms: hypertrophic, keloid, atrophic (sunken), normal maturing scar.
• Complaints: itching, pain, shrinkage/strain, less beautiful, sometimes movement restriction.
• Influences: age, heredity/skin color, place with a lot of stress, infection, sun.
• Treatment: including_{CO2 laser}, microneedling, scar massage, Plexr: often a combination of treatments.

How does a scar form?

Scars occur when the skin (dermis) is damaged. The body goes through three stages of healing:

1. Reaction phase (day 1-4): bleeding stops, inflammatory cells clear away dirt and bacteria.
2. Regeneration phase (day 4-21): new blood vessels and granulation tissue fill the wound, the skin closes.
3. Maturation phase (6 months – 2 years): collagen fibers rearrange, scar usually becomes flatter and smoother, but may also thicken or collapse.

Factors affecting scars

• Age: young (tendency to thick connective tissue) and older (slower healing) pose more risk.
• Skin color & heredity: darker skin types are more likely to have keloid scarring.
• Location & tension: shoulders, chest, back and around joints heal more often with thickening.
• Wound conditions: infection, tissue loss or repeated irritation interfere with healing.
• UV exposure: makes fresh scars darker and more noticeable.

Types of scars

Hypertrophic scar

A hypertrophic scar is thickened, red in color and lies on top of the skin. Scarring does remain within the original wound edges. Can be itchy and painful.

Keloid

A keloid scar is thickened and grows beyond the wound edges. These scars are often red to dark in color. Is more common in darker skin types and at younger ages.

Atrophic (sunken) scar

You can recognize these scars by small pits or sunken spots, often after acne or chicken pox. Not enough connective tissue formed during healing.

Normal maturing scar

A scar that heals properly will become lighter and more supple over time (months to 2 years) and will cause little to no symptoms.

What complaints can scarring cause?

• Itching, pain, burning or tightness
• Adhered skin or movement restriction (e.g., after burns or radiation)
• Cosmetic nuisance: color and texture difference
• Psychosocial impact: uncertainty or avoidance

Self-care & prevention

• Hygiene & rest: follow wound instructions, avoid rubbing and do not pull sutures.
• UV protection: SPF 50+ and cover for at least 6-12 months to prevent pigment disruption.
• Silicone (gel/plaster): helps regulate hydration and pressure, can reduce redness and thickening.
• Early massage: once allowed, makes the scar smoother and reduces adhesions.
• General factors: eat enough protein, take extra vitamin C and don’t smoke.

Treatments at Ivy clinics

The optimal approach depends on type, age, color, thickness and location of the scar. We often recommend a combination of skin care and cosmetic treatments for best results.

_{CO2 laser}(Youlaser MT)

With the_{CO2 laser}, we fractionally heat and evaporate scar tissue, stimulating collagen remodeling. Improves texture in atrophic scars, flattens thickened scars and reduces redness.

Microneedling

With microneedling, we create microchannels in the skin that activate repair and stimulate collagen production. Particularly effective for (acne) pits and superficial blemishes in the skin.

Scar massage

Massage of the scar improves blood flow and reduces pain and adhesion. This is complementary to other treatments and provides better results.

Plexr soft surgery

This is plasma technique for controlled skin contraction and skin renewal. Suitable for treating small, cosmetically disturbing scars.

Botox for keloid scar

Botox can help treat keloid scars by inhibiting overactive fibroblasts. By inhibiting collagen production, the scar can heal thinner, less red and more beautifully. Botox can also help relieve bothersome symptoms such as pain and itching that often accompany these types of scars.

Comparison treatments (brief overview)

*This is an indication. Exact number and interval depend on scar characteristics and skin type.

When (back) to the doctor?

• Rapidly growing, painful or very itchy thickened scar.
• Movement restriction.
• Darkening scar, despite avoiding the sun and good skincare.
• Uncertainty about the nature of the scar or skin changes.

Our working method

Our skin therapists specialize in treating scars. After a thorough analysis of the scar, we draw up an appropriate treatment plan and guide you throughout the process.

1. Analysis: type, location, age and complaints of the scar.
2. Plan: mono or combination treatment, including aftercare and sun advice.
3. Evaluation: measurable progress (photos/measurements) and adjust as needed.

Want to know what is most effective for your scar? Schedule a free, no-obligation consultation at Ivy clinics.