Understanding Scars
A scar is the natural result of the body repairing damaged skin. Every wound that reaches the deeper layer of the skin leaves some scar, but how visible, raised, tight or painful that scar becomes depends on the depth of the wound, the location on the body, tension on the skin, infection, genetics and skin type. People with darker skin tones, including many Indian patients, are more prone to keloid scars and pigmentation changes after injury.
Scar management at Aakar Aesthetics in Nashik starts with identifying the type of scar you have. The treatment for a keloid is different from the treatment for an acne scar or a wide surgical scar. Dr. Kiran Nerkar, a board-certified plastic surgeon, designs a stepwise plan that begins with the least invasive effective option.
Types of Scars We Treat
- Hypertrophic scars: raised, red and firm, but staying within the wound boundary.
- Keloids: raised scars that extend beyond the original wound, often itchy or tender, common on the chest, shoulders, earlobes and jawline.
- Atrophic scars: depressed scars, most often from acne or chickenpox.
- Widened surgical or injury scars, including C-section, appendectomy and road-accident scars.
- Contracture scars that tighten and restrict movement.
- Burn scars and stretch-mark-like scars.
- Pigmented (dark) or pale scars.
Scar Revision vs Skin Resurfacing: Knowing the Difference
Patients researching scar treatment online often come across two related but different approaches, and it helps to be clear on which one applies to a given scar. Scar revision refers to changing the physical structure of the scar itself, either surgically (excision, Z-plasty, grafting) or with treatments that target the scar tissue directly, such as steroid injections or subcision. Skin resurfacing, by contrast, refers to treatments such as certain lasers or chemical peels that work on the surface texture and pigmentation of the surrounding skin, and can be a useful complement to scar revision, particularly for shallow acne scarring or general skin tone irregularities around a scar. Many patients benefit from a combination of both approaches, planned in the right sequence, rather than either one alone.
Non-Surgical Scar Treatment
Many scars improve without an operation, especially when treated early.
- Silicone gel or sheets - flatten and soften raised scars when used consistently for months.
- Pressure therapy - used over burn and keloid scars.
- Steroid injections - reduce thickness, itching and redness of keloid and hypertrophic scars.
- Laser therapy - reduces redness, improves texture, and helps in selected acne and burn scars.
- Microneedling and subcision - help depressed acne scars by breaking tethering bands and stimulating collagen.
- Sun protection and moisturising - essential in all scar care because sunlight darkens scars.
Surgical Scar Revision Techniques
When a scar is wide, depressed, tethered, contracted or poorly positioned, surgical revision may give a much better result.
- Scar excision and re-closure -- the old scar is removed and the wound is closed again in fine layers with less tension, so it heals as a thin line.
- Z-plasty and W-plasty -- rearrange the scar to break up a straight line or lengthen a tight scar so that it is less visible and moves better.
- Punch excision and punch grafting -- for individual deep acne scars.
- Skin grafts or flaps -- for scars that have lost tissue or are contracted.
- Keloid surgery combined with adjuvant therapy -- keloids can regrow after simple excision, so surgery is combined with injections, pressure, or other treatments to lower the chance of recurrence.
Who Is a Good Candidate for Scar Revision?
Good candidates for scar revision are generally in good general health, have a scar that has finished, or largely finished, maturing, and have realistic expectations about improvement rather than complete removal. Surgical revision tends to suit scars that are wide, depressed, tethered to deeper tissue, positioned across a natural crease in an unflattering way, or restricting movement. On the other hand, a scar that is still young, actively red and evolving is often better served by waiting and using non-surgical measures such as silicone and sun protection first, since operating on immature tissue can sometimes produce a less favourable result than letting it settle naturally. People with a strong personal or family history of keloid scarring are not excluded from treatment, but the plan is adjusted specifically around that risk, often combining surgery with injections or pressure therapy from the outset.
Myths and Facts About Scar Treatment
- Myth: "Expensive creams can make a scar disappear completely." Fact: over-the-counter creams rarely have strong evidence behind them; silicone-based products are the non-surgical option with the supporting evidence, and even these soften and flatten scars rather than erasing them.
- Myth: "Once a scar has formed, nothing more can be done." Fact: scars can often be meaningfully improved months or even years after they form, through a combination of non-surgical treatments and, where appropriate, surgical revision.
- Myth: "Keloids are just a stubborn kind of normal scar." Fact: keloids behave differently from ordinary scars, growing beyond the original wound and having a real tendency to recur, which is why they need a specific, often combined, treatment strategy rather than simple excision alone.
- Myth: "Laser treatment removes a scar in one session." Fact: laser therapy for scars is typically done as a course of several sessions spaced weeks apart, with gradual improvement over that course rather than an instant result.
How We Decide the Right Treatment
Dr. Nerkar examines the scar's age, thickness, colour, width, tightness and location. He also considers your skin type, your history with scars, and your goals. A scar younger than about 6 to 12 months is usually still maturing, so non-surgical treatments and time are tried first unless function is affected. Photographs are taken at the start, so progress is tracked objectively.
Preparing for Your Scar Consultation
- How and when the scar formed, including whether it followed surgery, an injury, an infection or acne.
- Any treatments already tried, such as creams, injections, laser sessions or a previous revision, and how they went.
- Whether the scar is itchy, painful, tight or limiting movement in any way.
- Whether you or a close family member has a history of keloid or thick scarring.
- Photographs of the scar at different points in time, if you have them, since they help show how it has changed.
- Your specific goals for treatment, since these guide whether a non-surgical, surgical, or combined plan is recommended.
Living With a Visible Scar: The Emotional Side
A prominent scar, whether from an old injury, surgery or acne, can affect confidence and self-image well beyond its physical size, particularly when it is in a visible area such as the face, neck or hands. It is common to feel self-conscious, to develop habits of covering the area, or to avoid certain clothing or situations because of a scar, and these feelings are valid and worth discussing openly at your consultation, since they often shape which treatment approach will feel most worthwhile to you. Many patients find that even a partial improvement in a scar's colour, thickness or texture brings a disproportionate boost in confidence, because it changes how the scar is noticed in everyday interactions, not just how it looks under close inspection.
Lifestyle Factors That Affect Scar Outcomes
How a scar looks in the long run is shaped as much by aftercare as by the treatment itself. Consistent sun protection is one of the single most effective things you can do for any scar, since ultraviolet exposure can darken a scar permanently, especially in the first year while it is still maturing. Smoking reduces blood flow to healing skin and can worsen scarring after any revision procedure, so stopping before and after surgery is genuinely beneficial. Good nutrition supports the collagen remodelling that continues in a scar for many months after a wound closes. Avoiding unnecessary tension or stretching over a healing or revised scar, particularly across joints, also helps keep the final result as flat and thin as possible.
How This Differs From General Skincare Advice
It is worth distinguishing medical scar management from general skincare routines you may see recommended online. General skincare products are formulated for normal, intact skin and are not designed to address the altered collagen structure of a scar. Medical-grade silicone, prescribed steroid injections, and surgical techniques are specifically studied and used for scar tissue, which behaves differently from the surrounding normal skin in how it responds to pressure, hydration and active ingredients. This is why a dedicated scar-management plan, rather than a generic skincare routine, gives the most reliable results for a scar that is bothering you.
Recovery and Aftercare
- After surgery: dressings and taping keep tension off the new scar. Stitches are removed after about a week or two, earlier on the face.
- For the first 3 months: protect from sun and strain, use silicone if advised, and avoid stretching the area.
- For 6--12 months: the scar continues to mature. It may look red and slightly raised at first before it fades.
- Follow-up visits allow early treatment of any thickening.
Good scar care after the operation is just as important as the surgical technique.
Long-Term Outlook
Most revised scars continue to improve for six to twelve months after surgery, gradually softening, flattening and fading from an initial pink or slightly raised appearance to a paler, flatter line. By the one-year mark, the majority of patients see a scar that is thinner, less noticeable and better aligned with surrounding skin creases than the original. Keloid scars need particularly close, longer-term follow-up, since recurrence can occur even after successful initial treatment, and continuing agreed maintenance measures such as pressure or periodic injections over the following months reduces this risk considerably.
Follow-Up Care Schedule
An initial follow-up after surgical scar revision usually checks the wound and removes sutures around one to two weeks after the procedure. Further reviews are typically scheduled over the following months to track how the scar is maturing and to catch any early thickening or recurrence, particularly for keloid-prone patients, while it can still be managed with simple, non-surgical measures.
When to Seek Urgent Medical Attention
Contact the clinic promptly if a revised scar becomes increasingly red, swollen or painful, if the wound opens or discharges pus, if you develop fever, or if a scar that was settling well suddenly starts growing rapidly again. These are not the usual pattern of normal healing and are assessed quickly.
Risks and Realistic Results
No treatment removes a scar entirely. Revision can make a scar thinner, flatter, paler, less noticeable or less restrictive, but there is always a new scar. Risks include recurrence (especially keloid), infection, wound opening, pigment change and unsatisfactory appearance. Being honest about what can be achieved is part of the consultation.
Cost of Scar Treatment in Nashik
The cost depends on the type, size and number of scars, and whether you need a course of injections or laser sessions or a surgical procedure. Many scars need a combination approach across several visits. A treatment plan and price are shared at the end of your consultation.
Scar Management: Frequently Asked Questions
Can scars be removed completely?
No, but they can often be greatly improved. The goal is a scar that is thinner, flatter, softer and blends better with the surrounding skin.
Why did my scar become raised and dark?
Tension on the wound, infection, genetics and sun exposure can all cause raised or dark scars. Keloids are more common in people with a family history.
Will a keloid come back after surgery?
Recurrence is common if a keloid is only cut out. Combining surgery with injections, pressure or other therapy lowers the risk considerably.
When should I get my scar treated?
Start silicone and sun protection as soon as the wound has closed. Discuss surgical revision once the scar has matured, usually after 6 to 12 months, or earlier if it restricts movement.
Are acne scars treatable?
Yes. Treatment is usually a combination of procedures such as subcision, microneedling, laser and, for deep scars, punch techniques.
Does scar revision hurt?
Non-surgical treatments cause mild discomfort. Surgical revision is done under local or general anaesthesia, and you will not feel pain during the procedure.
Ready to improve a scar that bothers you? Book a scar assessment at Aakar Aesthetics, Nashik