Mature scar tissue can’t be erased completely, but silicone gel, lasers, and injections can make old scars flatter, softer, and less visible.
The realistic goal isn’t a blank slate — it’s visible improvement, and the method depends on your scar type and how well you protect it from the sun. The American Academy of Dermatology notes a scar’s age also changes which treatments work best: an approach that helped a six-month-old scar often does little for a fifteen-year-old one.
Can Old Scars Really Be Removed?
No — mature scar tissue generally cannot be returned to completely uninjured skin. Treatment changes how the scar behaves: flatter, softer, less itchy, less tethered, closer in color to surrounding skin.
Keloids and sunken acne scars don’t fade on their own the way many ordinary scars do, so “give it time” stops paying off once a scar has aged. Flat scars that have only changed color are the most forgiving; raised and keloid scars take the longest.
Matching Treatment To Scar Type
Treatment is chosen by scar type and location, not brand name. A raised scar and a sunken one need opposite approaches, and the AAD’s scar treatment guidance organizes options on exactly that basis.
| Scar Type | Best-Supported Options | What Improvement Looks Like |
|---|---|---|
| Raised or hypertrophic | Silicone gel or sheets, steroid injections, laser or light therapy | Flatter, softer, less red |
| Keloid | Steroid injections, cryosurgery, laser, sometimes pressure therapy | Gradual shrinkage, repeat sessions |
| Sunken or acne-related | Laser resurfacing, chemical peels, microneedling, fillers | Smoother texture, more even contour |
| Tight or contracture | Surgery, laser, scar revision combined with other treatments | More movement, less pulling |
| Flat but discolored | Daily sunscreen, silicone, laser | Less contrast with nearby skin |
| Itchy, painful, or tethered | Dermatologist evaluation first | Symptom relief, then appearance |
Combination treatment usually moves older scars: a keloid might get steroid injections to flatten it plus laser to blend color, and sunken acne scarring often needs several microneedling sessions spaced four to six weeks apart. All can cause side effects, so a dermatologist should choose and perform them. Surgery is reached for last — generally reserved for scars that are poorly aligned, painful, or limiting movement, and often combined with other treatments.
What You Can Do At Home
Silicone is the over-the-counter approach with real standing for old and new scars. Spread a thin, even layer over dry skin twice daily, and let it dry completely before adding anything else — sunscreen included. Visible improvement often begins around 60 days for newer scars and closer to 90 days for older ones, and only with consistent use. Silicone suits hypertrophic scars, keloids, and scars from surgery, trauma, wounds, and burns. If you’d rather not guess between brands, our tested picks for old scar removal cream compare the silicone formulas worth trying first.
Daily SPF 30 or higher over the scar limits the color contrast that makes it noticeable and protects skin that’s still remodeling. If silicone irritates your skin or a sheet won’t stay flat over a joint, ask a dermatologist about injections or laser instead. The mistake that wastes the most money is expecting one cream to erase a mature scar — nothing over the counter will flatten a keloid or fill a sunken scar.
The order that works: identify the scar type, protect it from the sun daily, start silicone twice daily, and book a dermatologist if the scar is raised, sunken, itchy, painful, or limiting movement. Mature scars respond slowly — that’s normal, not a sign you bought the wrong product.
Common Questions
Do Old Scars Fade On Their Own?
Many ordinary scars soften and lighten over a year or two, but that process slows as the scar matures. Keloids and sunken acne scars are the exceptions — they generally stay put or worsen without treatment. If a scar is still raised, indented, itchy, or noticeably darker after a year, it’s unlikely to change much by itself.
Is Scar Revision Surgery Covered By Insurance?
Often not when appearance is the only goal. Scar revision for looks alone is generally treated as cosmetic and not medically necessary, and chemical peels, dermabrasion, fillers, and fat transfer are commonly excluded. Coverage is more likely when a scar limits movement or causes ongoing symptoms. Confirm with your insurer before scheduling.
How Many Microneedling Sessions Do Sunken Scars Need?
Usually several. Microneedling for sunken or acne-related scarring is a series rather than a single appointment, with sessions typically spaced four to six weeks apart so skin can recover. Texture tends to shift gradually across the series, not after the first visit. A dermatologist can estimate how many rounds your scarring needs.
Sources
- American Academy of Dermatology. “Scars: Diagnosis and Treatment.” Supports matching treatment to scar type and the options listed for raised, sunken, and keloid scars.
- American Academy of Dermatology. “Scars: Will My Scar Go Away?” Explains why mature scars may not fade on their own and which scar types persist.
- Mayo Clinic News Network.