Wounds or surgical incisions that penetrate into, or through, the lower dermis are likely to cause scars. The scars that form are classified as hypertrophic (raised) or atrophic (depressed or flat). Keloid scars are hypertrophic scars with especially hard and prominent tissue. Following a wound, it can take a year or more for the scarred skin to fully heal.

Non-keloid scars will often become less prominent over time, but this can take many years. Most of the treatments to minimize scars are best performed either when the wound is closed, early in the healing process, or soon after the scar forms. Old scars can still be treated, but there are fewer options. In treating scars you should have a realistic goal of achieving improvement, rather than perfection. With topical treatments you must also be patient, because it will usually be a few months before results are noticeable.

As a wound heals, you can minimize scar formation by keeping it moist and free of infection. After the wound is cleaned and closed (if necessary), apply non-prescription Neosporin, Polysporin, or a similar antibiotic ointment under a bandage. Gently wash it every day with soap or an antibacterial cleanser, and apply a new bandage and ointment. Don't let the wound dry out, or the resulting scar will be worse. Don't pick off any scab that forms, let it fall off by itself.

For burns, you can also ask your doctor for prescription Silvadene ointment. Applying an ointment or cream with cod liver oil and zinc oxide after the skin has healed over may also help the epidermis regrow. Large burns, cuts, or lacerations must obviously be treated immediately by a medical professional; there are many new specialized techniques and wound dressings that can minimize scar formation in large injuries.

If you have a cut or laceration that is likely to cause a large noticeable scar, particularly on the face, you can request that a plastic surgeon close the wound. Some emergency-room doctors may not be as skilled in minimizing scars. Insurance may not cover the difference in cost of a plastic surgeon, but it is usually worth the money to have a less-noticeable scar.

Treatment of New Scars 

If you have a new, moderately-raised scar, daily massage of the scar using a moisturizer or oil can help soften the stiff scar collagen. Vitamin E oil is sometimes recommended for massaging into scars, but regular moisturizers may work just as well. Medical studies have generally found that vitamin E oil has no special effect on scars, but many Net posters say it has improved their scars when rubbed in daily.

Some Net reviewers have reported success using non-prescription Mederma Skin Care Gel on new, moderately-raised scars. However, others have reported little effect. The active ingredient in Mederma is onion extract, which has been shown to inhibit the growth of collagen in test tubes (possibly resulting in a flatter scar). Mederma costs $15 or $25 (depending on tube size).

You have to use it for a few months to see any effect. Mederma may inhibit epidermal healing when used on new wounds, so it should only be used after the skin has healed over the wound and a raised scar seems to be forming. Mederma doesn't work on depressed or pitted scars. (On depressed scars you don't want to inhibit collagen growth.) In the past, Mederma has offered a money-back guarantee, so check the box or the instructions before purchasing and keep your receipt.