A scar forms in three main overlapping stages: the Inflammatory Phase (cleaning the wound), the Proliferative Phase (building new tissue with collagen), and the Maturation/Remodeling Phase (strengthening and fading the scar), which can take months to years, transforming an initial red, raised scar into a softer, flatter, paler one.
The Four Stages of Scar Healing
Maturation- Maturation is the stage of healing when a scar softens, flattens and fades. You'll notice your wound looking more like the skin that was once there. During this stage, the body is strengthening the area. Depending on the severity of the wound, maturation may take a year or more to fully complete.
In the early healing stage, expect the scar to be red, purple, or pink, with a firm or raised texture. Over months, color fades and the scar becomes more similar to surrounding skin. The texture also evolves from hard and raised to softer and flatter.
An early scar has a reddish or pink color and is often raised. As months pass, normal scar maturation occurs and eventually the scar will fade to a white line and flatten. This scenario is typical of a well-healing scar and can take up to 9 to 14 months to occur.
How should I care for a scar following surgery/injury? Pat dry your scar after a bath or shower. Use a non-perfumed moisturising cream such as E45 cream or aqueous cream to moisturise the skin surrounding your scar twice a day. Avoid picking or scratching your scar.
Between approximately four and eight weeks the scar will look much wider and redder than it did initially. This is usually the worst the scar will look, and this is a natural part of the healing process. The scar will tend to remain red for 1-6 months afterwards.
Flat: Although it may be slightly raised at first, this type of scar flattens out as it heals. Flat scars are often pink or red. Over time, they may become slightly lighter or darker than the surrounding skin. Keloids: These scars are raised above the skin's surface and spread beyond the wounded area.
The healing process involves collagen production, which gives structural support and helps your tissue regenerate. Initially, scar tissue may appear raised and thick in shades of pink, red, or purple. However, with time, scars usually change in color and texture, becoming less noticeable.
Timing Your Diet During the Healing Process
This is when avoiding foods that promote inflammation is most critical. Sugar, refined carbohydrates, processed foods, excessive sodium, and alcohol should be strictly eliminated during this period.
Silicone products, such as silicone sheets and gels, can keep your scar moisturized and help it heal. You can use them under your makeup and clothing.
An environmental factor that clearly has an effect on the appearance on skin scarring is sunlight exposure. Scars can be more sensitive to ultraviolet light for more than a year. An inability to respond to 'photodamage' may lead to worsening inflammation and altered pigmentation.
For about six weeks after surgery the scar becomes red, firm and hard. This is the body's way of making a very strong and solid scar. Over the next four months the scar will soften and lose the redness. This is the normal process of scarring.
Your scar may be reddened at first and then settle down to become smoother and paler in colour. It can take up to 12-18 months after your injury or operation for a scar to heal. A normal scar will become darker initially and after a period of time this will start to fade.
Avoid using hydrogen peroxide, which can be harmful to healing wounds. The presence of debris, bacteria or other impurities in open skin can trigger infection and extend the inflammation period. Fisher says prolonged inflammation enhances scar formation.
Once there is no more scab and the wound is visibly closed (which means that the skin has healed) you can start caring for your scar with topical creams or oils.
Wet or moist treatment of wounds has been shown to promote re-epithelialization and result in reduced scar formation, as compared to treatment in a dry environment.
Keloid scars.
Instead of stopping when the skin is healed, the body keeps making collagen for months — or even years — after the injury, creating a raised scar. These types of scars can form anywhere but are most common on the abdomen, back, chest, ear, jaw, or shoulders.
Finally, the remodelling stage begins and continues for a period from several weeks to a few years. Scar remodelling is what changes a thick, red, raised scar to a thin, flat, white scar and over the course of time, your scars will usually fade and become barely noticeable.
Scars take time to settle. The lumpiness, puckering and thickening in the scar take 2-3 months to diminish, whilst the redness and pigmentation can take up to 9-12 months to fade. Most scars become flat and pale after 12 months.