TTG’s Ultimate Guide To Treating Stubborn Scars

It’s fair to say that I’m quite the unwilling authority when it comes to scars. After two operations in my early 20s (thank you, bad joints and too much netball), the most significant and noticeable ones are on both of my knees. But I also have the pleasure of smaller ones on my face (from childhood chickenpox), and my hand (after a nasty run-in with a shattered bottle of champagne, no less). Until recently, I assumed I’d be living with them all for the rest of my life. But, the tweakments world is offering solutions like never before… 

Why were scars hard to treat?

Traditionally, scars – especially larger surgical ones and pitted acne scars – were incredibly stubborn and difficult to make vanish, mainly due to the complex healing processes involved when a scar forms. While the skin has ‘repaired itself’, the scar tissue that forms is structurally different from the surrounding skin. It’s primarily made of dense collagen fibres, making it less flexible and hard to return to ‘normal’. No two scars really look alike either. They can vary widely from superficial discolourations to deep and raised (hypertrophic or keloid) or indented (atrophic), making ‘one size fits all’ solutions difficult to find.

Nowadays, though, a shift has occurred – something I noticed when I was in Thailand last year at the Alma Academy Conference. Doctors left, right and centre were particularly keen to show off incredible scar rejuvenation results for everything from motorcycle accidents to C-section scars. So, what innovative technologies are there now for scars (if you don’t want to put up with them)? From laser therapy and microneedling to injectables, here’s the TTG guide to scar management.

Our ultimate guide to treating stubborn scars…

1. Laser

Laser technology has just got better and better for scars, with multiple device-led options to choose from. Fractional CO2 lasers are your go-to for larger, deeper scars. They emit a high-energy beam of light, which is absorbed by the water in the skin. This means they can vaporise the outer layer of the scar tissue, while also creating columns of micro-injuries to stimulate scar-smoothing collagen and elastin production really deep within the target area. With these devices getting more precise (limiting what can be significant downtime), this not only helps to smooth out large scars, but improves overall skin texture and firmness, too.

If the colour of your scars is what bothers you (and you want less downtime), choose a laser that targets the pigment or red blood cells in your skin. For example, if your scar is flat and white, the lack of pigmentation is usually a result of the scar tissue not producing enough melanin after healing, so you need a laser – such as a picosecond laser that emits ultra-fast pulses of light that stimulates the underlying melanin-producing cells in the skin. Or, for darkened or vascular (red or purple scars), try a Nd:YAG laser. These are non-ablative, meaning they don’t remove the outer skin layer, but they penetrate deep into the skin to break up pigment and vascular irregularities.

Best for: large or pigmented scars

Pain: elastic band-like snaps reduced by numbing cream

Downtime: up to a week, including swelling and redness

Brands to know: Lumenis AcuPulse, Secret Duo by Cutera, Alma Harmony XL Pro, DEKA SmartXide

2. Microneedling / RF Microneedling

Both microneedling and RF microneedling are extremely popular treatments for scars, due to their ability to work simultaneously on the surface of your scar and deeper within your skin, with great accuracy. Traditional microneedling uses a device covered in tiny needles that is rolled over your skin, creating micro-injuries that stimulate healing and the production of collagen and elastin (key components in healthy, non-scarred skin). As the skin heals, it becomes smoother and more even, gradually filling in depressions left by scars and improving overall skin tone.

RF microneedling supercharges this process. It combines the benefits of traditional microneedling with radiofrequency energy, which is delivered through the microneedles. This energy penetrates deeper into the skin for even better collagen stimulation and improved skin tightening, making it especially effective for more stubborn, deeper scars.

Best for: raised scars 

Pain: uncomfortable scratching feeling, plus additional heat for RF microneedling 

Downtime: short-lived swelling and redness 

Brands to know: Sylfirm X and SkinPen Precision 

3. Dermal Filler 

If you’ve managed to clear up your acne, it can be so frustrating to be left with deep, pitted scars, like boxcar or rolling scars, as a reminder of the struggle you’ve faced. Luckily, that’s where dermal filler injections can come in. While not directly treating the scar tissue (or the underlying cause of your acne) what dermal filler can do is add targeted volume beneath the surface, smoothing out uneven skin texture by ‘filling in’ the gaps that formed as your acne healed. The effects – as with all dermal filler – are temporary, for up to 18 months, but it is much faster than treatments that rely on stimulating your own body’s healing process, and it can be pinpoint accurate.

Best for: acne scarring 

Pain: short discomfort from injections

Downtime: some potential bruising, soreness and redness 

Brands to know: Restylane, Lanluma, MaiLi and Sculptra

4. Chemical Peels

If your main concern around your scar is the discolouration and skin roughness that makes it more noticeable, then mild-to-medium-depth peels, such as TCA peels, are a great first step. Basically a stronger version of the peels you can get for at-home use, in-clinic peels use a cocktail of exfoliating acids to deeply exfoliate and remove the dead, dull skin surrounding your scar, while also stimulating healing and regeneration deeper within the skin. This can improve overall skin quality in the treated area, and, as a highly customisable treatment, side effects such as peeling and redness can be limited if required.

Best for: tackling discolouration 

Pain: warm, tingling sensation in treated area

Downtime: low to medium depending on peel strength

Discover our favourite chemical peel brands to know

5. Platelet-Rich Plasma (PRP)