How to Prevent or Minimize Surgery Scars

If you are planning to have surgery, you may be surprised to know that scarring can be reduced or prevented after your procedure. While some scarring is inevitable, you can help minimize scarring with good incision care and other methods of scar prevention.

This article explains the causes and risk factors for scarring after surgery. In addition, it offers suggestions for preventing scars and caring for your wound.

1

Causes of Surgical Scars

Woman's stomach with C-section scar

Westend 61 / Getty Images

Whenever the skin is damaged, there is the possibility of scarring. For example, as a child, repeatedly skinning your knee may result in a scar that lasts a lifetime.

The same is true of surgery—even cosmetic surgery. That's because making an incision typically requires cutting through all of the layers of the skin. As a result, surgery often results in a scar, regardless of the following:

  • Your surgeon's skill
  • The incision location
  • The reason for the surgery

Surgery performed by a less skilled surgeon may result in a greater degree of scarring. However, often the skill of the surgeon has little effect on how much scarring takes place. That is because your surgeon cannot control all the factors that determine how much you will scar.

2

Risk Factors for Scarring

Certain things beyond your control influence your ability to heal without scarring. Unfortunately, you can not change these risk factors, but knowing what they are can help you understand the likelihood of scarring after your procedure.

Your Age

As you age, your skin becomes thinner and less elastic. That is because collagen (which makes the skin flexible) reduces as we age. This change results in the fat layer under your skin becoming thinner. Therefore, skin does not heal as well or as quickly as we age.

In addition to collagen changes, some other things that make scarring more likely as you get older include:

  • Sun exposure
  • Smoking
  • Pollutants

On the upside, the imperfections that occur over time, like dark spots and wrinkles, actually help conceal scars that might be more obvious on younger skin.

Your Race

Some races are more likely to scar. For example, people of African descent are more likely to form hypertrophic and keloid scars. These scars are an overgrowth of scar tissue at the site of an injury.

This photo contains content that some people may find graphic or disturbing.

Hypertrophic sternotomy scar
Hypertrophic scar on sternum.

DermNet / CC BY-NC-ND

In general, scars typically remain very thin. How light or dark they appear depends on your skin color. For example:

  • Light skin: Scars are typically close to an exact match to the surrounding skin color and often fade away with time on people with lighter skin.
  • Dark skin: Those with darker skin may notice that their scars are darker than the surrounding tissue.

Genetic (Inherited) Tendency to Scar

If your parents or siblings tend to scar heavily, you are likely to do the same. Therefore, if you have a family tendency to scar badly, you may want to discuss this with your surgeon.

Size and Depth of Your Incision

A large incision is much more likely to leave a scar than a small one. The deeper and longer the cut, the longer the healing process and the greater the opportunity for scarring. That's because a larger incision may be exposed to more stress as you move, which can cause slower healing.

How Quickly Your Skin Heals

You may be one of the genetically blessed people who seem to heal quickly and easily with minimal scarring. Or, you may have skin that tends to heal slowly.

Sometimes slow-healing skin can be the result of an underlying medical condition, like diabetes. Regardless, how quickly you heal is individual and can change with illness or injury.

Recap

Certain factors increase the likelihood of scarring, such as age, skin color, genetics, and the depth of your incision. Some of these things are out of your control, but it can help to be aware of them.

3

Prevention

The good news is there are some factors you can control, which may help you prevent scars. Some ways are simple, like following the instructions your surgeon gives you to the letter. Others, like smoking, are not so easy.

Quit Smoking

Not only does smoking increase your risk for scars, but it can also slow your overall healing.

Smoking is such a significant risk factor that some plastic surgeons will not operate on a person who does not quit smoking altogether for at least two weeks before surgery.

So, to reduce your risk of scarring and surgical risks, quit smoking.

Stay Hydrated

Dehydration happens when you are not taking in enough fluids. In severe cases, this can cause electrolyte imbalances and heart problems. In less severe cases, you will feel thirsty and generally unwell.

So, stay well hydrated to feel your best and create the optimal environment for healing. You will know if you are well-hydrated when your urine is almost colorless or light in color. 

Since alcohol and caffeine tend to dehydrate your body, including your skin, avoid both while recovering. Instead, focus on non-caffeinated beverages.

Improve Nutrition

Protein makes up the building blocks of healing skin. Therefore, it is essential to provide your body with adequate protein to allow your skin to heal. So, eat a balanced diet with an emphasis on protein.

Some common protein choices include:

  • Chicken
  • Pork
  • Fish
  • Seafood
  • Beef
  • Dairy products
  • Nuts and legumes

If you do not like eating meat, soy products provide an excellent alternative as a lean protein source.

Maintain a Healthy Weight

If you have excess weight, you may be at greater risk of scarring. That's because the fat under your skin can work against your surgeon's best efforts to close your incision seamlessly.

Manage Chronic Illness

Diabetes and many other illnesses can slow healing. For the best possible outcome, be sure your condition is well-controlled before surgery and during your recovery.

For example, high glucose levels slow healing. So, if you have diabetes, work hard to keep your blood glucose levels within normal limits.

Recap

You can't entirely prevent scarring. However, there are some things you can do to increase the chances that your scar will heal well and be less noticeable. Keeping existing health conditions under control, eating a nourishing diet, and staying hydrated can all help.

4

Healing and Wound Care

In addition to preventative measures, you can also take steps during your recovery that may help minimize or prevent scarring. For example, good incision care to prevent infection is one of the best ways to prevent scarring after surgery.

Incision care includes:

  • Rest: If your healthcare provider suggests that you rest for two weeks, resist the urge to go back to work after one week of healing. Exhausting yourself can slow recovery.
  • Perform proper wound care: Taking the steps your surgeon recommends may be the most critical thing you can do to prevent scars. So, avoid ointments and other remedies unless your doctor prescribes them, and follow other general incision care techniques to increase the likelihood of healing without scars.
  • Identify infection quickly: Seek help from your healthcare provider immediately if you notice any signs of infection. An infection can seriously impair healing and contribute to scarring.
  • Reduce stress on your incision: Avoid lifting, bending, or doing anything that stretches or puts tension on your incision, including driving. This stress can pull the incision apart and delay healing. Often this makes the wound larger than it needs to be, which increases the size of your scar.
  • Avoid exposure to sunlight: Keep the sun off your incision whenever possible. If your scar is in a place that is difficult to cover, such as your face, use sunscreen after your incision heals. Your surgeon can tell you when to apply ointments, but it is usually safe to do so when the sutures are removed, or the incision has closed completely.
5

Surgical Scar Treatments

If you are concerned about scarring, consider discussing scar minimization and prevention with your surgeon. Your surgeon may be able to prescribe additional treatments that lower your chances of scarring.

Silicone Wound Treatment

Silicone wound dressings feel similar to a thick plastic wrap that you would use in the kitchen. There are a couple of ways to apply silicone dressings, including:

  • Silicone sheets: These are applied directly to the wound and stay there.
  • Silicone gel: This is applied directly over the scar and is left dry in place.

Studies have shown that silicone can help reduce scarring, and surgeons commonly use them after plastic surgery. Ask your surgeon if silicone dressings are a good option for you.

Incision Placement

In some surgeries, your surgeon can modify incision placement to reduce scar visibility. You may be able to talk to your surgeon about where they place the incision to either hide or help minimize scars.

For example, doctors can perform a cesarean section with a vertical incision, which may be more pronounced, or a horizontal incision, which a bikini may disguise.

Prescription Medications

If you tend to scar badly, your surgeon may be able to prescribe cleansers, ointments, or a wound care routine to help.

Massage

More healthcare providers are recommending scar tissue massage. Physical therapists typically perform this type of massage. But, be sure to wait until after the wound closes and any staples or sutures are removed.

Massaging an incision and the surrounding tissue may even out any bumps or lumps that remain after the healing process. Your physical therapist can usually show you how to massage your scar at home. Be sure to use ample lotion so that your fingers don’t “stick” to your skin but slide freely.

Steroid Injections

If you are prone to forming keloid scars, talk to your surgeon about having a steroid injection. Steroids may help prevent the formation of another keloid.

Recap

Scar treatments can reduce the appearance of scars. These types of treatments may include silicone sheets, modifying where your surgeon places an incision, prescriptions, and scar massage. Talk to your surgeon in advance to see whether these treatments are suitable for your situation.

Summary

Some scarring after a surgical incision is inevitable. But, there are some things you can do to prevent or reduce the visibility of scarring. In addition, post-surgical wound care can also contribute to a scar that heals optimally.

A Word From Verywell

Scarring after surgery varies widely from person to person. For example, one person may have a procedure and have virtually no scarring, while another may have a notable scar. 

If you're concerned about scarring or want to be vigilant about preventing severe scarring, talk to your healthcare provider about it. Even if you're not worried about scarring, remember that good incision care is still crucial for healing and preventing infection.

Frequently Asked Questions

  • How long does it take for surgical scars to fade?

    Some research has found the average length of time for surgical scars to fade from reddish (in the early stages of formation) to pink or flesh-colored is seven months. That said, some scars may take as long as two years to become less noticeable.

  • How can I get rid of an old surgical scar?

    A well-established scar is likely to require treatment by a dermatologist, particularly raised (hypertrophic or keloid) scars. Known as scar revision, the most common procedures for treating scars are injections of steroids or a chemotherapy medication called 5-Fluorouracil; cryotherapy (freezing) the scarred tissue; and various types of laser therapies.

  • Is it possible to completely get rid of surgical scars?

    No. Even scar revision procedures that can dramatically reduce the size and minimize the color and texture of scars will leave behind some degree of scarring. That said, it will be considerably less noticeable and less uncomfortable in the case of painful scars.

  • How can I fade surgical scars at home?

    Several over-the-counter treatments help fade scars. One is onion extract gel, available as Mederma and Mederma Advanced Scar Gel. You also can purchase silicone gel sheeting over the counter. Proper use of sunscreen also is essential, as it will help prevent scars from getting darker.

Was this page helpful?
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Scalise A, Calamita R, Tartaglione C, et al. Improving wound healing and preventing surgical site complications of closed surgical incisions: a possible role of Incisional Negative Pressure Wound Therapy. A systematic review of the literatureInt Wound J. 2016;13(6):1260‐1281. doi:10.1111/iwj.12492

  2. Bayat A, McGrouther DA, Ferguson MW. Skin scarringBMJ. 2003;326(7380):88‐92. doi:10.1136/bmj.326.7380.88

  3. Jelinek LA, Jones MW. Surgical Access Incisions. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541018/

  4. Son D, Harijan A. Overview of surgical scar prevention and management. J Korean Med Sci. 2014;29(6):751-7. doi:10.3346/jkms.2014.29.6.751

  5. Sawada Y, Sone K. Hydration and occlusion treatment for hypertrophic scars and keloidsBr J Plast Surg. 1992;45(8):599‐603. doi:10.1016/0007-1226(92)90027-u

  6. Lan CC, Wu CS, Huang SM, Wu IH, Chen GS. High-glucose environment enhanced oxidative stress and increased interleukin-8 secretion from keratinocytes: new insights into impaired diabetic wound healing. Diabetes. 2013;62(7):2530-8. doi:10.2337/db12-1714

  7. Ubbink DT, Brölmann FE, Go PM, Vermeulen H. Evidence-Based Care of Acute Wounds: A PerspectiveAdv Wound Care (New Rochelle). 2015;4(5):286‐294. doi:10.1089/wound.2014.0592

  8. Dreifke MB, Jayasuriya AA, Jayasuriya AC. Current wound healing procedures and potential careMater Sci Eng C Mater Biol Appl. 2015;48:651‐662. doi:10.1016/j.msec.2014.12.068

  9. Chadwick S, Heath R, Shah M. Abnormal pigmentation within cutaneous scars: A complication of wound healingIndian J Plast Surg. 2012;45(2):403‐411. doi:10.4103/0970-0358.101328

  10. Bleasdale B, Finnegan S, Murray K, Kelly S, Percival SL. The Use of Silicone Adhesives for Scar ReductionAdv Wound Care (New Rochelle). 2015;4(7):422‐430. doi:10.1089/wound.2015.0625

  11. Rennekampff HO, Tenenhaus M. Theoretical basis for optimal surgical incision planning to reduce hypertrophic scar formation [published online ahead of print, 2020 Mar 17]Med Hypotheses. 2020;140:109672. doi:10.1016/j.mehy.2020.109672

  12. Shin TM, Bordeax JS. The role of massage in scar management: a literature review. Dermatol Surg. 2012;38(3):414-23. doi:10.1111/j.1524-4725.2011.02201.x

  13. Bond JS, Duncan JAL, Mason T, et al. Scar redness in humans: how long does it persist after incisional and excisional wounding?Plast Reconstr Surg. 2008;121(2):487-496. doi:10.1097/01.prs.0000299183.88334.37

  14. National Health Service. Scars.

  15. Gauglitz GG. Management of keloids and hypertrophic scars: current and emerging optionsClin Cosmet Investig Dermatol. 2013;6:103-114. Published 2013 Apr 24. doi:10.2147/CCID.S35252

  16. Poetschke J, Gauglitz GG. Current options for the treatment of pathological scarringJ Dtsch Dermatol Ges. 2016;14(5):467-477. doi:10.1111/ddg.13027

  17. John Hopkins Medicine. Scar Revision.

  18. University of Michigan Health System. Plastic Surgery. Sunscreen Recommendation for Scars.

  19. University of Michigan Health System. Plastic Surgery. Sunscreen Recommendations for Scars.

Additional Reading