Scars go through many color changes as they mature over time. When a wound first heals, the new scar tissue is often red or pink. Over several months to a year or more, scars usually fade and take on a lighter color. However, there are many factors that affect the final color a scar will turn.
What Causes Scars to Change Color?
When skin is wounded, the body triggers a healing process that involves inflammation, tissue formation, and tissue remodeling. This healing process causes scars to go through predictable color changes:
- Initially, a fresh scar will appear pink or red.
- Over 3-6 months, redness fades and the scar lightens to a pink or light brown shade.
- From 6-12 months, the scar continues to mature and pale.
- After a year or more, the scar usually achieves its final whitish color.
The initial redness of a new scar results from increased blood flow to the injured area during healing. As the scar matures over many months, blood flow decreases, collagen reorganizes, and scar tissue becomes less active metabolically. All these factors cause the scar to gradually lose its dark red coloration.
What Is the Final Color of a Mature Scar?
Fully mature scars are often slightly lighter or darker than the surrounding normal skin. Here are the typical final colors of old scars:
- Whitish: This is the most common mature scar color. Scars blend in with surrounding skin and tend to be barely noticeable.
- Light brown: Slightly hyperpigmented scars are darker than surrounding skin but not red.
- White: Hypopigmented scars have no melanin pigment and are lighter than surrounding skin.
Keep in mind that a scar’s final color depends on your skin tone. Those with darker complexions tend to form darker, more visible scars than those with fair skin.
Factors That Affect Scar Color
Several factors can cause a scar to heal with abnormal pigmentation that doesn’t match surrounding skin:
Wound Size
Larger wounds form thicker, more visible scars that tend to retain a red or dark color. Smaller wounds typically produce thinner scars that fade to a lighter color.
Wound Depth
Deep wounds that damage deeper skin layers produce more prominent scarring with altered pigmentation. Superficial wounds limit scar formation to the upper skin layers only.
Genetics
Genes play a role in your body’s wound healing capabilities and propensity for abnormal scar formation. Some people are just prone to visible, darkly pigmented scarring even from small cuts.
Ethnicity
Darker skinned ethnicities tend to form more visible, hyperpigmented scars. Lighter skinned individuals often have scars that are not as noticeable.
Body Location
The chest, shoulders, and upper back display scarring more prominently. Scars tend to blend in better when located on the extremities.
Sun Exposure
Ultraviolet radiation can darken scar tissue and make it stand out compared to surrounding skin. Limiting sun exposure helps prevent this hyperpigmentation.
Inflammation
Ongoing inflammation during the healing process can cause scars to remain red or turn brown. Scars turn whiter when the wound heals with minimal inflammation.
Smoking
Smoking impairs wound healing and leads to increased inflammation and abnormal scar pigmentation. The toxins in cigarettes also discolor scar tissue.
Scar Color Changes Over Time
To summarize, here are the typical color changes that occur as scars mature:
| Time Frame | Scar Color |
|---|---|
| 0-3 months | Red |
| 3-6 months | Purple, pink, or light brown |
| 6-12 months | Light brown or brown |
| 1-2 years | Whitish, light brown, white, or brown |
Treating Abnormally Colored Scars
While most scars naturally fade to an inconspicuous color, some remain darkly pigmented even after a year. There are treatments available to lighten discolored scars:
Topical Creams
Over-the-counter topical treatments like Mederma, aloe vera, vitamin E oil, and onion extract may gradually lighten scars over several months. Improvement is modest for most creams.
Steroid Injections
Injecting a steroid like triamcinolone directly into thick, raised scars can reduce their size and dark color. Several injections may be needed for optimal results.
Laser Resurfacing
A dermatologist can use laser energy to remove outer layers of a scar, promoting new collagen growth and skin cell regeneration for scar remodeling. Multiple treatments are required.
Dermabrasion
This procedure uses a rotating wire brush or rapidly moving crystals to abrade the top layers of scarred skin. New skin grows back with improved texture and color.
Chemical Peels
Applying a chemical solution causes controlled peeling of the scarred skin layers. Gentler peels like glycolic acid provide mild improvement while deeper peels have more significant effects.
Silicone Sheeting
Wearing silicone gel sheets over scars for several months can flatten and smooth them, while also reducing discoloration.
Home Scar Treatment Tips
Here are some tips to help new scars heal optimally with minimal pigmentation:
- Keep the wound moisturized – Applying ointment like petroleum jelly helps prevent scabs and lessens inflammation.
- Massage the scar – Gentle daily massage helps break down internal scar tissue and prevents bands from forming.
- Avoid sun exposure – Use sunscreen or keep the scar covered to prevent UV rays from darkening it.
- Don’t reopen wounds – Repeated injury causes more inflammation and darker scarring.
- Stop smoking – Smoking impedes healing and leads to darker, thicker scars.
When to See a Doctor
Consult a dermatologist if you have a scar with the following characteristics:
- Very dark or reddish color that persists beyond a year
- Thick, raised, or lumpy texture
- Itchiness, pain, or changes in sensation
- Impairment of movement if over a joint
- Poor healing with repeated reopening of the wound
A severely discolored or painful scar may benefit from medical procedures performed by a dermatologist. Early intervention leads to better outcomes.
Conclusion
It’s normal for new scars to appear reddish or darkly pigmented at first. Over the course of a year or more, most scars fade to a lighter color that blends with surrounding skin. However, some scars retain abnormal pigmentation or remain raised and noticeable. Many treatments are available to improve the appearance of problematic scars if they don’t mature normally. With time and proper care, the color of most scars will improve until they become barely visible.
