What is Scarring?

Scarring is a natural outcome of the skin's healing response to deep or intense injury reaching the dermis and deeper tissue with normal skin permanently replaced by fibrotic scar tissue. Causes include skin injury and trauma from acne, burns, lacerations, surgical wounds, and skin infections, with genetics determining the type and severity of the resulting scar. Common forms include flat normotrophic scars, depressed atrophic scars, and raised hypertrophic and keloid scars.

Scarring

What Are the Main Forms of Scarring?

Flat Scars or Normotrophic Scars

Flat scars on skin

Normotrophic scars sit level with the surrounding skin, appearing slightly discoloured, as fibrotic scar tissue replaces normal skin. Commonly resulting from well-healed surgical scars, minor and superficial wounds and acne lesions, or subtle chickenpox marks.

Cause: Skin trauma with balanced inflammation and healing – influenced by genetics.

Depressed Scars or
Atrophic Scars or
Hypotrophic Scars

Depressed acne scars on skin

Atrophic scars appear as visible depressions below the skin surface – asice pick and boxcar scars from insufficient repair tissue or rolling scars where fibrous bands pull the skin downward. Typically resulting from chickenpox or acne lesions –  particularly cysts and nodules, and more severe papules and pustules.

Cause: Skin trauma with severe or prolonged inflammation that disrupts balanced healing –  influenced by genetics.

Raised Scars or
Hypertrophic Scars & Keloid Scars

Raised scars on skin

Hypertrophic and keloid scars rise above the skin surface as firm, thickened fibrotic tissue. Hypertrophic scars remain within the original wound boundary while keloid scars extend beyond it, often becoming itchy or painful – both more common in darker Fitzpatrick skins.

Cause: Skin trauma with severe or prolonged inflammation that disrupts balanced healing – influenced by genetics and skin tension.

Scarring diagram types of scars
  • Skin trauma – deep or uncontrolled skin injury reaching the deep dermis results in permanent scarring. The body responds to injury with inflammation and fills the wound with repair tissue – the intensity of this response and how the repair tissue organises during healing determines the type and severity of the scar.
    • Common examples of skin trauma that result in scarring include cystic and nodular acne, deep burns, lacerations, surgical wounds, skin infections such as chickenpox, and repeated picking or squeezing of acne lesions – the deeper and more prolonged the injury and inflammation, the greater the scarring risk.
  • Genetics – an individual’s genetic makeup significantly influences how their skin heals after injury, determining their predisposition to specific scar types.
    • Those with a genetic tendency toward excess collagen production during wound healing are more prone to raised scars such as hypertrophic scars and keloid scars – more common in darker Fitzpatrick skins
    • Those predisposed to collagen deficiency during healing are more likely to develop depressed or atrophic scars, the most common form of acne scarring – more common in lighter Fitzpatrick skins.
    • A family history of keloid or hypertrophic scarring is one of the strongest predictors of individual scarring risk.

How To Prevent or Minimise Scarring?

Summary Scarring Early Intervention - Anova Skin Clinic

EARLY INTERVENTION & MANAGEMENT

  • ⚠️Early Treatment of Skin Conditions & Injuries – early management and treatment is the most effective strategy for preventing scarring and improving scar outcomes – for example seeking treatment before acne progresses to more severe stages reduces the risk of scarring.
Summary Scarring Pimple Popping - Anova Skin Clinic

PIMPLE POPPING AVOIDANCE

  • Avoid picking, squeezing, and popping pimples and other lesions — this extends inflammation, increases infection risk, and causes abnormal healing, significantly worsening scarring outcomes.
  • Professional in-clinic skin treatments and extractions can help clear clogged follicles and reduce pimples.
Summary Hyperpigmentation SPF 50 - Anova Skin Clinic

DAILY SUN PROTECTION

  • Healing & Existing Scars – UV radiation darkens scar tissue, delays improvement and worsens long-term scarring outcomes.
  • Broad-Spectrum SPF 50+ – provides high and broad protection against UVA and UVB radiation, both of which darken and damage scar tissue.
  • UPF 50+ Clothing – fabric with a certified Ultraviolet Protection Factor of 50+ to protect healing scar tissue from direct UV exposure outdoors.
Skin Ageing Daily Skincare - Anova Skin Clinic

DAILY SKINCARE

  • Silicone Gel or Sheets help to flatten hypertrophic scars and keloids when applied consistently for a minimum of 8–12 weeks.    
  • Niacinamide (Vitamin B3) reduces post-scar redness and supports barrier integrity during scar remodelling.
  • L-Ascorbic Acid (Vitamin C) stimulates collagen synthesis and provides antioxidant protection that supports healthy wound healing.
  • Retinoids stimulate collagen production and accelerate cell turnover, improving scar texture and depth over time.

What Are Well-Researched Skincare Ingredients to Minimise Scarring?

⚠️While no treatment can fully remove scarring – the right skincare ingredients can support skin health and reduce their appearance over time.

INGREDIENT & ACTIONReduces InflammationStimulates CollagenPromotes
Cell Turnover
Antioxidant ProtectionStrengthens Skin BarrierFlattens
Raised Scars
Retinoids* (Retinol, Retinal,
Retinoic Acid)
++++++++++
L-Ascorbic Acid
(Vitamin C)
++++++++
Niacinamide (Vitamin B3)+++++++
Lactic & Mandelic Acid (AHAs)+++++++++
Centella Asiatica (Cica)++++++++++
Silicone Gel or Sheet**+++++++
Grading:   +++ Strong action     ++ Moderate action     + Mild action     – Not applicable
*Topical retinoids range in strength & delivery system – prescription-strength retinoic acid delivers faster results but carries a higher irritation potential.
**Silicone gel or sheet is most effective for hypertrophic and keloid scars and should be applied consistently for a minimum of 8–12 weeks for meaningful scar improvement.
INGREDIENT & ACTIONReduces InflammationStimulates CollagenPromotes Cell TurnoverAntioxidant ProtectionStrengthens Skin Barrier
Bakuchiol+++++++++++
Resveratrol+++++++
Gluconolactone & Lactobionic Acid (PHAs)+++++++++
Tranexamic Acid++++
Glabridin (from
Liquorice Root Extract)
+++++++
Grading:   +++ Strong action     ++ Moderate action     + Mild action     – Not applicable