The Best Scar Treatment

Cuts and scarpes don't have to mark you for life.We found the latest strategies fortreating old scars and preventing new ones

If you're like most women, you have a few battle scars: lifelong reminders of the time you wiped out on your bike at age 6, the knee surgery you had in college, a recent run-in with a paring knife. Any skin injury that's more serious than a superficial cut or scrape will leave a scar, says David J. Leffell, M.D., a professor of dermatology and surgery at Yale School of Medicine and author of Total Skin (Hyperion, 2000). Composed mainly of collagen, a protein fiber normally found in the skin's second layer, these marks are the body's way of repairing itself.

Fortunately, many scars will fade in time. For those that don't, new procedures like laser treatments can minimize them considerably. But your best bet is prevention. Treating wounds promptly and properly will go a long way in decreasing the appearance and development of scars, says Dr. Leffell. The following do's and don'ts will help you keep new scars at bay and may even erase that pesky memento of the first time you shaved your legs!

DON'T swab wounds with hydrogen peroxide. The bubbles make it look like something good is happening, but hydrogen peroxide is known to destroy the new skin cells that immediately begin to grow, says Dr. Leffell.
DO cover a cut. Allowing a fresh cut to breathe is an old wives'tale that will actually delay healing by as much as 50 percent. "Moisture prevents the formation of a hard scab, which acts as a barrier to the development of new tissue," says dermatologist Bruce Katz, M.D., an associate clinical professor at Columbia University College of Physicians and Surgeons and director of Juva Skin and Laser Center in New York City. He advises treating the affected area daily with an antibiotic ointment like Neosporin (which will prevent infection, another hindrance to healing) and keeping it covered with a bandage. After a week, switch to plain Vaseline petroleum jelly, and continue using it underneath the bandage until new skin grows over the wound.

DON'T treat with vitamin E. Despite what your grandmother may have told you, vitamin E has been shown in a University of Miami study to impair wound healing. (In addition, one-third of the patients tested also developed an allergic reaction.)
DO maintain constant pressure on the wound with special bandages or silicone sheeting pads. According to several studies, coverings like these help to flatten scars, including keloids, scars with ropy tissue that grows uncontrollably over their natural boundaries. (Though it's not known why, darker-skinned individuals are more prone to this type of scar.) to try: Curad Scar Therapy Cosmetic Pads, ReJuveness Pure Silicone Sheeting, Scar Fx and Syprex Scar Sheets.

DON'T expose new scars to the sun. Ultraviolet rays can slow the healing process and, since they stimulate melanocytes (the cells that produce pigment), can cause dark discoloration. When you're outdoors, always slather on a broad-spectrum sunscreen with an SPF of 15 or higher. to try: Neutrogena Healthy Defense Oil-Free Sunblock SPF 30 and L'Oral Ombrelle Sunscreen Lotion SPF 30.

DO gently massage the mark once the surface is completely healed. "Massage helps break down the dense bands of collagen that attach to underlying tissue¡ªa common reaction to cesarean sections, appendectomies or hand wounds," notes Robert Bernard, M.D., a plastic surgeon based in White Plains, New York, and president-elect of the American Society for Aesthetic Plastic Surgery. Once skin has grown over the site, gently massage the area with lotion in a circular manner for 15 to 30 seconds a few times a day. Another preemptive strike: Apply Mederma, a nonprescription ointment that contains onion extract, which has been shown to inhibit the formation of collagen.

DON'T ignore a scar that becomes raised, itchy or red. It may be a sign of infection or an allergic reaction to the antibacterial cream or even the bandage. Injections of corticosteroids can reduce inflammation and break down excess scar tissue. Also, if you know that the scar isn't one you'll be able to live with (for instance, if it's on your face or particularly disfiguring), speak to your doctor early on about laser treatment. Lasering scars when they're "fresh" (six to eight weeks after an injury) can improve them tremendously. That timing is key, notes Dr. Katz, whose studies show that when treated early, one half of scars became undetectable and the other half improved significantly.
DO ask your physician to remove external stitches before they leave "track" marks. To prevent those little bumps that form on either side of the incision and become permanent reminders, Dr. Bernard routinely removes stitches after a week.

DON'T discount laser treatments for old scars. The same lasers used on new scars can also diminish those acquired even decades ago, says Dr. Katz. "The improvement is highly variable and unpredictable, but mature scars often respond to some degree, sometimes remarkably well." For instance, the pulsed-dye laser helps flatten and remove redness from scars, including keloids. Nonablative lasers (like the Cool Touch, Smoothbeam and Nlite) are best for treating acne scars because they stimulate the production of collagen without marring the skin's surface. Finally, ablative lasers (like CO2 and erbium), which vaporize the scar, allowing smoother skin to take its place, are the favored fix for shallow scars with soft, irregular borders. All of these treatments frequently require more than one zap and can range in price from $300 to $600 per session.