A fresh scar stands a better chance of becoming a seamless part of your skin’s landscape when treated right away, but what about really old scars? When is it too late to use scar creams and gels? What if they are older than a year, five years, or a decade? Experts say it’s not too late to flatten them out. “There’s a myriad of techniques to minimize old scars for both the face and body,” says Wayne, NJ facial plastic surgeon Jeffrey B. Wise, MD. Here’s what you need to know.

When is a scar considered “old?”

“Typically, it takes about one year before a scar matures,” explains New York plastic surgeon Mokhtar Asaadi, MD. “After one year, that scar can be considered old.” 

Another way to measure a scar’s maturity is by monitoring the color. “The clinical appearance is also a reliable indicator,” notes Southlake, TX, and Monroe, LA dermatologist Janine Hopkins, MD. “Most ‘new’ scars still have some degree of redness. Once a scar is white for people with fair skin or dark for people of color, it has matured.” 

What should you use on fresh wounds before they become scars?

To minimize the risk of scarring early on, proper wound care is essential. “I often recommend Cereva or Aquaphor healing ointment for new clean wounds,” says Dr. Hopkins. “Other products to help wounds heal well include DuoDerm wound healing pads or medicinal honey. Once healed, I recommend patients use either silicone creams or silicone scar pads daily for the first four to six weeks.”

Why is it important to treat scars early on?

To minimize new scars, first you must be sure there’s no tension present at the time of closure, says Dr. Asaadi. “As soon as you treat scars after any procedure, whether face or body, you will get better results,” he adds. “We treat scars with a vascular laser every month and also we instruct patients to massage scars a few times a day and apply silicone cream.”

What can you do for scars that are older than a year?

Dr. Wise says laser therapy and injections with antimetabolites can help flatten older scars. “For raised scars or hypertrophic scars we inject them with Kenalog steroid injections or 5- fluorouracil which has been shown to decrease hypertophic scar formation,” adds Dr. Asaadi.

“For older scars, I recommend microneedling which works great for acne scars and stretch marks,” Dr. Hopkins advises. “For Keloid scars, I inject these with Kenalog steroids and use laser treatments to break up old scar tissue. The best cure for keloids is image-guided superficial radiation therapy, which can be done in three sessions.”