How can I improve this 5 month old scar? (Photo)

Question

This is from a hitting my head in a skiing injury 5 months ago. Thank you

Anna Chacon, MD, FAAD · Answer

Thank you for your question and for providing a clear photo. Based on the image and the fact that the scar is now 5 months old, here are several recommendations to improve its appearance:

1. Topical Silicone Treatments
Silicone gel or silicone sheets remain the gold standard for scar management. They help flatten, soften, and fade scars over time. Use them consistently, ideally for several hours daily, for a few months.

2. Sun Protection
UV exposure can darken scars and make them more noticeable. Continue using a high-SPF sunscreen (SPF 50+) on the scar daily to prevent discoloration and support healing.

3. Scar Creams with Active Ingredients
Look for over-the-counter products that contain ingredients like:

Allium cepa (onion extract)

Vitamin E (with caution – some people are sensitive)

Niacinamide (to improve texture and tone)

Hydrocortisone 1% (short-term, for any redness or inflammation)

4. Gentle Massage
Regularly massaging the scar can help soften the tissue and reduce tightness or lumpiness. Use circular motions with light pressure, ideally while applying your scar cream or silicone gel.

5. Professional Procedures to Consider
For persistent texture or discoloration, you may consider the following in-office treatments later:

Laser therapy (e.g., fractional or pulsed dye laser) – for redness and texture

Microneedling – stimulates collagen production and improves scar depth

Steroid injections – if the scar becomes raised or thickened (hypertrophic)

Your scar already appears relatively flat and healing well. With consistent care, it should continue to improve in both color and texture. Patience is key—scar remodeling can take up to 12–18 months.

Nelson Lee Novick, MD · Answer

It has been recognized since the late 1980s that there is an ideal time frame for treating wounds of any kind, such as from acne, infection (like chickenpox), post-surgery, or injury (as in this case). If a healing wound is properly treated between the end of week four after its formation (when the wound is strong is enough to withstand treatment and the end of week twelve (when the scar is considered "mature"), there is a good chance for maximal improvement. If treated afterward, the likelihood of complete improvement becomes increasingly less likely. Beyond, twelve weeks, cosmetic improvement of scars tends to fall into the range of sixty to eighty percent overall improvement in appearance.
In this instance, you are four weeks past the twelve week mark, so it would be wise to seek proper treatment ASAP in order to maximize your chances for improvement. 
Scar revision surgery runs the risk, particularly in areas, such as the forehead, subject to a great deal of static and dynamic muscular tension, of the development of stretch scars and even stitch tracks. 
The use of subcision to elevate and smooth the scar and mechanical microneedling to better blend the area with the surrounding normal skin are reasonable treatment options. 
Hope this helps and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented  scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve  the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture.  Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.

Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best, 
Dr. Karamanoukian
Realself100 Surgeon

Paul Flashner, MD · Answer

CO2 will significantly improve the appearance of the scar by resurfacing the skin and stimulating collagen production. Depending on the depth of the scar, multiple treatments may be needed in the area.

Darryl J. Blinski, MD · Answer

You’re posted photo shows a typical trapdoor deformity scar event with the best option is surgical revision with multiple Z plasty or W plasty repair expect fee range from $2500-$5000. Best of virtual concert with this procedure can be done under local anesthesia.

How can I improve this 5 month old scar? (Photo)

Answers (5)

Answer: Laser Resurfacing

Answer: Laser Resurfacing

Answer: Mid forehead between eyebrow, trapped door, deformity scar

Answer: Mid forehead between eyebrow, trapped door, deformity scar

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How can I improve this 5 month old scar? (Photo)

Answers (5)

Answer: Laser Resurfacing

Answer: Laser Resurfacing

Answer: Mid forehead between eyebrow, trapped door, deformity scar

Answer: Mid forehead between eyebrow, trapped door, deformity scar

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Recommended reading

Everything you need to know about Scar Removal

Our mission is to create a world where every investment in modern beauty is Worth It.