Options for discoloured scars?

Question

I have few bad surgical scars on my face. They have been successfully treated so that they are even with the skin - but not with the colour! Some scars are hypo- and some hyperepigmented. I would love to hear about some options of treating skin discolouration. Whiter scars can be tattooed I believe, but are there any home remedies to improve the colour and make it match into surrounding skin?

Anna Chacon, MD, FAAD · Answer

First, I want to acknowledge how frustrating this stage can be. Many patients are told that their scars are “healed” once they become flat and smooth, but for facial scars, color mismatch is often what remains most noticeable. The encouraging part is that pigment-related scar problems are often more treatable than raised or indented scars, especially when the texture has already been successfully corrected.

You’re dealing with two different problems:

Hyperpigmented scars  darker than the surrounding skin
Hypopigmented scars  lighter or white compared with the surrounding skin

These usually require different treatment strategies.

For Darker (Hyperpigmented) Scars

These tend to respond better to topical treatments and light-based therapies.

At-Home Options

The most useful ingredients are:

Broad-spectrum sunscreen SPF 30–50 every single day (this is the most important step)
Azelaic acid 15–20%
Niacinamide 4–5%
Vitamin C (L-ascorbic acid 10–20%)
Retinoids (tretinoin, adapalene, or retinaldehyde if tolerated)

A simple routine would be:

Morning

Gentle cleanser
Vitamin C or niacinamide
Moisturizer
SPF 50

Night

Gentle cleanser
Azelaic acid or a retinoid
Moisturizer

These ingredients can gradually reduce post-inflammatory hyperpigmentation, but improvement is usually slow (3–6 months or longer).

In-Office Treatments

If the darker scars are stubborn, dermatologists often consider:

Pico lasers
Q-switched lasers
Fractional non-ablative lasers
Superficial chemical peels (glycolic, mandelic, or low-strength TCA in selected patients)
For White (Hypopigmented) Scars

This is the harder problem. Unfortunately, there are no proven home remedies that reliably restore lost pigment once a scar has become truly hypopigmented.

Things That May Help a Little

If the scars are not completely depigmented, some patients see mild improvement with:

Tacrolimus ointment
Tretinoin
Microneedling combined with topical pigment-stimulating treatments

However, these approaches are unpredictable, and the evidence is much weaker than it is for treating dark scars.

More Effective Medical Options

For persistent white scars, options include:

308-nm excimer laser (used to stimulate melanocytes)
Fractional laser resurfacing to encourage repigmentation
Micropigmentation (medical tattooing), which can be very effective when performed by an experienced practitioner
Melanocyte-keratinocyte transplantation in highly selected cases (usually for larger depigmented areas)

You’re correct that medical tattooing is often one of the best cosmetic options for stable white facial scars, particularly when the surrounding skin tone is relatively uniform.

One Important Question

How old are the scars?

Less than 1 year: there is still significant potential for spontaneous color improvement.
More than 12–18 months: the pigment is more likely to be stable, and procedural treatments become more relevant.

Because you mentioned they are surgical scars that have already undergone successful texture treatment, I suspect they may be relatively mature, which means further spontaneous improvement is possible but probably limited.

A Realistic Expectation

The goal with scar discoloration is usually blending, not making the scar disappear completely.

Dark scars can often improve 50–80% with diligent sun protection and pigment-targeted treatment.
White scars are more challenging; they can often be made less noticeable, but complete color matching is rarely guaranteed.
My Honest Impression

If I were approaching this as a facial scar patient, I would focus on:

Aggressive daily sun protection
Niacinamide + azelaic acid + a retinoid for the darker scars
Allowing at least 6 months of consistent topical therapy
For the white scars, I would be cautious about spending a lot of time and money on “home remedies,” because the evidence for true repigmentation is quite limited. If those scars are stable and particularly bothersome, medical tattooing or laser-based repigmentation approaches are usually more effective than topical treatments alone.

The fact that your scars are already flat and level with the surrounding skin is actually a major advantage. Color mismatch is often much easier to camouflage and improve than contour irregularities, and patients with smooth scars generally have better cosmetic outcomes from pigment-focused treatments than those who still have raised or indented scars.

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

Monika Kiripolsky, MD · Answer

Hi Hreed,
We can do some new techniques with topical drug assisted delivery via microcolumns created with fractionated lasers or microneedling to lighten dark scars. We can do the same to attempt to darken areas of hypopigmentation (same technique but with a different topical applied). 
Hope this helps!
Dr. Kiripolsky

Options for discoloured scars?

Answers (3)

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