How can I treat an 11 year old scar? (Photos)

Question

When I was 14 years old, I self harmed. These scars are on my left butt cheek. ,. There are a bunch of tiny ones but there is one big scar. I went way too deep and probably should have gotten stiches. It’s my biggest insecurity and I just want it gone.

Anna Chacon, MD, FAAD · Answer

First, I want to acknowledge how personal this is. Scars like this often carry much more emotional weight than physical symptoms, and it makes sense that after so many years, you’d want to feel more comfortable in your skin.

From a medical standpoint, what you’re describing—multiple small scars with one larger, deeper one—is consistent with long-standing atrophic and possibly mixed-texture scarring from a deeper injury that healed without suturing. At 11 years old, the scar is considered fully mature, which means it will not continue to change on its own, but it can still be improved.

The important point is this: we can improve the appearance, but we usually cannot erase it completely. That distinction helps set realistic expectations while still aiming for meaningful change.

What determines the best treatment

Scar treatment depends on:

depth (superficial vs deeper dermal loss)
texture (flat, indented, or irregular)
color mismatch vs skin tone
and how the surrounding skin behaves in that area

In older scars like this, the main issue is usually loss of normal collagen structure in the dermis, rather than active inflammation.

Treatment options that can help
1. Laser resurfacing (fractional laser / CO2)

This is often one of the most effective options for long-standing scars.

Helps remodel collagen in deeper layers
Smooths texture irregularities
Can soften the appearance of both small and larger scars
Usually requires 1–3 sessions depending on depth

CO2 laser tends to give stronger improvement for deeper scars, while fractional options may be more gradual.

2. Microneedling (with or without RF)
Stimulates collagen production gradually
Good for improving texture and blending edges of scars
Often requires multiple sessions (3–6 treatments)
Less aggressive than laser, but also more subtle results
3. Subcision (for deeper indented scars)

If that “big scar” feels tethered or sunken, subcision can help:

releases fibrous bands pulling the skin down
allows the skin to lift slightly
often combined with laser or microneedling for better results
4. Scar revision surgery (for select cases)

If there is a single very prominent scar with poor contour, a minor surgical revision can sometimes:

reorient the scar
remove abnormal tissue
and allow for a cleaner healing pattern

This is usually considered when non-surgical methods are not enough.

What won’t fully work on its own
creams alone
over-the-counter scar gels
or topical lightening agents

These may help surface color slightly, but they do not remodel deep scar structure.

Realistic expectation

With the right combination approach, most patients see:

smoother texture
softer edges of the scar
reduced visibility in normal lighting
better blending with surrounding skin

But even with optimal treatment, scars like this typically become less noticeable rather than completely invisible.

Most important takeaway

What you have is a fully mature, structural scar, which means improvement comes from rebuilding collagen architecture, not surface treatment alone. Combination therapies usually give the most natural, blended results over time.

And just as important as the physical treatment is the fact that wanting to address this after so many years is completely valid—these kinds of scars can absolutely be improved in a meaningful, confidence-restoring way.

How can I treat an 11 year old scar? (Photos)

Answers (1)

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