Scars come in many colors, depending on factors like your skin tone, the location of the injury, how old the scar is, and the cause of the scar. When skin is damaged and a scar forms, it goes through different healing stages that affect the scar’s color. With time, most permanent scars tend to fade and become lighter. But some may remain a dark reddish or purplish color permanently. Understanding the common colors of scars and what causes them can help you know what to expect with your own scars.
What are scars and how do they form?
A scar forms as the skin heals after an injury like a cut, burn, surgery incision, or inflammation from acne or other skin conditions. When the deeper layers of the skin are damaged, the body forms new collagen fibers to mend the damaged tissue. Collagen provides structure and strength but does not contain melanocytes, the cells that produce skin pigment. So the healed area often lacks melanin and appears lighter than surrounding skin.
The scar tissue may appear reddish or purplish initially as blood vessels reform. With time, blood flow decreases and most scars fade and become paler. But some scars retain a darker reddish or purplish hue because more blood vessels developed during healing. The natural aging process also contributes to lighter scarring over time.
What affects the color of a scar?
Several factors influence the color of scars:
Skin tone
On darker skin, scars tend to appear darker and more noticeable because of the contrast with unaffected skin. On paler skin, scars tend to blend in more and be less conspicuous.
Location
Areas like the shoulders and back tend to develop paler scars because they have less pigment-producing melanocytes than areas like the face and neck. Scars also tend to tan less than surrounding skin, so may appear lighter in sun-exposed areas.
Type of injury
The cause and depth of the original wound influences scar pigmentation. Deeper wounds and third-degree burns often result in darker scars because thicker skin layers and more blood vessels were damaged.
Age of scar
In the first 3-6 months, scars are often reddish because of increased blood flow during healing. From 6-12 months, reddish hues start fading. After a year, scars lighten and shrink further. But some may remain darker than surrounding skin.
Genetics
Research shows people with darker complexions tend to develop more raised, reddish scars called keloids. Lighter skinned people are prone to flatter, paler scars. Genetics plays a role in these tendencies.
Common colors of scars
Red or reddish-purple
Scars are often red or reddish-purple for the first 6 to 12 months as blood vessels reform. Deeper wounds may retain this hue longer before fading. Thick, raised keloids also tend to appear reddish indefinitely due to high vascularity.
Light pink
As scars mature past a year old, redness often fades to a light pink shade. This is common with surgical incisions and shallow cuts where skin can regenerate more completely. Light pink is often the final color of flat, smooth scars.
White
On lighter skin, scars often lack melanin and appear white compared to the surrounding skin. They may resemble a scar from a superficial peel or be nearly indistinguishable from normal skin. White scars are also common on areas with little natural pigment like the mid back.
Hyperpigmented or dark brown
Sometimes a scar becomes darker than the surrounding normal skin, especially in people with darker complexions. This hyperpigmentation relates to excess melanin produced during skin healing and tends to gradually improve over time.
Mottled pink and white
Some mature scars have a blotchy, mottled appearance mixing pink and white areas. This can result from uneven distribution of melanocytes and blood vessels in different regions of the scar tissue.
| Scar Color | Timing | Causes |
|---|---|---|
| Red or reddish-purple | 0-6 months | New blood vessel formation |
| Light pink | 6-12+ months | Maturation of scar tissue |
| White | Any age | Lack of melanin |
| Hyperpigmented or dark brown | 0-12+ months | Excess melanin production |
| Mottled pink and white | 12+ months | Uneven melanocytes and vasculature |
Do scars change color permanently or temporarily?
For most scars, the redness or dark pigment that develops initially will lighten over time. The scar color 12-18 months after the injury offers a good indication if it will permanenly retain some discoloration compared to surrounding skin. However, there are instances where scar color can change again later:
Scar whitening
Overall, scars tend to become paler with age due to reduced blood flow. A once-red scar may turn light pink or white many years later. Silicone sheets and gels are also thought to decrease vascularity and whiten older scars.
Scar darkening
Color can return to an old, pale scar if it becomes reinjured or inflamed. Things like sunburn, irritation from shaving, or infection can make the scar temporarily red and obvious again. Rarely, an old scar may turn darker than surrounding skin due to delayed excessive melanin formation.
Skin tone changes
If your natural skin color lightens or darkens significantly over time, an old scar may seem more or less noticeable by comparison even though its color remains the same. Weight loss, pregnancy, hormonal shifts, and aging all influence natural skin pigmentation.
Do keloid scars change color?
Keloids tend to be darker and redder than typical scars initially. The thick, raised scar tissue contains more blood vessels. Like other scars, keloids often lighten a bit and become less red over the first year. However, they rarely fade completely to blend with surrounding skin. Without treatment, keloids tend to persist as reddish growths indefinitely. Some keloids enlarge and thicken over time, becoming darker again.
Treatments to lighten the color of scars
While most scars naturally lighten to some degree over time, treatments are available to speed up the fading process. Options to reduce the visible color difference between scars and normal skin include:
Silicone sheets and gels
Silicone is thought to hydrate scars and reduce collagen production, limiting vascularity. This helps flatten and whiten scars. Silicone sheets are applied and worn for 12+ hours daily. Gels can be applied 2-3 times per day. Improvement is gradual over 2-3 months.
Steroid injections
Injecting steroids like triamcinolone directly into keloid scars helps shrink collagen overgrowth and reduce redness. Effects are temporary so injections every 4-6 weeks are needed to maintain results.
Laser resurfacing
Ablative and non-ablative lasers remove the scarred outer skin layers to improve texture, thickness, and color. Multiple treatments spaced 4-6 weeks apart provide gradual lightening of scarred areas.
Dermabrasion
This procedure uses a rotating wire brush or abrasive wand to remove the top layers of scarred skin. As smoother, healthier skin regenerates, the scar blends in better. Redness and dark pigment also improve.
Chemical peels
Applying acidic solutions like glycolic acid removes the thicker scar tissue to retexture and reduce discoloration. A series of light, medium, or deep peels about a month apart can reduce scar redness. Healing takes about a week.
Surgical scar revision
For severely raised or discolored scars, surgeons can surgically re-open the scar, remove excess tissue, and re-suture the area for a thinner, smoother, less pigmented scar. This is used on problem keloids unresponsive to other treatments.
Home scar care for optimal healing
Proper home care of wounds and scars promotes healing with minimal pigmentation:
– Keep the area moist with products like petroleum jelly to optimize new tissue growth. Let scabs naturally slough off.
– Avoid picking scabs or re-injuring the area to prevent complications like excess melanin production.
– Use sun protection on scars with SPF 30+ to prevent darkening from UV exposure during healing.
– Massage the scar daily with vitamin E or moisturizers to increase pliability and collagen remodeling.
– Apply silicone sheets or gels regularly per package instructions to hydrate and whiten scars.
When to see a dermatologist
Consult a dermatologist if a scar:
– Remains very reddish or dark after a year
– Becomes thicker, more painful, or enlarges over time
– Causes significant emotional distress due to its appearance
A dermatologist can determine if prescription treatments like steroid injections, laser therapy, or surgical revision could improve the scar’s texture and color.
Conclusion
Scar color changes over time as injuries heal, often becoming lighter. Deeper wounds, darker skin types, and locations with more melanocytes tend to result in darker scarring. While some retain a reddish or hyperpigmented hue permanently, most will fade considerably within a year. Silicone products, chemical peels, laser resurfacing, steroid shots, and scar revision surgery can improve the color of problematic scars. With proper wound care and sun protection, most scars will blend in more over time. Consult a dermatologist if a scar remains significantly discolored after a year or causes emotional distress.