How to get rid of scars by matching the type

Choosing how to get rid of scars starts with identifying the type, because an atrophic scar needs the exact opposite approach to a raised one. Many people buy the first cream they find, then feel let down when it does nothing — usually because it was never designed for their kind of scar. This guide explains how to choose sensibly for your situation, the role of medical silicone, the difference between scar types, and when a scar has outgrown what any cream can do.

Start with one honest expectation: topical creams improve the look of many marks, but they rarely erase a scar completely, especially older, deeper ones. Aim for "better", not "gone". For a product-by-product view, our guide on how to pick a scar cream by ingredient and stage goes further.

Atrophic vs raised scars: know the type first

Before buying anything, work out which kind of scar you have. The difference between atrophic and raised scars sets the entire direction of treatment:

Atrophic scars (pits): these form when tissue is under-produced during healing, leaving a depression below the skin surface. They are very common after inflammatory acne and need collagen to be stimulated so the pit can fill.
Raised scars: these form when collagen is over-produced, so the scar sits above the skin. They include hypertrophic scars, which stay within the original wound border, and keloids, which spread beyond it. These need collagen production calmed, not stimulated.

Feature	Atrophic scar	Raised scar
Level	Below the skin surface	Above the skin surface
Cause	Too little tissue made	Too much collagen made
Examples	Acne pits	Hypertrophic scar, keloid
Direction of care	Encourage filling	Smooth and flatten

Using a raised-scar treatment on a sunken pit — or the reverse — is one of the most common reasons a treatment fails and confidence takes a knock.

Choosing a route by scar type

This simple map turns the type of mark into a starting direction. It is orientation, not a prescription.

flowchart TD
  A[A scar or mark appears] --> B{Raised or sunken?}
  B -->|Raised above skin| C[Raised scar]
  B -->|Sunken pit| D[Atrophic scar]
  B -->|Flat discolouration only| E[Surface colour mark]
  C --> F[Medical silicone or a raised-scar review]
  D --> G[Collagen-stimulating clinic treatments]
  E --> H[Sunscreen plus brightening ingredients, with advice]

Flat colour marks are not scars

A large share of what people call "scars" after acne are not scars at all — they are flat marks left in the skin's colour, with no change in its surface. A brown or grey patch is post-inflammatory pigmentation, and a pink or red patch is often residual inflammation in the small blood vessels. Press the skin gently: a flat mark does not have the dip of a pit or the rise of a raised scar.

This matters because flat colour marks follow different rules. They tend to fade on their own over months, they respond to sunscreen and gentle brightening ingredients rather than to silicone or collagen stimulation, and sun exposure is their single biggest enemy. Treating a flat mark as though it were a pit wastes both time and money — the same touch test, applied to marks left by cuts and scratches, separates the two in seconds. Much of what looks like scarring after acne is really flat red or brown marks that fade on a different path from pits. The same logic governs pigment left by shaving on a man's face, where the mark is colour rather than texture and the fix starts with stopping the inflammation.

Medical silicone: the most evidence-backed topical

Medical silicone is one of the best-supported topical options in the literature for improving the look of scars, especially raised and recent ones. It comes as a gel you spread on or a sheet you place over the scar, and it works by hydrating the scar tissue, helping to regulate collagen, and gradually reducing redness and itch.

Silicone rewards commitment and patience: regular use over several weeks to months is what produces a visible difference. It tends to do more for raised, newer scars than for deep, sunken pits, which is why the type of scar has to guide the choice before anything reaches your basket.

How to get rid of scars with the right cream ingredient

When you look for a scar removal cream, judge it by its ingredients and their fit for your type of mark, not by the marketing on the tube:

Medical silicone: the best-supported option for raised and recent scars.
Onion extract, heparin and allantoin: common ingredients in scar-improvement products.
Brightening ingredients (with guidance): useful for flat colour marks, not for pits.
Sunscreen: always essential, because sun exposure darkens marks and slows their fading.

Contractubex and onion-extract gels

Contractubex is a widely circulated gel containing a blend of onion extract, heparin and allantoin. It is usually used with regular massage over the scar for several weeks, and tends to suit newer, raised scars better than deep, sunken pits. Its results vary from one person to another depending on the scar's type and age, and it is not a guaranteed answer for everyone. Before relying on it, it is best to ask a clinician whether it fits your particular case. If your marks come from acne, how to fade acne marks on the face sets out steps aimed at that specifically.

Can you treat old scars?

Treating old scars is harder than treating fresh ones, because the tissue has settled and matured. Home creams have a limited effect here, and may improve colour or texture slightly without changing the depth in any real way. That is not a reason to despair — it means the stronger tools usually sit in the clinic rather than on a pharmacy shelf. For post-acne marks in particular, our guide to removing acne marks from the face covers the most suitable ingredients.

An old scar responds slowly and calls for realistic expectations: the goal is a clear improvement in appearance, not a return of the skin to exactly how it was before.

In-clinic scar treatments

When a scar has outgrown what creams can do, in-clinic scar treatments offer stronger options, chosen by the scar's type and depth:

Treatment	Best suited to	Nature of the result
Laser	Texture, colour and shallow pits	Gradual, over sessions
Microneedling	Atrophic pits, by stimulating collagen	Progressive improvement
Medical peels	Colour and surface marks	Needs repeated sessions
Targeted injections	Some raised scars and keloids	Under close medical supervision

These treatments are delivered in the clinic under supervision, and not all of them suit every skin or scar type. Choosing the right one — and sometimes combining more than one approach — is a medical decision that rests on a careful assessment of the individual case. Chemical peeling is one such option; our article on how exfoliating peels work explains when it suits surface marks.

Frequently asked questions

What is the best cream for scars?

No single cream suits every scar. The most evidence-backed topical is medical silicone, as a gel or sheet, used to soften a scar and improve how it looks. Onion-extract and heparin creams are also common. The right choice depends on the scar's type, age and colour, and creams improve appearance far more often than they erase a scar completely.

Does Contractubex gel work on scars and marks?

Contractubex is a widely sold gel that combines onion extract, heparin and allantoin. It is used with regular massage over several weeks to improve the look of some scars, especially newer, raised ones, and tends to do less for deep, sunken pits. Results vary from person to person, so it is worth asking a clinician whether it suits your particular scar.

What is the difference between atrophic and raised scars?

An atrophic scar forms when too little tissue is made during healing, leaving a dip below the skin, common after acne. A raised scar forms from too much collagen and sits above the skin, as with a hypertrophic scar or a keloid. The distinction matters because each type needs an opposite approach to treatment.

Can old scars be treated?

Yes, but older scars are harder than fresh ones and respond more slowly. Home creams do little for well-established scars, whereas in-clinic options such as laser, microneedling and peels give stronger tools to improve their appearance. Meaningful improvement is often possible, though complete erasure is rare and results take sessions and patience.

When to see a dermatologist

If your scars are deep pits, raised and growing, or old and unchanged after weeks of a suitable cream, or if they are weighing on you emotionally, creams alone usually will not be enough. Pinning down the scar type precisely changes the plan entirely, and some scars — keloids in particular — need special caution. At InJasmine we start by assessing the type and age of the mark and your skin tone before suggesting anything, so the approach chosen is the safest and most fitting for you.