Red, sometimes bulging, long after the wound has closed… The scar does not always follow the schedule we imagine. While some fade naturally over time, others seem to hang on and attract the eye for much longer than expected. Why does this redness persist, and when should it alert you? Dr. Gérald Kierzek, emergency physician and medical director of True Medical, analyzes a common skin phenomenon, but not always trivial.
Why do some scars stay red for so long?
Contrary to popular belief, the healing process is not always linear: it can be slowed down by various factors, thus prolonging this glowing color.
“Red scars often persist due to prolonged inflammation, overproduction of collagen (hypertrophic or keloid scars), and neovascularization, which is the formation of new blood vessels that remain visible years after the initial injury,” says Dr Gérald Kierzek.
However, when should you start worrying about it? In reality, a scar is considered “abnormal” when it remains very red, thickens or becomes painful.
“In some genetically predisposed people, the body produces too much collagen, forming a hypertrophic (bulging, limited to the wound) or keloid (extending beyond) scar, which remains red, thick and sometimes painful well beyond 18 months. confirms the medical director of True Medical.
Moreover, certain factors worsen the proper healing of our wounds:
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Exposure to the sun (UV rays stimulate pigmentation and inflammation);
- Mechanical irritations (friction);
- Residual infections;
- Significant stress;
- Nutritional deficiencies (vitamins A and C, proteins) which disrupt the repair of the skin, preventing it from turning pale white.
Skin type and individual factors also play an important role: fair or sensitive skin, as well as areas subject to high tension such as the shoulders or chest, heal more markedly.
“However, even with appropriate care (hydration, protection), the inflammatory phase can last several years, particularly if neovascularization persists,” warns the emergency doctor. “Fortunately, in 80 to 90% of cases, this redness is temporary and fades within one to two years; on the other hand, when they remain stable beyond two years, they can reflect pathological healing.”
Red scars: how to fade them?
In order to reduce these unsightly marks the best is still to soothe the epidermis. To do this, some good practices have proven themselves:
- Regular application of silicone creams or gels, sometimes combined with restorative active ingredients such as centella asiatica, which helps to moisturize and reduce inflammation;
- Gentle massages, two to three times a day, to improve the flexibility of the tissues;
- Sun protection, essential here: an SPF 50+ applied daily limits the impact of UV rays on redness.
If the scar remains very visible, medical treatments may also be offered to you:
- Corticosteroid injections, which reduce the redness and thickness of the scar in three to six sessions;
- Vascular laser, which targets the blood vessels responsible for the red coloring or fractional laser, which acts on the quality of collagen;
- Cryotherapy sessions (which consists of exposing an area to intense cold), a technique that can be useful for targeting small lesions.
And when all these measures don’t work?
In this case, other options should be considered, depending on your situation: “compression by specific clothing for hypertrophic scars, chemical peels, radiofrequency… or more rarely surgery associated with radiotherapy, due to the risk of recurrence“, specifies Dr Gérald Kierzek.
“A dermatological opinion nevertheless remains essential to make a precise diagnosis (with biopsy if a keloid is suspected) and obtain personalized treatment. The first results appear in three to six months, but keep in mind that a scar never completely disappears“, concludes the medical director of True Medical.