Scars and sunlight: why a new scar needs protecting for a year

Healing moves through recognised phases. Bleeding is stopped, an inflammatory phase clears debris and fights contamination, a proliferative phase lays down new tissue and closes the surface, and then a long remodelling phase reorganises the collagen that was laid down quickly into something stronger and more orderly.

That last phase is the long one. It runs for a year, often longer, and it is why a scar at three months and the same scar at eighteen months can look quite different. Redness fades, thickness softens, the line flattens and pales. It is also why judgments about a scar, including whether anything should be done about it, are best not made early.

Immature scar tissue is different from the skin around it. The surface layer is thinner and offers less natural protection, and the pigment-producing cells in and around the scar are in a reactive state after injury. Ultraviolet exposure in that window can provoke pigment production in exactly the place you least want it.

The resulting darkening can persist long after the scar itself has matured, which means a line that would have faded to something barely visible instead stays obvious. This is one of the few aspects of scarring that is genuinely within your control, and the window in which it matters is the first year.

While the wound is still closing, follow the specific instructions you were given, keep it clean and dry, and do not put anything on it that was not advised. Sunscreen is for closed, healed skin, not for a fresh wound.

Once healed, the order of protection is shade first, clothing second, sunscreen third. Fabric over a scar outperforms any product, and for scars in exposed positions a high broad-spectrum sunscreen applied consistently is the practical answer. Consistency matters more than the number on the bottle.

Silicone, as a sheet or a gel, is the topical measure with the strongest evidence behind it for improving the appearance of scars, and it is used for a sustained period rather than briefly. Massage, once the wound is fully closed and only if you have been told it is appropriate, is commonly advised. Tension across a scar tends to widen it, which is part of why activity restrictions exist.

Most scars mature into a flat, pale line. Some become hypertrophic: raised, red and firm, but staying within the boundary of the original wound, and often improving over time. Keloid scars extend beyond the original wound into surrounding skin, tend to persist, and are more common in richly pigmented skin and at certain sites such as the chest, shoulders and earlobes.

A personal or family history of keloid scarring is important information before any elective procedure, and it should be raised at the consultation rather than discovered afterwards.

Burn and reconstructive scars are their own category. They cover larger areas, they can contract across joints and limit movement, and their management runs over a much longer timeline with pressure therapy and staged treatment. This is reconstructive work rather than cosmetic aftercare.

A range of options exists for scars that settle poorly, and the right one depends on the scar type, its site, its age and your skin. Timing is part of the decision: an immature scar is still changing, and intervening too early can mean treating something that would have improved on its own.

The honest framing throughout is improvement rather than removal. A scar can be made flatter, paler, softer or less conspicuous. It cannot be erased, and any assessment that starts from that premise is the one worth trusting.